CHLORPROMAZINE

Code
900.0803
Name
CHLORPROMAZINE
Category
None
Department
Send-Out
Start Date
Expiration Date
Synonyms
Largactil, Ormazine, Thorazaine, Thorazine Spansule
CPT Codes
84022
Site
SBMF
Reference Test
44089
ATLAS Test Code

CHLORPROMAZINE

Specimen Information

Type

Red top (serum) or Lavender, EDTA

Volume

2.0 ml

Transport Info

Centrifuge and immediately transfer serum or plasma to separate plastic tube Refrigerated

Fasting Required?
False
Patient Instructions

Reference Range

Therapeutic Range: Adult Therapeutic: 50-300 ng/mL Toxic: > 500 ng/mL Child Therapeutic: 30-80 ng/mL Toxic: > 200 ng/mL

Methodology

Quantitative Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

Clinical Significance

Evaluate toxicity; monitor therapeutic levels. Although intestinal absorption is complete, the oral bioavailability is 32%±19% because of variable metabolism in the intestinal wall and liver (marked first-pass effect). Time to peak plasma concentration is two to four hours. After intramuscular administration, peak plasma concentrations are four to 10 times higher than after oral administration; onset of action occurs within 20-30 minutes, and the peak levels are noted in two to three hours. Volume of distribution (21±9 L/kg) is high and plasma binding (95% to 98%) is extensive. Clearance after intramuscular administration is 8.6±2.9 mL/minute/kg. Less than 1% of the drug is excreted unchanged by the kidney. The nominal elimination plasma half-life is 30±7 hours; however, some metabolites are eliminated slowly (months) in the urine. Hepatic enzyme induction with increased clearance usually is a minor effect that varies considerably among individuals. At least 100 metabolites of chlorpromazine appear in humans; most are minor. Several, including 7-hydroxychlorpromazine, 11- hydroxychlorpromazine, norchlorpromazine, and possibly chlorpromazine N-oxide are neuropharmacologically active.

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