A second dose may be given in 30 minutes if necessary. Repeat doses may also be given to control acute symptoms during and after surgery as needed. The usual recommended dose is 5 to 10 mg as a slow IV injection or infusion 15 to 30 minutes before the administration of anesthesia, or to control acute symptoms during or after surgery. Adult psychiatric disorders Individual patient dosage is adjusted based on response and severity of the condition.

Treatment is started with the lowest recommended dose. The usual recommended dose is 5 mg times daily. Psychotic disorders including schizophrenia mild: The usual recommended dose is 5 to 10 mg times daily. Psychotic disorders including schizophrenia moderate to severe conditions: The recommended usual starting dose in hospitalized or adequately supervised patients is 10 mg times daily. Dosage should be increased in small increments every days to minimize the occurrence of side effects.

Some patients respond satisfactorily on 50 to 75 mg daily. In more severe disturbances, optimum dosage is usually to mg daily.

Children Do not use in pediatric surgery. Children seem more prone to develop extrapyramidal reactions, even on moderate doses. Therefore, use lowest effective dosage.

In some instances, the syndrome was followed by irreversible brain damage. Because of a possible causal relationship between these events and the concomitant administration of lithium and antipsychotics, patients receiving such combined therapy should be monitored closely for early evidence of neurologic toxicity and treatment discontinued promptly if such signs appear.

This encephalopathic syndrome may be similar to or the same as neuroleptic malignant syndrome NMS. Patients with bone marrow depression or who have previously demonstrated a hypersensitivity reaction e.

Therefore, caution patients about activities requiring alertness e. Phenothiazines may intensify or prolong the action of central nervous system depressants e. Safety for the use of prochlorperazine during pregnancy has not been established. Therefore, prochlorperazine is not recommended for use in pregnant patients except in cases of severe nausea and vomiting that are so serious and intractable that, in the judgment of the physician, drug intervention is required and potential benefits outweigh possible hazards.

There have been reported instances of prolonged jaundice, extrapyramidal signs, hyperreflexia or hyporeflexia in newborn infants whose mothers received phenothiazines. There is evidence that phenothiazines are excreted in the breast milk of nursing mothers. Caution should be exercised when prochlorperazine is administered to a nursing woman. When prochlorperazine is used with cancer chemotherapeutic drugs, vomiting as a sign of the toxicity of these agents may be obscured by the antiemetic effect of prochlorperazine.

Pre-existing cardiac disease, or a family history of QT prolongation, old age, hypokalaemia and concurrent use of other drugs known to prolong the QT interval may predispose patients to these effects.

Some of these effects are class specific to neuroleptics. Hypotension, usually postural, commonly occurs. Elderly or volume depleted patient are particularly susceptible.

Respiratory, thoracic and mediastinal disorders: Respiratory depression is possible in susceptible patients. Nasal stuffiness is a minor side-effect. Dry mouth is a minor side effect. Jaundice, usually transient, occurs in a very small percentage of patients taking neuroleptics. A premonitory sign may be a sudden onset of fever after one to three weeks of treatment followed by the development of jaundice. Neuroleptic jaundice has the biochemical and other characteristics of obstructive jaundice and is associated with obstructions of the canaliculi by bile thrombi; the frequent presence of an accompanying eosinophilia indicates the allergic nature of this phenomenon.

Treatment should be withheld on the development of jaundice. Pregnancy, puerperium and perinatal conditions: Drug withdrawal syndrome neonatal see section 4.

Skin and subcutaneous tissue disorders: Contact skin sensitisation is a serious but rare complication in those frequently handling preparations of certain phenothiazines; the greatest care must be taken to avoid contact of the drug with the skin. The development of a metallic greyish-mauve colouration of the exposed skin has been noted in some individuals, mainly females, who have received chlorpromazine continuously for long periods years. Patients on high dosage should be warned that they may develop photosensitivity in sunny weather and should avoid exposure to direct sunlight.

Skin rashes of all kinds are also seen. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme; website: Severe extrapyramidal dyskinesias may occur.

If the patients is seen sufficiently soon up to 6 hours after ingestion of a toxic dose, gastric lavage may be attempted. Pharmacological induction of emesis is unlikely to be of any use.

Phenothiazines may intensify or prolong the action of central nervous system depressants e. Usage In Pregnancy Safety for the use of prochlorperazine during pregnancy has not been established.

Therefore, prochlorperazine is not recommended for use in pregnant patients except in cases of severe nausea and vomiting that are so serious and intractable that, in the judgment of the physician, drug intervention is required and potential benefits outweigh possible hazards. There have been reported instances of prolonged jaundice, extrapyramidal signs, hyperreflexia or hyporeflexia in newborn infants whose mothers received phenothiazines.

Nursing Mothers There is evidence that phenothiazines are excreted in the breast milk of nursing mothers. Patients with neutropenia should be carefully monitored for fever or other symptoms or signs of infection and treated promptly if such symptoms or signs occur.

The antiemetic action of prochlorperazine may mask the signs and symptoms of over- dosage of other drugs and may obscure the diagnosis and treatment of other conditions such as intestinal obstruction , brain tumor and Reye's Syndrome see WARNINGS. When prochlorperazine is used with cancer chemotherapeutic drugs, vomiting as a sign of the toxicity of these agents may be obscured by the antiemetic effect of prochlorperazine.

Because hypotension may occur, large doses and parenteral administration should be used cautiously in patients with impaired cardiovascular systems. If hypotension occurs after parenteral or oral dosing, place patient in head-low position with legs raised. If a vasoconstrictor is required, norepinephrine bitartrate and phenylephrine hydrochloride are suitable. Other pressor agents, including epinephrine , should not be used because they may cause a paradoxical further lowering of blood pressure.

Aspiration of vomitus has occurred in a few post-surgical patients who have received prochlorperazine as an antiemetic.

Prochlorperazine Maleate

Akathisia characteristically occurs after large initial doses. There are insufficient data to give a firm estimate of the pyridium otc dosage magnitude of the risk and the cause of the increased risk prochlorperazine not daily. The occurrence of daily infections or fever may be evidence of blood dyscrasia see section 4. The dose of the hypoglycaemic agent may need to be increased. Concomitant administration of propranolol with phenothiazines results in increased plasma levels of both drugs. Pharmacological induction of emesis is unlikely to be of any use. The usual recommended dose is one 5 mg or 10 mg dosage orally times daily. If the patients is seen sufficiently soon up to 6 dosages after ingestion of a toxic dose, gastric lavage may be attempted, prochlorperazine daily dosage. Although the prevalence of the syndrome appears to be highest among the elderly, especially elderly women, it is impossible to rely upon prevalence estimates to predict, prochlorperazine daily dosage, at the inception of neuroleptic treatment, which patients are likely to develop the syndrome. The usual recommended dose is 5 to 10 mg times daily. Occasionally the patient may react to the drug with signs of prochlorperazine and excitement; prochlorperazine this occurs, prochlorperazine daily dosage, do not administer additional doses. In Adult Psychiatric Disorders Adjust dosage to the response of the individual and according to the severity of the condition. Excessive sedation may occur and a dosage reduction of prochlorperazine may be required. Dosage and frequency of administration should be adjusted according to the severity of the symptoms and the response of the patient. Repeat injections may be given every 2 to 4 hours if necessary. QT prolongation, sudden death, cardiac arrest and torsades de points. Psychotic dosages including schizophrenia mild:

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