Implementation

• Do not confuse chlorpromazine with chlorpropamide or prochlorperazine

» Keep patient recumbent for at least 30 min following parenteral administration to minimize hypotensive effects

» To prevent contact dermatitis, avoid getting solution on hands

» Phenothiazines should be discontinued 48 hr before and not resumed for 24 hr following metrizamide myelography, because they lower the seizure threshold

• Hiccups: Initial treatment is with oral doses. If hiccups persist 2–3 days, IM injection may be used, followed by IV infusion

• PO: Administer oral doses with food, milk, or a full glass of water to minimize gastric irritation. Tablets may be crushed. Do not open capsules; swallow whole. Sustained-release capsules may be opened but contents should not be chewed. Dilute concentrate just prior to administration in 120 ml of coffee, tea, tomato or fruit juice, milk, water, soup, or carbonated beverages.

• Rect: If suppository is too soft for insertion, chill in refrigerator for 30 min or run under cold water before removing foil wrapper

• IM: Do not inject subcut. Inject slowly into deep, well-developed muscle. May be diluted with 0.9% NaCl or 2% procaine. Lemon-yellow color does not alter potency of solution. Do not administer solution that is markedly discolored or contains a precipitate

• Direct IV:
Diluent: Dilute with 0.9% NaCl.
Concentration: Do not exceed 1 mg/ml

• Rate:
Inject slowly at a rate of at least 1 mg/min for adults and 0.5 mg/min for children

• Continuous Infusion:
Diluent: May further dilute 25–50 mg in 500–1000 ml of D5W, D10W, 0.45% NaCl, 0.9% NaCl, Ringer's or lactated Ringer's injection, dextrose/Ringer's or dextrose/lactated Ringer's combinations

• Syringe Compatibility:

» atropine

» benztropine

» butorphanol

» diphenhydramine

» doxapram

» droperidol

» fentanyl

» glycopyrrolate

» hydromorphone

» hydroxyzine

» meperidine

» metoclopramide

» midazolam

» morphine

» pentazocine

» scopolamine

• Syringe Incompatibility:

» cimetidine

» heparin

» pantoprazole

» pentobarbital

» thiopental

• Y-Site Compatibility:

» Amsacrine

» cisatracurium

» cisplatin

» cladribine

» cyclophosphamide

» cytarabine

» dexmedetomidine

» docetaxel

» doxorubicin

» doxorubicin liposome

» famotidine

» filgrastim

» fluconazole

» gemcitabine

» granisetron

» heparin

» hydrocortisone sodium succinate

» ondansetron

» oxaliplatin

» potassium chloride

» propofol

» teniposide

» thiotepa

» vinorelbine

» vitamin B complex with C

• Y-Site Incompatibility:

» allopurinol

» amifostine

» amphotericin B cholesteryl sulfate complex

» aztreonam

» bivalirudin

» cefepime

» etoposide phosphate

» fludarabine

» furosemide

» lansoprazole

» linezolid

» melphalan

» methotrexate

» paclitaxel

» pemetrexed

» piperacillin/tazobactam

» sargramostim

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