Ateneo de Davao University College of Nursing

In Partial Fulfillment of the Requirements in Nursing Care Management (RLE)

Drug Study (Fluphenazine)

Submitted To:

Submitted By:
Joan Leah D. Magallanes
BSN 3C - Group 2

February 20, 2012

Generic Name: Fluphenazine Brand Name: Prolixin

Indication: This medication is used to treat symptoms of a certain type of mental/mood condition (schizophrenia). Fluphenazine belongs to a class of medications called phenothiazines and is also referred to as a neuroleptic. It works by affecting the balance of natural chemicals (neurotransmitters) in the brain.Some of the benefits of continued use of this medication include reduced episodes of hallucinations, delusions, or bizarre behaviors that occur in patients with schizophrenia.This medication is not recommended for use in children under 12 years of age. Also, it should not be used to manage behavioral problems in patients with mental retardation.

Dosage: Oral: Initial dose: 0.5 to 10 mg/day orally in divided doses every 6 to 8 hours. Maintenance dose: A daily dose in excess of 3 mg is rarely necessary. Once symptoms have been controlled, the dosage should be gradually reduced to a daily maintenance dose of 1 to 5 mg which can often be administered as a single daily dose.

Parenteral: Initial dose: 2.5 to 10 mg/day IM divided every 6 to 8 hours (2.5 mg/mL). Enanthate/Decanoate (25 mg/mL): Initial dose: 12.5 to 25 mg IM or subcutaneously. Maintenance dose: Administer enanthate/decanoate dose usually every 3 to 4 weeks.

Side Effects: Drowsiness, lethargy, dizziness, nausea, loss of appetite, sweating, dry mouth, blurred vision, headache, or constipation may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Contraindications: Allergy to any phenothiazine; comatose or severely depressed states; concurrent use of large doses of other CNS depressants; bone marrow depression or blood dyscrasias; liver damage; cerebral arteriosclerosis; coronary artery disease; severe hypotension or hypertension; subcortical brain damage; children younger than 12 years of age (decanoate).

Drug-Drug Interactions: Anticholinergics (e.g., atropine), dopamine agonists (e.g., cabergoline, pergolide), guanadrel, guanethidine,lithium, sibutramine.Also report the use of drugs which might increase seizure risk (decrease seizure threshold) when combined with fluphenazine decanoate, such as isoniazid (INH), theophylline, bupropion, or tramadol, among others. Consult your doctor or pharmacist for more details.Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: antihistamines that cause drowsiness (e.g., diphenhydramine), anti-anxietydrugs (e.g., diazepam), antiseizure drugs (e.g., carbamazepine), medicine for sleep (e.g., zolpidem), muscle relaxants, narcotic pain relievers (e.g.,codeine), other psychiatric medicines (e.g., other phenothiazines such as chlorpromazine, or tricyclics such as amitriptyline), tranquilizers.Check the labels on all your medicines (e.g., cold-and-cough products)

because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products.This drug may interfere with certain laboratory tests (pregnancy test, phenylketonuria test, some urine tests). Nursing Considerations: History: Coma or severe CNS depression; bone marrow depression; blood dyscrasia; circulatory collapse; subcortical brain damage; Parkinson's disease; liver damage; cerebral arteriosclerosis; coronary disease; severe hypotension or hypertension; respiratory disorders; glaucoma, prostatic hypertrophy; epilepsy; breast cancer; thyrotoxicosis; peptic ulcer, decreased renal function; myelography within previous 24 hr or myelography scheduled within 48 hr; exposure to heat or phosphorous insecticides; children < 12 yr, chickenpox, CNS infections; pregnancy

Physical: Weight, T; reflexes, orientation, intraocular pressure; P, BP, orthostatic BP; R, adventitious sounds; bowel sounds and normal output, liver evaluation; urinary output, prostate size; CBC, urinalysis, thyroid, liver and kidney function tests

INTERVENTIONS Arrange for discontinuation of drug if serum creatinine, BUN become abnormal or if WBC count is depressed. Monitor elderly patients for dehydration, institute remedial measures promptly. Sedation and decreased sensation of thirst related to CNS effects can lead to severe dehydration. Consult physician regarding appropriate warning of patient or patient's guardian about tardive dyskinesias. Consult physician about dosage reduction, use of anticholinergic antiparkinsonian drugs (controversial) if extrapyramidal effects occur.

TEACHING POINTS Take drug exactly as prescribed. Avoid driving or engaging in other dangerous activities if CNS, vision changes occur. Avoid prolonged exposure to sun; use a sunscreen or covering garments if exposure is unavoidable. Maintain fluid intake, and use precautions against heatstroke in hot weather. Report sore throat, fever, unusual bleeding or bruising, rash, weakness, tremors, impaired vision, dark urine (pink or reddish brown urine is expected), pale stools, yellowing of skin or eyes.