Phenothiazine overdose
Phenothiazines are medicines used to treat serious mental and emotional disorders, and to reduce nausea. This article discusses an overdose of phenothiazines. Overdose occurs when someone takes more than the normal or recommended amount of a certain substance. This can be by accident or on purpose.
Overdose
An overdose is when you take more than the normal or recommended amount of something, usually a drug. An overdose may result in serious, harmful sym...
This is for information only and not for use in the treatment or management of an actual overdose. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
Poisonous Ingredient
The poisonous ingredient is phenothiazine, which may be found in many medicines.
Where Found
These medicines contain phenothiazine:
- Acetophenazine
- Chlorpromazine (Thorazine)
- Chlorprothixene (Taractan)
- Clozapine (Clozaril)
- Fluphenazine (Prolixin)
- Haloperidol (Haldol)
- Loxapine (Loxitane)
- Mesoridazine (Serentil)
- Molindone (Moban)
- Perphenazine (Trilafon)
- Pimozide (Orap)
- Prochlorperazine (Compazine)
- Promazine (Sparine)
- Thioridazine (Mellaril)
- Thiothixene (Navane)
- Trifluoperazine (Stelazine)
- Triflupromazine
- Promethazine (Phenergan)
Other medicines may also contain phenothiazine.
Symptoms
Below are symptoms of a phenothiazine overdose in different parts of the body.
AIRWAYS AND LUNGS
- No breathing
- Rapid breathing
- Shallow breathing
BLADDER AND KIDNEYS
- Cannot urinate
EYES, EARS, NOSE, MOUTH, AND THROAT
-
Blurred vision
Blurred vision
There are many types of eye problems and vision disturbances, such as: HalosBlurred vision (the loss of sharpness of vision and the inability to see ...
- Congested nose
- Drooling
- Dry mouth
- Swallowing difficulties
- Sores in the mouth, on the tongue, or in the throat
- Vision color changes (things look brownish)
- Yellow eyes
HEART AND BLOOD
- High or very low blood pressure
- Irregular heartbeat
- Rapid heartbeat
MUSCLES AND JOINTS
- Muscle spasms, particularly of the neck, face, and back
- Muscle stiffness
NERVOUS SYSTEM
- Agitation
-
Clumsiness
Clumsiness
Uncoordinated movement is due to a muscle control problem that causes an inability to coordinate movements. It leads to a jerky, unsteady, to-and-fr...
-
Coma
Coma
Decreased alertness is a state of reduced awareness. A coma is a state of decreased alertness from which a person cannot be awakened. A long-term co...
-
Confusion
Confusion
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
- Convulsions
- Deep sleep
- Difficulty walking or a shuffling gait
- Fainting
- Hallucinations (rare)
- Lack of coordination
- Irritability
- Needing to move, restlessness
- Tremor
- Weakness
SKIN
- Rapid sunburn if exposed to the sun
- Bluish skin (changing to purplish)
STOMACH AND INTESTINAL TRACT
-
Constipation
Constipation
Constipation in infants and children occurs when they have hard stools or have problems passing stools. A child may have pain while passing stools o...
- Loss of appetite
- Nausea
OTHER
- Changes in menstrual pattern in women, from long-term use
- Fever
- Low body temperature
Home Care
Seek medical help right away.
Do NOT make a person throw up unless poison control or a health care provider tells you to.
Before Calling Emergency
Have this information ready:
- Person's age, weight, and condition
- The name of the medicine, and strength, if known
- The amount swallowed
- The time it was swallowed
- If the medicine was prescribed for the person
Poison Control
Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.
Local poison center
For a POISON EMERGENCY call:1-800-222-1222ANYWHERE IN THE UNITED STATESThis national hotline number will let you talk to experts in poisoning. This ...
This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
What to Expect at the Emergency Room
Take the container with you to the hospital, if possible.
The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated. The person may receive:
- Activated charcoal
- Blood and urine tests
- Breathing support, including oxygen and tube through the mouth into the lungs
- Chest x-ray
- CT scan (advanced brain imaging)
- EKG (electrocardiogram, or heart tracing)
- Intravenous (IV) fluids through a vein
- Laxative
- Medicine to reverse the effects of the drug
- Tube placed down the nose and into the stomach (gastric lavage)
Outlook (Prognosis)
Recovery depends on the amount of damage. Survival past 2 days is usually a good sign. Nervous system symptoms may be permanent. The most serious side effects are usually due to damage to the heart. If heart damage can be stabilized, recovery is likely.
References
Kellerman RD. Physical and chemical injuries. In: Kellerman RD, ed. Conn's Current Therapy 2015 . Philadelphia, PA: Elsevier Saunders; 2015:chap 21.
Levine M, Burns MJ. Antipsychotic agents. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 38.
Nockowitz RA, Rund DA. Psychotropic medications. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide . 6th ed. New York, NY: McGraw-Hill; 2004:chap 290.
Velez LI, Feng S-Y. Anticholinergics. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 150.
Wittler MA, Lavonas EJ. Antipsychotics. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 161.
Review Date: 7/11/2015
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.