Home Drug Guide Thiethylperazine Maleate

Drug Guide

Generic Name

Thiethylperazine Maleate

Brand Names Torecan

Classification

Therapeutic: Anti-emetic, Antipsychotic

Pharmacological: Phenothiazine derivative

FDA Approved Indications

  • Nausea and vomiting

Mechanism of Action

Thiethylperazine acts by blocking dopamine receptors in the brain's chemoreceptor trigger zone, thereby reducing nausea and vomiting.

Dosage and Administration

Adult: 25-50 mg orally 3-4 times daily, with adjustments based on response.

Pediatric: Not generally recommended for pediatric use due to limited safety data.

Geriatric: Start at lower end of dosing range; monitor closely for side effects.

Renal Impairment: Adjust dose based on renal function; consult specific guidelines.

Hepatic Impairment: Use with caution; dose adjustments may be necessary.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses blood-brain barrier.

Metabolism: Hepatic metabolism via CYP enzymes.

Excretion: Primarily renal.

Half Life: Approximately 12-15 hours.

Contraindications

  • Severe CNS depression
  • Comicted Enterocolitis
  • Comatose states

Precautions

  • History of extrapyramidal symptoms
  • Lower seizure threshold
  • Use with caution in Parkinson's disease, elderly, and those with cardiovascular disease.

Adverse Reactions - Common

  • Drowsiness (Common)
  • Dry mouth (Common)
  • Dizziness (Common)

Adverse Reactions - Serious

  • Extrapyramidal reactions (Less common)
  • Agranulocytosis (Rare)
  • QT prolongation and arrhythmias (Rare)

Drug-Drug Interactions

  • Other CNS depressants
  • Anticholinergic drugs
  • QT prolonging drugs

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for extrapyramidal symptoms, sedation, cardiac rhythm, blood counts.

Diagnoses:

  • Risk for injury related to extrapyramidal reactions or sedation.
  • Impaired mobility.

Implementation: Administer as prescribed. Monitor vital signs and mental status.

Evaluation: Assess efficacy in reducing nausea and observe for adverse reactions.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report any unusual movements or symptoms.
  • Caution about operating machinery until response is known.

Special Considerations

Black Box Warnings:

  • Potential for tardive dyskinesia with long-term use.

Genetic Factors: None specific.

Lab Test Interference: None.

Overdose Management

Signs/Symptoms: Extrapyramidal symptoms, sedation, hypotension, confusion.

Treatment: Supportive care, maintain airway, monitor cardiac status, and use antiparkinsonian agents if extrapyramidal symptoms are severe.

Storage and Handling

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

Stability: Stable for 24 months 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.