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Category:
Description:
Indications:
Contraindications:
-
Severe
toxic CNS depression, coma, subcortical brain damage, bone marrow
depression
-
Severe
liver or cardiac disease, narrow-angle glaucoma, pediatric surgery
Precautions:
-
Pregnancy
category C; evidence indicates safety in low doses; expect sedation in
nursing infants
-
Children
<5 years, prolonged use, cardiovascular disease, epilepsy
-
Hepatic
or renal disease, glaucoma, prostatic hypertrophy, severe asthma
-
Emphysema,
hypocalcemia, thyrotoxicosis, tartrazine sensitivity
Adverse
Reactions (Side Effects):
-
CNS:
agitation, anxiety, catatonic-like behavioral states, confusion,
depression, drowsiness, EPS, euphoria, exacerbation of psychotic
symptoms including hallucinations, headache, heat or cold intolerance,
insomnia, lethargy, neuroleptic malignant syndrome, restlessness,
seizures, vertigo
-
CV:
ECG changes, hypertension, hypotension, tachycardia
-
EENT:
blurred vision, cataracts, dry eyes, dry mouth, glaucoma, pigmentaion
of retina or cornea, retinopathy
-
GI:
anorexia, constipation, diarrhea, dyspepsia, hypersalivation, nausea,
vomiting
-
GU:
priapism, urinary retention
-
HEME:
agranulocytosis, anemia, aplastic anemia, hemolytic anemia,
leukocytosis, transient leukopenia
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METAB:
breast engorgement, gynecomastia, hyperglycemia, hyperprolactinemia,
hypoglycemia, hyponatremia, impotence, increased libido, lactation,
mastalgia, menstrual irregularities
-
RESP:
bronchospasm, increased depth of respiration, laryngospasm
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SKIN:
diaphoresis, loss of hair, maculopapular and acneiform skin reactions,
photosensitivity
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Dosage:
Administered
orally, intramuscularly, intravenously, rectally
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Adult:
-
Antiemetic:
PO 5-10mg 3-4 times daily, usual max 40mg daily; PO extended
release 10mg 2 times daily or 15mg once daily; IM 5-10mg every 3-4
hours, usual max 40mg daily; IV 2.5-10mg every 3-4 hours, max 10mg
per dose, 40 mg/day; PR 25mg 2 times daily
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Psychosis:
PO 5-10mg 3-4 times daily, increase dose as needed, max 150mg
daily; IM 10-20mg every 4 hours as needed, convert to PO as soon
as possible
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Child:
-
Antiemetic:
PO/PR 9-14kg: 2.5mg every 12 –24 hours, max 7.5mg daily;
14-18kg: 2.5mg every 8 hours or 5mg every 12 hours, max 15mg
daily; IM 0.1-0.5 mg/kg/dose, convert to PO as soon as possible
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Psychosis:
PO/PR 2-12 years: 2.5mg 2-3 times daily, increase dose as
needed, max 20mg daily; 2-5 years: 25mg daily; IM 6-12 years: 0.13
mg/kg/dose, convert to PO as soon as possible
Drug
interactions:
·
Levodopa:
inhibited effect of levodopa on Parkinson’s disease
·
Indomethacin:
possible increased CNS side effects, other NSAIDs less likely to have
effect
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Narcotic
analgesics: excessive CNS depression, hypotension, respiratory depression
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