perphenazine


Also found in: Dictionary, Thesaurus, Encyclopedia, Wikipedia.

perphenazine

 [per-fen´ah-zēn]
a phenothiazine compound used orally and intramuscularly as an antipsychotic agent and antiemetic.

perphenazine

Apo-Perphenazine (CA), Fentazin (UK)

Pharmacologic class: Phenothiazine, dopaminergic antagonist

Therapeutic class: Antipsychotic, antiemetic

Pregnancy risk category NR

Action

Unknown. Thought to antagonize dopamine and serotonin type 2 in CNS. Also antagonizes muscarinic receptors in respiratory tract, causing cholinergic activation.

Availability

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.

Off-label uses

• Intractable hiccups

Contraindications

• Hypersensitivity to drug, its components, or related compounds

• Blood dyscrasias

• Bone marrow depression

• Hepatic damage

• Subcortical damage

• Coma

• Concurrent use of high-dose CNS depressants

Precautions

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.

Administration

• Give with food to avoid GI upset.

Adverse reactions

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

Interactions

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

Patient monitoring

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.

Patient teaching

• 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.

per·phe·na·zine

(per-fen'ă-zēn),
An antipsychotic of the phenothiazine type.

perphenazine

(pər-fĕn′ə-zēn′)
n.
A crystalline compound, C21H26ClN3OS, used as a tranquilizer especially in the treatment of psychosis and to prevent or alleviate nausea and vomiting.

perphenazine

Etrafon, 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.

perphenazine

A 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.
References in periodicals archive ?
To reduce polypharmacy, certain psychotropic medications were tapered: mirtazapine was reduced to 45 mg every bedtime, lurasidone to 20 mg every bedtime, perphenazine to 2 mg twice daily, and quetiapine to 100 mg every morning and 600 mg every bedtime.
One of the strongest hits in the zebrafish screen was the drug perphenazine. It is a member of the phenothiazines, a family of antipsychotic medications used for 50 years, because they can block dopamine receptors.
Antipsychotic medication Drug substance Atypical Amisulpride Aripiprazole Clozapine Olanzapine Paliperidone Quetiapine Risperidone Sertindole Zotepine Typical Perphenazine Benperidol Chlorpromazine Chlorprothixene Droperidol Flupentixol Fluphenazine Haloperidol Levomepromazine Loxapine Oxypertine Pericyazine Pimozide Promazine Remoxipride Sulpiride Thioridazine Trifluoperazine Trifluperidol Zuclopenthixol GPRD were recorded and collected independently from each other.
Simultaneous spectrophotometric determination of chlorpromazine, perphenazine and acetopromazine by use of kinetic wavelength pair method.
Morphine sulphate (Cumhuriyet University Hospital, Turkey), perphenazine, SCH 23390 and eticlopride (Sigma Chemical Co., St.
Rigney, 37, of 701 Main St., Worcester, charged with possession of a class B substance with intent to distribute, amended from possession of cocaine with intent to distribute, sentenced to 2-1/2 years in the House of Correction; possession of perphenazine, amended from possession of perphenazine with intent to distribute, sentenced to a concurrent term of 6 months in the House of Correction; selling or possessing an electric stun gun and drug violation near a school or park, dismissed.
Cost-effectiveness of second generation antipsychotics and perphenazine in a randomized trial of treatment for chronic schizophrenia.
medication, which included perphenazine, haloperidol and fluphenazine,
[3] Ireland F A, Loch W E, Worthy K, Anthony R V, Effects of bromocriptine and perphenazine on prolactin and progesterone concentration in pregnant pony mares during late gestation, J Reprod Fertil, 92 (1990) 179.
The most damaging blow to the atypicals was an authoritative 2005 study funded by the National Institute of Mental Health--the so-called CATIE study--which found that the atypical antipsychotics worked no better than a much older antipsychotic called Trilafon (perphenazine), which was developed in the 1950s.
Similarly, Alberto DiMascio contributed enormously to the study of the effects of different drug families such as anxiolytics (oxazepam, chlordiazepoxide), antidepressants (imipramine, desipramine), stimulants (d-amphetamine) and neuroleptics (chlorpromazine, promethazine, trifluoperazine, and perphenazine), among others, in both normal and pathological subjects (DiMascio, Klerman, Rinkel, Greenblatt & Brown 1958; DiMascio, Havens & Klerman, 1963a, 1963b; DiMascio & Buie, 1964; DiMascio, Heninger & Klerman, 1964; DiMascio, Klerman & Prusoff, 1975; DiMascio, Bernardo, Greenblatt & Marder, 1976).