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Apo-Perphenazine (CA), Fentazin (UK)
Pharmacologic class: Phenothiazine, dopaminergic antagonist
Therapeutic class: Antipsychotic, antiemetic
Pregnancy risk category NR
Unknown. Thought to antagonize dopamine and serotonin type 2 in CNS. Also antagonizes muscarinic receptors in respiratory tract, causing cholinergic activation.
Tablets: 2 mg, 4 mg, 8 mg, 16 mg
⊘Indications and dosages
➣ Schizophrenia in nonhospitalized patients
Adults and children older than age 12: Initially, 4 to 8 mg P.O. t.i.d.
➣ Schizophrenia in hospitalized patients
Adults and children older than age 12: Initially, 8 to 16 mg P.O. two to four times daily, increased p.r.n.; avoid dosages greater than 64 mg daily.
➣ Severe nausea and vomiting
Adults: 8 to 16 mg P.O. daily in divided doses, to a maximum of 24 mg.
• Intractable hiccups
• Hypersensitivity to drug, its components, or related compounds
• Blood dyscrasias
• Bone marrow depression
• Hepatic damage
• Subcortical damage
• Concurrent use of high-dose CNS depressants
Use cautiously in:
• respiratory disorders, hepatic or renal dysfunction, breast cancer, alcohol withdrawal symptoms, suicidal tendency, surgery
• patients taking CNS depressants or anticholinergics
• elderly patients
• pregnant or breastfeeding patients
• children younger than age 12.
• Give with food to avoid GI upset.
CNS: drowsiness, dizziness, insomnia, vertigo, headache, hyperactivity, nocturnal confusion, bizarre dreams, tremor, ataxia, slurring, exacerbation of psychotic symptoms, paranoid reactions, parkin-sonism, dystonias, akathisia, tardive dyskinesia, hyperreflexia, cerebrospinal fluid abnormality, catatonic-like state, paradoxical stimulation, seizures, neuroleptic malignant syndrome
CV: hypotension, orthostatic hypotension, hypertension, peripheral edema, ECG changes, tachycardia, bradycardia, cardiac arrest, heart failure
EENT: glaucoma, blurred vision, miosis, mydriasis, corneal and lens deposits, pigmentary retinopathy, oculogyric crisis, photophobia, nasal congestion, dysphagia
GI: nausea, vomiting, diarrhea, constipation, obstipation, abnormal tongue color or movement, dry mouth, anorexia, adynamic ileus
GU: dark urine, urinary retention, urinary frequency, urinary incontinence, bladder paralysis, galactorrhea, lactation, breast enlargement, menstrual irregularities, inhibited ejaculation, libido changes
Hematologic: hemolytic anemia, leukopenia, agranulocytosis, thrombocytopenic purpura
Hepatic: jaundice, biliary stasis
Metabolic: hyponatremia, glycosuria, hyperglycemia, hypoglycemia, syndrome of inappropriate antidiuretic hormone secretion, pituitary tumor
Musculoskeletal: numbness and aching of arms and legs
Respiratory: dyspnea, suppressed cough reflex, asthma, bronchospasm, laryngospasm, laryngeal edema
Skin: urticaria, pallor, erythema, eczema, pruritus, perspiration, pigmentation changes, photosensitivity, angioedema, exfoliative dermatitis
Other: increased appetite, weight gain, fever, systemic lupus erythematosuslike syndrome, hypersensitivity reactions including anaphylactoid reaction
Drug-drug.Anticholinergics: increased risk of adverse anticholinergic reactions
CNS depressants: increased perphenazine effects, increased adverse CNS reactions
Tricyclic antidepressants: increased perphenazine blood level, greater risk of adverse reactions
Drug-diagnostic tests.Eosinophils, liver function tests: increased values Glucose: increased or decreased level Granulocytes, hemoglobin, platelets, sodium, white blood cells: decreased levels
Pregnancy test: false-positive result
Drug-herbs.Kava: dystonic reactions
St. John's wort: photosensitivity
Yohimbe: yohimbe toxicity
Drug-behaviors.Alcohol use: increased CNS depression
Sun exposure: increased risk of photosensitivity reaction
☞ Watch for anaphylactoid reaction and angioedema. Monitor neurologic status; stay alert for signs and symptoms of neuroleptic malignant syndrome (high fever, unstable blood pressure, stupor, muscle rigidity, autonomic dysfunction), parkinsonian symptoms, and catatonic-like state.
• Monitor cardiovascular status and vital signs periodically.
☞ Evaluate respiratory status, especially for dyspnea and airway spasm.
☞ Monitor CBC, glucose level, and liver function tests. Watch for evidence of blood dyscrasias.
• Explain importance of combining drug therapy with psychotherapy.
• Tell patient to take exactly as prescribed and to report adverse reactions promptly.
• Instruct patient to avoid sun exposure and to wear sunscreen outdoors to prevent photosensitivity reaction.
• Advise patient to consult prescriber before taking other prescription drugs or over-the-counter preparations.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects him.
• Instruct patient to avoid alcohol, smoking, caffeine, and herbs.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.
perphenazine/per·phen·a·zine/ (-fen´ah-zēn) a phenothiazine used as an antipsychotic and as an antiemetic.
perphenazineEtrafon, Trilafon® Pharmacology A phenothiazine and tricyclic antidepressant combination used to manage anxiety, depression, agitation, severe N&V, hiccups, pain Adverse effects Extrapyramidal symptoms–involuntary movement–opisthotonus, trismus, torticollis, retrocollis, aching, numbness of limbs, motor restlessness, oculogyric crisis, hyperreflexia, dystonia, sedative effects, jaundice, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenic purpura, pancytopenia. See Mitriptyline.
perphenazineA phenothiazine derivative drug used in the treatment of SCHIZOPHRENIA and other psychotic conditions. It is also used to relieve severe vomiting and control persistent hiccups. A brand name is Fentazin.
drug class: phenothiazine antipsychotic;
action: blocks neurotransmission at dopaminergic synapses in the cerebral cortex, hypothalamus, and limbic system; mechanism for antipsychotic effects unclear;
uses: psychotic disorders, schizophrenia, alcoholism, nausea, vomiting.