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Chlorpromazine is a medication used to manage and treat schizophrenia, bipolar disorder, and acute psychosis. It is a member of the typical antipsychotics or neuroleptic medication category, also known as first-generation antipsychotics. This activity illustrates the use of chlorpromazine in relieving nausea and vomiting. It outlines the indications, actions, adverse effects, contraindications, and other key elements of chlorpromazine therapy in the clinical settings used by healthcare professionals in managing patients with schizophrenia, bipolar disorders, and related psychosis. Objectives: Identify the mechanism of action of chlorpromazine. Describe the potential adverse effects of chlorpromazine. Outline the importance of monitoring patients on chlorpromazine and describe the symptoms of the toxicity. Explain the importance of improving care coordination and communication among interprofessional team members to improve the outcomes of patients after initiating treatment with chlorpromazine. Access free multiple choice questions on this topic.

Patients who are allergic to phenothiazines can develop hypersensitive anaphylactic reactions with chlorpromazine. Such patients can be treated by discontinuing the drug and administering steroids or antihistaminic drugs. Chlorpromazine use also requires caution in patients with cerebrovascular and cardiovascular diseases. Patients should start on a low dose of chlorpromazine as an initial dosage, and the increase in subsequent dosing should be gradual. However, treatment should be discontinued if the patient develops agranulocytosis.[8] In the event of an overdose, ensure adequate ventilation. No specific antidote is available, and treatment primarily addresses symptoms with regular cardiac and respiratory monitoring. Gastric lavage may be attempted if the patient presents to the emergency department within 4 to 6 hours. Activated charcoal is also an option. ECGs are necessary to assess for arrhythmias or QT-interval prolongation. NMS should be treated supportively with cooling and by giving dantrolene sodium. Treatment for TD can be done by discontinuing chlorpromazine and starting a second-generation antipsychotic along with valbenazine or deutetrabenazine.

Chlorpromazine is a low-potency antipsychotic drug that is usually started by a psychiatrist. However, the patient's follow-up on the drug can involve many healthcare professionals on the interprofessional team, including primary care providers, mid-level practitioners (NPs and PAs), psychologists, pharmacists, nurses, or emergency department personnel. Psychiatric nurses monitor patients, provide education, and inform the prescriber of any concerns, such as adverse events or therapeutic ineffectiveness. Pharmacists review the dosage, perform drug interaction checks, and educate patients about the importance of compliance and side effects. Adequate communication is necessary among the providers for effective patient care and to limit medical errors. Patients should be assessed for movement disorder and blood work; ECGs should be obtained at regular visits. If the side effects are present at any level, effective communication should occur, and referrals should be made to help the patients maintain an adequate quality of life. Patients should understand to limit the consumption of alcohol and consume a healthy meal while on the drug. Interprofessional teamwork is a necessary component of successful therapy with chlorpromazine. [Level 5]