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    PO: 30-75 mg/day divided q6-12hr initially; maintenance: usually 200 mg/day (up to 800 mg/day in some patients; some patients may require 1-2 g/day) IV/IM: 25 mg initially, followed PRN with 25-50 mg after 1-4 hours, then increased to maximum of 400 mg q4-6hr until patient is controlled; usual dosage 300-800 mg/day 25-50 mg PO q6-8hr; if hiccups persist after 2-3 days of oral therapy, administer 25-50 mg IM q3-4hr; if symptoms persist, administer 25-50 mg by slow IV infusion with patient lying flat in bed; monitor BP 6 months: 50-100 mg/day PO/IM; 200 mg/day or more may be necessary for older hospitalized patients; for outpatients, may administer 0.55 mg/kg q4-6hr PRN 6 months: 50-100 mg/day PO/IM; 200 mg/day or more may be necessary for older hospitalized patients; for outpatients, may administer 0.55 mg/kg q4-6hr PRN');" class="calc_link" Patients with dementia-related psychosis who are treated with antipsychotic drugs are at increased risk for death, as shown in short-term controlled trials; deaths in these trials appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature This drug is not approved for treatment of patients with dementia-related psychosis Hypersensitivity to phenothiazines Coma, severe hypotension, severe central nervous system (CNS) depression, concurrent administration of large amounts of CNS depressants, subcortical brain damage, poorly controlled seizure disorder Severe cardiovascular disease Lactation Avoid using in children with suspected Reye syndrome Use caution in glaucoma, prostatic hypertrophy, stenosing peptic ulcer disease (PUD), history of NMS, Parkinson disease, hypocalcemia, renal or hepatic impairment, history of severe reaction to insulin or electroconvulsive therapy (ECT), history of seizures, asthma, respiratory tract infection, cardiovascular disease, myelosuppression Risk of extrapyramidal symptoms (EPS), NMS, hypotension Significant hypotension may occur, especially with parenteral administraiton; hypotension may be particularly severe in patients with pheochromocytoma or mitral insufficiency; in case of severe hypotension, use norepinephrine or phenylepinephrine, and do not use epinephrine or dopamine May alter cardiac conduction; life threatening arrhythmias reported with therapeutic doses of phenothiazines; may cause QT prolongation and subsequent torsade de pointes; avoid use in patients diagnosed or suspected congenital long QT syndrome May cause anticholinergic effects; use caution in patients with paralytic ileus, gastrointestinal motility, urinary retention, xerostomia, or visual problems Agranulocytosis, leukopenia, and neutropenia reported with antipsychotic use; periodic blood count assessment recommended in patients with history of risk factors, including history of drug-induced leuko/neutropenia or preexisting low WBC Esophageal dysmotility and aspiration reported with antipsychotic use; use caution in patients at risk of pneumonia May cause extrapyramidal symptoms, including akathisia, acute dystonic reactions, and pseudoparkinsonism, and tardive dyskinesia; risk of dystonia greater with increased doses Therapy is associated with increased prolactin levels; significance unknown May cause pigmentary retinopathy, and lenticular and corneal deposits with prolonged therapy May cause orthostatic hypotension; use caution in patients with risk factors, including patients who do not tolerate transient hypotensive episodes such as hypovolemia, cerebrovascular disease, cardiovascular disease, or medicatioin predisposing to hypotension/bradycardia May impair physical or mental abilities due to sedating properties; use caution when operating heavy machinery Depresses hypothalamic thermoregulatory mechanism; exposure to extreme temperatures may cause hypo- or hyperthermia Antiemetic effect may obscure toxicity of chemotherapeutic drugs Anticholinergic antiparkinsonian agent may be needed to counter EPS Strong anticholinergic agent and alpha blocker Potential for priapism US Food and Drug Administration (FDA) warning regarding off-label use for dementia in elderly Pregnancy category: C; neonates exposed to antipsychotic drugs during 3rd trimester of pregnancy are at risk for EPS or withdrawal symptoms after delivery; these complications vary in severity, with some being self-limited and others necessitating ICU support and prolonged hospitalization Lactation: Drug enters breast milk; not recommended (American Academy of Pediatrics [AAP] states that this is "of concern") Direct IV injection: Dilute with NS to concentration no higher than 1 mg/m L, and administer at rate of 1 mg/min in adults and 0.5 mg/min in children; avoid administering undiluted drug IV infusion: Add appropriate dose to 500-1000 m L of NS, and administer slowly The above information is provided for general informational and educational purposes only. The above Registration and Operating Fees apply to the Eagle’s Nest.


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