help with psyche med

[melanie1126]

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.

[dosamigos76, RN]

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

[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

[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.

[BJLynn]

I would question that as well. That is almost a complete bottle me thinks.

[KellNY, RN]

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?

[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)

[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....