Home Drug Guide Piperacetazine

Drug Guide

Generic Name

Piperacetazine

Brand Names Quide

Classification

Therapeutic: Antipsychotic

Pharmacological: Phenothiazine derivative, typical antipsychotic

FDA Approved Indications

  • Schizophrenia

Mechanism of Action

Piperacetazine works by antagonizing dopamine D2 receptors in the brain, reducing psychotic symptoms; it may also have antihistamine and anticholinergic effects.

Dosage and Administration

Adult: Dosage varies; typically 25-75 mg three times daily, titrated based on response and tolerance.

Pediatric: Not commonly used in pediatric patients; consult specific guidelines.

Geriatric: Start at lower doses due to increased sensitivity and risk of adverse effects.

Renal Impairment: Adjust dosage as needed; closely monitor.

Hepatic Impairment: Use caution; hepatic dosing adjustments may be necessary.

Pharmacokinetics

Absorption: Well absorbed after oral administration.

Distribution: Widely distributed, crosses blood-brain barrier.

Metabolism: Hepatic via CYP450 enzymes.

Excretion: Primarily in urine as metabolites.

Half Life: Approximately 10-20 hours.

Contraindications

  • Comatose states, severe central nervous system depression, severe liver disease, hypersensitivity to phenothiazines.

Precautions

  • Use cautiously in patients with cardiovascular disease, history of seizure, or intraocular pressure issues; monitor for EPS and tardive dyskinesia.

Adverse Reactions - Common

  • Extrapyramidal symptoms (EPS) (Common)
  • Drowsiness (Common)
  • Weight gain (Common)

Adverse Reactions - Serious

  • QT prolongation / arrhythmias (Serious)
  • Neuroleptic malignant syndrome (NMS) (Serious)
  • Agranulocytosis (Serious)

Drug-Drug Interactions

  • Other CNS depressants, antihypertensives, drugs prolonging QT interval

Drug-Food Interactions

  • Alcohol may enhance sedative effects.

Drug-Herb Interactions

  • Use with caution: St. John’s Wort, valerian, kava (may increase sedation and risk of EPS).

Nursing Implications

Assessment: Monitor mental status, EPS signs, cardiac status (ECG), and blood counts.

Diagnoses:

  • Risk for falls, risk for extrapyramidal side effects, risk for cardiac arrhythmias.

Implementation: Administer with food to minimize gastrointestinal upset; monitor for adverse effects.

Evaluation: Assess therapeutic response and adverse effects regularly.

Patient/Family Teaching

  • Do not stop medication suddenly.
  • Report signs of EPS, fever, sore throat, or signs of infection.
  • Avoid alcohol and CNS depressants.
  • Attend regular follow-up appointments.

Special Considerations

Black Box Warnings:

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

Genetic Factors: Individual response may vary; consider genetic testing if indicated.

Lab Test Interference: May cause false positives in certain drug screening tests.

Overdose Management

Signs/Symptoms: Drowsiness, hypotension, extrapyramidal symptoms, potential coma.

Treatment: Supportive care, stabilize vital signs, activated charcoal if recent ingestion, and consider anticholinergic agents for EPS; dialysis generally not effective.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable under recommended storage conditions for specified shelf life.

🛡️ 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.