Skip to Main Content

++

INTRODUCTION

++

fluphenazine (floo-fen-a-zeen)

Apo-Fluphenazine, Image not available.Modecate Concentrate, PMS-Fluphenazine, Prolixin, Prolixin Decanoate

Classification

Therapeutic: antipsychotics

Pharmacologic: phenothiazines

++
Indications
++

Acute and chronic psychoses.

++
Action
++

Alters the effects of dopamine in the CNS. Has anticholinergic and alpha-adrenergic blocking activity. Therapeutic Effects: Diminished signs and symptoms of psychoses.

++
Adverse Reactions/Side Effects
++

CNS: NEUROLEPTIC MALIGNANT SYNDROME, extrapyramidal reactions, sedation, tardive dyskinesia. EENT: blurred vision, dry eyes. CV: hypertension, hypotension, tachycardia. GI: anorexia, constipation, drug-induced hepatitis, dry mouth, ileus, nausea, weight gain. GU: urinary retention. Derm: photosensitivity, pigment changes, rashes. Endo: galactorrhea. Hemat: AGRANULOCYTOSIS, leukopenia, thrombocytopenia. Misc: allergic reactions.

++

PHYSICAL THERAPY IMPLICATIONS

++
Examination and Evaluation
++

  • Monitor and report signs of neuroleptic malignant syndrome (hyperthermia, diaphoresis, generalized muscle rigidity, altered mental status, tachycardia, changes in blood pressure [BP], incontinence). Symptoms typically occur within 4–14 days after initiation of drug therapy, but can occur at any time during drug use.

  • Monitor signs of agranulocytosis and leukopenia (fever, sore throat, mucosal lesions, signs of infection) or thrombocytopenia (bruising, nose bleeds, bleeding gums). Report these signs to the physician or nursing staff immediately.

  • Assess motor function, and be alert for extrapyramidal symptoms. Report these symptoms immediately, especially tardive dyskinesia, because this problem may be irreversible. Common extrapyramidal symptoms include:

    • Tardive dyskinesia (uncontrolled rhythmic movement of mouth, face, and extremities, lip smacking or puckering, puffing of cheeks, uncontrolled chewing, rapid or worm-like movements of tongue).

    • Pseudoparkinsonism (shuffling gait, rigidity, tremor, pill-rolling motion, loss of balance control, difficulty speaking or swallowing, mask-like face).

    • Akathisia (restlessness or desire to keep moving).

    • Other dystonias and dyskinesias (dystonic muscle spasms, twisting motions, twitching, inability to move eyes, weakness of arms or legs).

  • Monitor signs of allergic reactions, including pulmonary symptoms (laryngeal edema, wheezing, dyspnea) or skin reactions (rash, pruritus, urticaria). Notify physician or nursing staff immediately if these reactions occur.

  • Assess BP and compare to normal values (See Appendix F). Report changes in BP, either a problematic decrease in BP (hypotension) or a sustained increase in BP (hypertension).

  • Assess heart rate, ECG, and heart sounds, especially during exercise (See Appendices G, H). Report an increased heart rate (tachycardia) or symptoms of other arrhythmias, including palpitations, chest discomfort, shortness of breath, fainting, and fatigue/weakness.

  • Periodically assess body weight and other anthropometric measures (body mass index, body composition). Report a rapid or unexplained weight gain or increased body fat.

++
Interventions
++

  • Guard against falls and trauma (hip fractures, head injury, and so forth) caused by drowsiness, blurred vision, or extrapyramidal symptoms; implement fall-prevention strategies (See Appendix E).

  • Use caution during aerobic exercise and other forms of therapeutic exercise because of the risk of tachycardia and abnormal BP responses. Assess exercise tolerance frequently (BP, heart rate, fatigue levels), and terminate exercise immediately if any untoward ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.