Prochlorperazine

Prochlorperazine

Drug monograph · NCLEX study reference
Trade names	Compazine
Therapeutic class	Antiemetic, antipsychotic
Pharmacologic class	Phenothiazine
Onset / peak / duration	Onset 30 to 60 minutes PO; faster IM or IV; duration 3 to 4 hours.
Half-life / level	Variable; no routine level.
Routes	PO (oral), IV, IM, Rectal
High-alert (ISMP)	No
Black box warning	Yes (see Safety)
Antidote / reversal	Diphenhydramine for acute dystonia.
Pregnancy / lactation	Use with caution.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Prochlorperazine (brand name Compazine) — Antiemetic, antipsychotic; Phenothiazine.

Identification

• Therapeutic class: Antiemetic, antipsychotic.
• Pharmacologic class: Phenothiazine.

Pharmacology

• Mechanism of action: Blocks central dopamine receptors in the chemoreceptor trigger zone.
• Onset / peak / duration: Onset 30 to 60 minutes PO; faster IM or IV; duration 3 to 4 hours.
• Half-life / therapeutic level: Variable; no routine level.

Clinical use

• Indications: Severe nausea and vomiting; also used for psychosis at higher doses.
• Usual dose, route, frequency: 5 to 10 mg PO, IM, or IV; 25 mg rectally.
• Maximum dose / adjustments: Reduce in elderly.

Safety

• Contraindications: Coma, large doses of central nervous system depressants, pediatric surgery use.
• Black box warning: Antipsychotics increase mortality in elderly patients with dementia-related psychosis.
• Interactions: Central nervous system depressants, anticholinergics, QT-prolonging drugs.
• Pregnancy / lactation: Use with caution.
• High-alert: No.

Adverse effects

• Common side effects: Sedation, dry mouth, hypotension, dizziness.
• Serious effects to report: Extrapyramidal symptoms, neuroleptic malignant syndrome, QT prolongation.
• Antidote / reversal: Diphenhydramine for acute dystonia.

Nursing process

• Assessment before administration: Movement baseline, blood pressure, hydration.
• Interventions during therapy: Monitor for abnormal movements and orthostasis.
• Monitor: Movements, blood pressure, nausea relief.
• Evaluation / expected outcome: Reduced nausea.

Patient teaching

• Patient teaching: Causes drowsiness; rise slowly.
• Notify provider if: Involuntary movements, muscle stiffness with fever.
• Administration tips: Multiple routes; protect from hypotension.