PHENOTHIAZINES

Thiethylperazine and prochlorperazine are useful drugs in preventing and controlling nausea and vomiting. They are less sedating than chlorpromazine. The usual oral dose of thiethylperazine is 10mg 2 or 3 times a day. It is also available in suppository form (10mg every 12 hours). The usual oral dose of prochlorperazine is 5mg 3 times a day, or 25mg by suppository every 12 hours.

Chlorprormazine is too sedative for routine use as an anti-emetic; it is useful when an anti-emetic and anxiolytic action are needed together. It is useful as an adjunct to benzodiazepines for severe insomnia, with a 25mg to 50mg dose at 5:00 p.m., followed by temazepam 40mg to 60mg at bedtime.

Methotrimeprazine is best thought of as a double strength chlorpromazine. It is a powerful anti-emetic and is particularly useful in a continuous subcutaneous infusion. Methotrimeprazine is also very useful in the management of terminal agitation. (see Subcutaneous Infusions, Terminal Phase)

Haloperidol is a useful drug in terminal care, as a non-sedating anti-emetic or anxiolytic. 1.5mg at bedtime is the usual dose in the prevention of nausea; 5mg 2 times a day is the usual starting dose in the drug management of anxiety. It can be used to calm a severely agitated patient, using 10mg subcutaneously per hour until the patient settles.

The author and publisher have taken precautions to ensure that the information in this book is error-free. However, readers must be guided by their own personal and professional standards of good practice in evaluating and applying recommendations made herein. The contents of this book represent the views and experience of the author, and not necessarily those of the publisher.