proklorperazin

Proklorperazin, more commonly known in English as prochlorperazine, is a phenothiazine derivative used primarily as an antiemetic and, to a lesser extent, as an antipsychotic. It has a long-standing role in the management of nausea and vomiting, including postoperative and chemotherapy-induced cases, and it may also be used for vertigo and migraine-associated symptoms in some settings. In German-language medical literature it is often spelled with a “k” as Proklorperazin.

Mechanism of action for prochlorperazine involves antagonism of dopamine D2 receptors in the chemoreceptor trigger zone of the brain, which reduces vomiting reflex activity. Additional antihistamine and anticholinergic properties contribute to its sedative and antiemetic effects. These actions underlie its clinical uses but also account for a range of adverse effects.

Common indications include treatment and prevention of nausea and vomiting caused by surgery, chemotherapy, or other conditions, as well as relief of vertigo symptoms in certain circumstances. It is not typically a first-line antipsychotic due to notable extrapyramidal and other side effects; when used for psychiatric purposes, it is generally in short-term or specific clinical contexts under supervision.

Adverse effects are related to its dopaminergic blockade and anticholinergic activity. They include extrapyramidal symptoms (dystonias, akathisia, parkinsonism), sedation, dizziness, hypotension, and anticholinergic effects such as dry mouth and blurred vision. QT interval prolongation and rare hematologic effects have been reported, and the risk of neuroleptic malignant syndrome exists with rare frequency. Caution is advised in elderly patients and those with underlying cardiac, hepatic, or CNS disease.

Prochlorperazine is available in oral, rectal, and injectable forms. It should be used with caution during pregnancy and lactation, and interactions with other CNS depressants and QT-prolonging drugs should be considered.