Nurses Compass
Drug Guide
Piperazine Citrate
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.