Understanding Anesthesiology - The Global Regional Anesthesia ...

PROCHLORPERAZINE
Class
Although it has several uses, in anesthetic practice it is
used as an antiemetic for post-operative nausea and
vomiting (PONV).
Mechanism of Action
Central inhibition of the dopamine D 2 receptors in the
medullary chemoreceptor trigger zone. Prochlorperazine
also inhibits the vagus nerve in the gastrointestinal
tract. The anticholinergic, sedative and antihistaminic
effects of prochlorperazine also contribute to its antiemetic
action.
Dose
2.5-10 mg IV, max. 40 mg/day (adults)
CNS
Sedative effects which are additive to other-hypnotics>
May cause extra-pyramidal syndromes (motor restlessness,
oculogyric crisis, opisthotonus, dystonias),especially
in young male patients.
CVS
Hypotension caused by #-adrenergic blocking effect.
May potentiate hypotensive effect of vasodilators and
diuretics. Causes QT interval prolongation.
Misc.
Diminishes effects of anticoagulants. Possible hyperthermia
in the presence of hypothalamic dysfunction.
Neuroleptic malignant syndrome.
Onset
10-20 minutes
Duration
3-4 hours
Elimination
Enterohepatic
Effects
Prochlorperazine has anticholinergic properties which
are additive to the anticholinergic effects of other
drugs. As a phenothiazine, it also has the potential to
cause extrapyramidal symptoms.
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