Name of the Procedure:

Injection, chlorpromazine hcl, up to 50 mg (HCPCS Code J3230)
Common Name(s): Chlorpromazine injection
Technical Terms: Intramuscular (IM) or intravenous (IV) injection of chlorpromazine hydrochloride

Summary

Chlorpromazine hydrochloride is a medication that can be injected into a muscle (intramuscular) or vein (intravenous) to help manage certain mental and mood disorders. It is primarily used to treat symptoms of schizophrenia, psychotic disorders, nausea and vomiting, hiccups, and severe anxiety.

Purpose

The injection is used to address symptoms associated with various psychiatric and medical conditions. The main goals are to alleviate symptoms such as hallucinations, severe nausea, and anxiety, contributing to improved patient stability and comfort.

Indications

• Schizophrenia and other psychotic disorders
• Severe nausea and vomiting
• Intractable hiccups
• Severe anxiety and agitation

• Certain cases of tetanus and porphyria

  Patient criteria include individuals who have not responded adequately to oral medications or require rapid symptom control.

Preparation

• Patients may be advised to avoid eating or drinking for a few hours before the injection.
• Any current medications should be discussed with the healthcare provider to prevent adverse interactions.
• Baseline diagnostic tests might include blood pressure monitoring and a complete medical history assessment.

Procedure Description

1. Preparation: The healthcare provider cleans the injection site with an antiseptic.
2. Injection: The provider will administer up to 50 mg of chlorpromazine HCL either intramuscularly or intravenously, based on the condition being treated.
3. Post-Injection Monitoring: The patient will be monitored for any immediate adverse reactions, such as changes in blood pressure or allergic reactions.

The required tools include sterile syringes, chlorpromazine HCL solution, antiseptics, and medical monitoring equipment.

Duration

The injection itself takes only a few minutes, but monitoring for immediate effects may last for 30 minutes to an hour.

Setting

The procedure is typically performed in a hospital, outpatient clinic, or an emergency setting.

Personnel

• Licensed healthcare providers such as doctors, nurses, or physician assistants
• No anesthesiologist is required unless the procedure necessitates sedation for other reasons

Risks and Complications

• Common Risks: Pain at the injection site, dizziness, drowsiness, dry mouth
• Rare Risks: Severe allergic reactions, hypotension, tardive dyskinesia, neuroleptic malignant syndrome Any severe reactions will be managed promptly with appropriate medical interventions like antihistamines, intravenous fluids, or emergency medications.

Benefits

• Rapid relief of symptoms such as severe nausea, psychosis, or anxiety.
• Improvement in patient quality of life and stability. Benefits are often noticed within minutes to hours of the injection.

Recovery

• Monitor for side effects like drowsiness and dizziness.
• Follow up with a healthcare provider to adjust dosage or switch to oral medication if appropriate.
• Recovery is usually swift, with most patients returning to normal activities within a few hours, adhering to any personalized restrictions advised by their healthcare provider.

Alternatives

• Oral chlorpromazine tablets
• Other antipsychotic medications like olanzapine or risperidone

• Non-pharmacological treatments like cognitive-behavioral therapy (CBT)

  The choice of treatment depends on the patient's specific condition, response to previous treatments, and overall health profile.

Patient Experience

Patients may feel a brief sting or discomfort at the injection site. During the procedure, the effect of the medication might cause drowsiness or a mild sedative effect. Post-procedure, patients should inform healthcare providers of any unusual symptoms for immediate management. Pain management includes local anesthetics or pain relievers if necessary, ensuring patient comfort throughout the process.