Chlorpromazine Toxicity - An Overview

Introduction

A drug called Chlorpromazine belongs to the class of drugs known as first-generation antipsychotics, often known as typical antipsychotics or neuroleptic medications. Chlorpromazine is used to treat a variety of mental illnesses, including schizophrenia, psychotic disorders, the manic phase of bipolar disorder, and severe behavioral issues in young patients. Additionally, the medicine helps one think more clearly and feel less anxious. It contributes to a decrease in aggressive behavior. Hallucinations are reduced with the aid of Chlorpromazine. Chlorpromazine is a member of the phenothiazine antipsychotics pharmacological class. It is applied to the management of schizophrenia and other psychotic disease symptoms.

How Is Chlorpromazine Taken?

Tablets of Chlorpromazine are available. Tablets of Chlorpromazine are typically used two to four times daily. For the treatment of nausea and vomiting, Chlorpromazine is taken three to four times with a four to six-hour break between each dose. In order to reduce anxiety before surgery, the recommended dosage should be taken one to two hours before the procedure. The recommended dosage for treating hiccups is to take it three to four times daily for at least three days.

Starting with a modest dose of Chlorpromazine, the physician might gradually raise it. Once the condition is under control, the physician may reduce the dose. Tell the physician how one feels while receiving Chlorpromazine medication. Chlorpromazine may manage the symptoms if one is using it to treat schizophrenia or another psychotic disorder, but it will not make the problem go away. Regardless of how one feels, continue taking Chlorpromazine.

What Are the Symptoms of Chlorpromazine Overdose?

The signs of a Chlorpromazine overdose in various body areas are listed below.

• Lungs and Airways:

  • No breathing.

  • Breathes rapidly.

  • Inadequate breathing.

• Bladder and Kidneys:

  • Urinary incontinence.

  • A poor urine flow.

• Throat, Mouth, Nose, and Eyes:

  • The vision is hazy.

  • Having trouble swallowing.

  • Drooling.

  • A dry mouth.

  • Throat or tongue sores or sores on the gums.

  • Clogged nose.

  • Yellow eyes.

• High or Very Low Blood Pressure:

  • Heart and blood pressure.

  • Irregular, quick heartbeat.

• Bones, Joints, and Muscles:

  • Muscle cramp.

  • Face motions that happen quickly and uncontrollably, such as chewing, blinking, grimacing, and tongue movements.

  • Stiff neck muscles or back muscles.

• Nervous System:

  • Coma, drowsiness.

  • Confusion and unusual hallucinations.

  • Convulsions.

  • Fainting.

  • Fever.

  • Unable to stay seated still.

  • Irritability.

  • Reduced body temperature.

  • Tremor.

  • Movement incoordination and weakness.

• Reproductive System:

  • Modification in a woman's menstrual cycle.

• Skin:

  • Bluish skin tone.

  • Warm skin.

  • Rash.

• Intestines and Stomach:

  • Constipation.

  • Decrease in appetite.

  • Nausea.

What Happens in Chlorpromazine Toxicity?

People who are allergic to Phenothiazines may experience hypersensitive anaphylactic reactions when using Chlorpromazine. These individuals are treated by quitting their medication and being given steroids or antihistamines. Chlorpromazine use should be cautious in patients with cardiovascular and cerebrovascular conditions. Patients should begin treatment with a low dose of Chlorpromazine and progressively increase it over time. However, if the patient begins to experience agranulocytosis (an abnormally low number of granulocytes, a type of white blood cell), medication should be stopped.

How Is Chlorpromazine Toxicity Managed?

Make sure there is enough ventilation in the event of an overdose. Since there is no known cure, daily cardiac and respiratory monitoring is used to treat the symptoms. If the patient arrives at the emergency room during the first four to six hours, gastric lavage may be done. Another choice is activated charcoal. ECGs (electrocardiograms) are required to check for arrhythmias or prolonged QT intervals. Supportive care for NMS (neuroleptic malignant syndrome - a life-threatening neurologic emergency) should include cooling and the use of Dantrolene sodium. Chlorpromazine can be stopped as part of the treatment for TD (tardive dyskinesia - a movement disorder), and second-generation antipsychotics can be added to Valbenazine or Deutetrabenazine.

How to Prepare for an Emergency Room?

If at all possible, bring the container along to the hospital. The patient's vital indicators, such as temperature, pulse, breathing rate, and blood pressure, will be measured and observed by the healthcare professional. The symptoms will be managed. The individual might get:

• Oxygen, a tube through the mouth into the lungs, and a breathing machine (ventilator) are all forms of breathing support.

• Tests on blood and urine.

• A chest X-ray.

• CT scan (sometimes known as advanced brain imaging or computerized axial tomography).

• ECG (also known as a heart trace).

• Intravenous fluids are administered through a vein.

• Laxative.

• Medicine to alleviate symptoms and undo the effects of the substance.

What Is the Prognosis of Chlorpromazine Toxicity?

In general, Chlorpromazine is safe. The majority of the time, an overdose will merely result in drowsiness and a few temporary side effects, including uncontrollable movements of the lips, eyes, head, and neck. If they are not swiftly and effectively addressed, these trends could continue.

An overdose can occasionally result in more severe symptoms. Symptoms of the nervous system may last a lifetime. Heart damage typically causes the most severe negative effects. Recovery is likely if heart damage can be stabilized. Heart rhythm disorders that are life-threatening may be fatal and difficult to cure. Survival for more than two days is typically a positive indicator.

How Is Chlorpromazine Overdose Preventable?

It is possible to avoid a Chlorpromazine overdose by:

• Taking prescription medications as directed and in the proper dosage.

• Avoiding medications that might affect Chlorpromazine. It is usually a good idea to check with one's healthcare practitioner on this as the medication is frequently seen to alter the effects of other medications.

• If the suggested dosage of Chlorpromazine does not sufficiently relieve the symptoms, speak with the medical practitioner.

• Avoid taking drugs past the time frame specified by the doctor without first speaking with the practitioner and getting their approval.

• Avoiding self-medication.

• When taking any medication, stay away from alcohol.

• Do not suggest or discuss the medications one is taking with people who may have the same or nearly the same medical issues.

• Being cautious when taking various medications when using Chlorpromazine.

• Putting prescriptions in child-resistant containers to keep them out of the hands of kids.

• To avoid multiple dosages, drugs for elderly people and those who tend to forget should be kept in single-dose containers with time labels.

• Keep an eye on patient intake, particularly if they suffer from depression or have suicidal thoughts and tendencies.

Give the doctor a thorough inventory of any prescription and over-the-counter medications one is currently using. They will be better able to identify potential drug interactions between different prescriptions and avoid/prevent unintended or inadvertent hazardous drug side effects.

Conclusion

Low-potency antipsychotic medication Chlorpromazine is typically prescribed by a psychiatrist. However, a large number of medical specialists from the interprofessional team may be included in the patient's pharmacological follow-up. Effective communication and referrals should be made if any adverse effects are present in order to help the patients maintain a suitable standard of living. Patients should be aware that while taking the medication, they should restrict their alcohol intake and have a balanced diet. For Chlorpromazine therapy to be effective, interprofessional collaboration is essential