Fluphenazine is a potent medication employed in the management of schizophrenia. Extensive research has demonstrated its comparable efficacy to low-potency antipsychotics like chlorpromazine (González et al., 2018). Various brand names, including modecate, moditen, and rhophenazine, are used to market this medication. Fluphenazine has obtained FDA approval for the treatment of schizophrenia and addressing related symptoms such as malevolence, delusions, and hallucinations. Limited evidence and both guided and non-guided support exist for the off- label utilization of fluphenazine in children and adult. Classification Fluphenazine is classified as a phenothiazine medication, specifically a neuroleptic. It shares the same drug class as chlorpromazine and thiordazine (Siragusa et al., 2020). Their mechanism of action involves modifying the chemical equilibrium of neurotransmitters within the brainworth noting that fluphenazine's antagonistic effects on the A-1 adrenergic receptors may lead to potential cardiac side effects. Additionally, like other antipsychotic medications, fluphenazine exhibits significant effects on the M-1 and H-1 receptors. Pharmacokinetics Fluphenazine demonstrates rapid bioavailability with efficient absorption. Its onset of action varies depending on the formulation: the decanoate form takes approximately 24 to 72 hours to initiate effects, while the monohydrate salt form starts working within 1 hou (Correll et al., 2021)r. The duration of action differs as well, with the monohydrate salt providing therapeutic effects for 6 to 8 hours, whereas the decanoate formulation maintains its effectiveness over a span of 4 weeks. Peak plasma concentration is achieved at around 8 to 10 hours for the decanoate form and 2 hours for the monohydrate salt. The peak effect of the decanoate formulation is typically observed between 48 to 96 hours after administration. Pharmacodynamics Fluphenazine acts by blocking the postsynaptic D1 and D2 receptors in the mesolimbic dopaminergic system, effectively inhibiting their function. Additionally, it is believed to impede the release of hormones originating from the hypothalamus and hypophysis (Bandala et al., 2023). Moreover, fluphenazine is thought to exert an inhibitory effect on the reticular activating system, which plays a role in regulating various physiological functions such as basal metabolism, the temperature, sleep patterns, tone, and emesis
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