Understanding Anesthesiology - The Global Regional Anesthesia ...

Prochlorperazine
Class
Although it has several uses, in anesthetic practice it is used as an antiemetic for postoperative
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)
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.
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.
Related Glossary Terms
Antiemetic agents, Chemoreceptor trigger zone, Dimenhydrinate, Ondansetron, Postoperative
nausea and vomiting (PONV)
Index
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Chapter 4 - Recovery
Chapter 6 - Drug Finder
Chapter 6 - Antiemetics