help with psyche med

  1. Hi. I tried to post this question earlier but my computer froze up midpost so I aplogize if you've already seen half of a question from me earlier.

    Anyway, I was given an order today for Prolixin Dec 150 mg IM. I have only administered this drug once before and the order was for 37.5 mg. I have only been a nurse for a short time Also, my skills are mostly in med -surge, very limited in psych so I did some research online and in a couple of drug books and have come across a notation that "the dose should not be more than 100mg" . My first question is has anyone ever seen an order like this and is it common to give this much?
    Also, the im form of this drug comes 25/ml so I would end up giving 6 ml. I was taught in school not to give more than 5 mls in an injection. So is it right that this would have to be done in 2 injections? This is not the type of patient that is going to sit quietly and let me give this twice.
    I would appreciate feedback from a psych nurse or anyone else who regularly gives this drug in large doses. Thanks in advance.
    •  
  2. 7 Comments

  3. by   dosamigos76
    ANY time you have concerns regarding an order, I would question it. Depending on where you are practicing, ask the MD or the pharmacist. Good for you for looking it up instead of just giving it.

    Cheryl M
  4. by   leslie :-D
    i would definitely question this order.
    i went to medscape and prolixin wasn't listed.
    its' chemical name, fluphenazine, was and its' dosage was listed as a max of 25mg.
    i then googled it and checked on mentalhealth.com.
    it did say that it 'some' instances, a 100 mg had been given but the norm is 25mg and less.
    i would be checking and double checking this dosage.
    kudos to you for your vigilance in this order.
    let us know what happens?

    leslie
  5. by   AnRNIam
    15mg is a common dose of Prolixin Dec. given IM. The 150 mg is way off. I worked with many mental health patients in an AODA center and I've never seen more than 75mg given IM. Good job questioning the order and researching the med.
  6. by   BJLynn
    I would question that as well. That is almost a complete bottle me thinks.
  7. by   KellNY
    Quote from AnRNIam
    15mg is a common dose of Prolixin Dec. given IM. The 150 mg is way off. I worked with many mental health patients in an AODA center and I've never seen more than 75mg given IM. Good job questioning the order and researching the med.
    I was thinking that. Did the genius write 15.0 and the decimal got missed?
    What did pharmacy say/do? Anything?
  8. by   GingerSue
    My pharmacology textbook says that Prolixin decanoate for adults under 50 year - is given IM; Sub-Q 12.5 mg initially followed by 25 mg every 2 weeks and that dosage requirements rarely exceed 100 mg q 2-6 weeks (and adults over 50 years, debilitated clients, or clients with a history of extrapyramidal reactions: 2.5 mg initially followed by 2.5 - 5 mg q 10 - 14 days)
  9. by   MALE*RN*777
    I have several pts. with that dosage who receive this amount Q2weeks. The 37.5mg sounds like a Risperdal Consta injection dosage. Be sure that you are giving the decanoate and not the regular injection. Also, I was taught 2ml in the arm 3 mls in the backside were the max to be given in any on site injection. Something is not right here....

close