Home Drug Guide Acetophenazine Maleate

Drug Guide

Generic Name

Acetophenazine Maleate

Brand Names Tindal

Classification

Therapeutic: Antipsychotic

Pharmacological: Phenothiazine derivative

FDA Approved Indications

  • Schizophrenia

Mechanism of Action

Blocks dopamine D2 receptors in the brain, leading to decreased dopaminergic transmission, which helps alleviate psychotic symptoms.

Dosage and Administration

Adult: Initial dose typically 6-10 mg three times daily, can be adjusted based on response and tolerability.

Pediatric: Not established; use under medical supervision if prescribed.

Geriatric: Start at lower doses due to increased sensitivity; adjust carefully.

Renal Impairment: Use with caution; no specific dose adjustment established.

Hepatic Impairment: Use cautiously; monitor closely.

Pharmacokinetics

Absorption: Rapidly absorbed from GI tract.

Distribution: Wide distribution, crosses blood-brain barrier.

Metabolism: Extensively metabolized in the liver, primarily via CYP450 enzymes.

Excretion: Excreted mainly in urine and bile.

Half Life: Approx. 12-24 hours, allowing for once or twice daily dosing.

Contraindications

  • Hypersensitivity to phenothiazines or other components.
  • Comatose states.
  • Severe CNS depression.

Precautions

  • Use cautiously in patients with cardiovascular diseases, epilepsy, or Parkinson’s disease.
  • Monitor for signs of neuroleptic malignant syndrome.
  • Pregnancy Category C; use only if clearly needed.

Adverse Reactions - Common

  • Sedation (Common)
  • Extrapyramidal symptoms (dystonia, parkinsonism, akathisia) (Common)
  • Dry mouth (Common)
  • Orthostatic hypotension (Common)

Adverse Reactions - Serious

  • Neuroleptic malignant syndrome (Rare)
  • QT prolongation and arrhythmias (Rare)
  • Aggressive behavior or confusion in elderly (Rare)

Drug-Drug Interactions

  • CNS depressants, additive sedative effects.
  • Other dopamine antagonists may increase side effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor mental status, blood pressure, and for extrapyramidal symptoms.

Diagnoses:

  • Risk for falls related to sedation and orthostatic hypotension.
  • Imbalanced nutrition less than body requirements due to dry mouth or nausea.

Implementation: Administer with food if GI upset occurs, monitor for adverse reactions.

Evaluation: Assess effectiveness in symptom control and monitor for adverse effects.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Be cautious about activities requiring alertness.
  • Report symptoms such as muscle stiffness, high fever, or irregular heartbeat immediately.
  • Avoid alcohol and CNS depressants.

Special Considerations

Black Box Warnings:

  • Increased mortality in elderly patients with dementia-related psychosis.

Genetic Factors: Consider pharmacogenetic testing for CYP450 enzymes affecting metabolism.

Lab Test Interference: May alter liver function tests and blood counts.

Overdose Management

Signs/Symptoms: Severe drowsiness, decreased respiration, extrapyramidal symptoms, hypotension.

Treatment: Supportive care, activated charcoal if early, correcting hypotension, IV fluids, and monitoring cardiac status.

Storage and Handling

Storage: Store in a cool, dry place away from light.

Stability: Stable for 2-3 years when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.