METHOTRIMEPRAZINE (Nozinan)

Name:	METHOTRIMEPRAZINE (Nozinan^R)
Classification:	*phenothiazine; neuroleptic* antipsychotic anxiolytic sedative and analgesic properties
Dose:	Bolus: 5-25 mg IV direct Infusion: 2-8 mg/hr, titrated to patient response A provider order is required for each infusion rate change (nurses are not approved to titrate to effect). Rate change recommendations are by 1-2 mg/hr every 2-4 hours to as required).
Administration:	IV Infusion: 50 mg/50 ml dextrose 5% or sodium chloride 0.9% for syringe pump infusion or 100mg/100ml dextrose 5% or sodium chloride 0.9%
Adverse Effects:	anticholinergic effects: urinary retention tachycardia orthostatic hypotension drowsiness agranulocytosis (rare) cholestatic jaundice malignant neuroleptic syndrome altered thermic response (poikilithermic effect) thus may not be able to adapt to temperature changes
Cautions:	*in patients with glaucoma, due to anticholingergic effects* *in epileptic patients due to possible reduction of seizure threshold*
Drug Interactions:	methotrimprazine + epinephrine = diminished effect of epinephrine on blood pressure methotrimprazine + CNS depressants = increased CNS depressant effects
Monitoring Therapy:	continuous heart rate and rhythm QT interval blood pressure mental status, delirum screen urine output muscle rigidity, fever, altered metal state bilirubin appropriate response to ambient temperature, temperature CBC level of sedation
Adult Critical Care Protocol:	May be administed IV direct or by IV infusion by a nurse in Adult Critical Care Continuous infusions must be administered by infusion device with pump library enabled.