Home Drug Guide Piperazine Citrate

Drug Guide

Generic Name

Piperazine Citrate

Brand Names Antepar, Multifuge, Bryrel, Vermidol

Classification

Therapeutic: Antiparasitic, Anthelmintic

Pharmacological: Piperazine Derivative (parasiticidal agent)

FDA Approved Indications

  • Treatment of roundworm infections (ascariasis) and pinworm infections (oxyuriasis)

Mechanism of Action

Piperazine citrate acts as a neuro-muscular blocker by antagonizing GABA receptors on parasitic nerve cells, leading to paralysis of the worms and subsequent expulsion from the host's gastrointestinal tract.

Dosage and Administration

Adult: Typically, 1-2 grams orally, repeated after 2 hours if needed, or as directed by physician.

Pediatric: Dosage based on body weight or age; generally 75-100 mg/kg divided into doses over 1-2 days.

Geriatric: Dose adjustments may be necessary; lower initial doses and careful monitoring advised.

Renal Impairment: Use with caution; dosage adjustments may be necessary and renal function should be monitored.

Hepatic Impairment: Use with caution; no specific guidelines established.

Pharmacokinetics

Absorption: Good oral absorption.

Distribution: Widely distributed; crosses into gastrointestinal lumen where worms reside.

Metabolism: Primarily unmetabolized; small extent of hepatic metabolism possible.

Excretion: Mainly excreted unchanged in urine.

Half Life: Approximately 6-8 hours.

Contraindications

  • Hypersensitivity to piperazine or related compounds

Precautions

  • Use with caution in pregnancy and lactation; consult healthcare provider. Monitor for neurological or gastrointestinal side effects.

Adverse Reactions - Common

  • Gastrointestinal upset (nausea, vomiting, abdominal pain) (Common)

Adverse Reactions - Serious

  • Neurotoxicity including ataxia, confusion, or seizures (Rare)

Drug-Drug Interactions

  • May enhance neurotoxicity when combined with other neuroactive drugs.

Drug-Food Interactions

  • No significant interactions known.

Drug-Herb Interactions

  • Limited data; potential interactions not well characterized.

Nursing Implications

Assessment: Assess for hypersensitivity, neurological status, and gastrointestinal symptoms before and during therapy.

Diagnoses:

  • Risk for electrolyte imbalance due to vomiting or diarrhea.
  • Risk for neurological adverse effects.

Implementation: Administer as prescribed, usually with food to minimize gastrointestinal discomfort. Monitor for adverse effects.

Evaluation: Effectiveness assessed by resolution of parasitic symptoms and absence of adverse effects.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Complete the full course of therapy.
  • Report any neurological symptoms, severe gastrointestinal side effects, or allergic reactions.
  • Maintain good hygiene to prevent re-infection.

Special Considerations

Black Box Warnings:

  • None currently.

Genetic Factors: None identified.

Lab Test Interference: Generally does not interfere with laboratory tests.

Overdose Management

Signs/Symptoms: Neurotoxicity, including seizures, ataxia, irritability, or gastrointestinal symptoms.

Treatment: Supportive care: maintain airway, monitor neurological status; activated charcoal if ingestion recent; seizures treated with anticonvulsants.

Storage and Handling

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

Stability: Stable under recommended storage conditions; check expiration date.

🛡️ 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.