Phenothiazines

Prochlorperazine is the most commonly used phenothiazine for nausea and vomiting. Others include perphenazine and chlorpromazine. They block dopamine-D 2 receptors in the chemoreceptor trigger zone and have variable anticholinergic affects. Intravenous doses of prochlorperazine for nausea or vomiting are 5 to 12.5 mg. Side-effects are frequent, and include hypotension, sedation, extrapyramidal reactions, and, more rarely, neuroleptic malignant syndrome. The phenothiazines are less effective than alternative drugs for vomiting during cancer chemotherapy, but are commonly used after anesthesia or to minimize opiate-induced nausea and vomiting.

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