Home Drug Guide Thiothixene

Drug Guide

Generic Name

Thiothixene

Brand Names Navane

Classification

Therapeutic: Antipsychotic, typical

Pharmacological: Thioxanthene derivative, dopamine D2 receptor antagonist

FDA Approved Indications

  • Schizophrenia

Mechanism of Action

Thiothixene primarily acts by blocking dopamine D2 receptors in the brain, which helps to reduce psychotic symptoms such as hallucinations and delusions.

Dosage and Administration

Adult: 10-30 mg daily in divided doses, adjusted based on response and tolerability

Pediatric: Not typically recommended for pediatric use

Geriatric: Start at lower doses due to increased sensitivity; monitor closely

Renal Impairment: Use caution; no specific adjustment recommended but monitor closely

Hepatic Impairment: Use caution; dose adjustments may be necessary based on liver function

Pharmacokinetics

Absorption: Well absorbed orally

Distribution: Widely distributed in body tissues, crosses the blood-brain barrier

Metabolism: Primarily metabolized in the liver via CYP450 enzymes

Excretion: Excreted mainly in urine and feces

Half Life: Approximately 4-6 hours; active metabolites may have longer half-lives

Contraindications

  • Coma or severe CNS depression
  • Use of large amounts of CNS depressants
  • Parkinson’s disease

Precautions

  • History of QT prolongation, arrhythmias, or electrolyte imbalances; caution in elderly due to risk of falls and confusion; careful monitoring of blood counts and metabolic parameters

Adverse Reactions - Common

  • Drowsiness/Sedation (Common)
  • Extrapyramidal symptoms (EPS) (Common)
  • Dry mouth (Common)
  • Weight gain (Common)

Adverse Reactions - Serious

  • QT prolongation and risk of torsades de pointes (Serious, dose-related)
  • Neuroleptic Malignant Syndrome (NMS) (Rare but serious)
  • Agranulocytosis (Rare)
  • Tardive dyskinesia (Less common with long-term use)

Drug-Drug Interactions

  • Other CNS depressants, levodopa, anticoagulants, drugs that prolong QT interval

Drug-Food Interactions

  • Alcohol, caffeine, grapefruit juice (may affect metabolism)

Drug-Herb Interactions

  • St. John’s Wort, Ginseng (may interact with CNS drugs)

Nursing Implications

Assessment: Monitor for signs of neuroleptic side effects, cardiovascular status, and metabolic changes. Baseline ECG recommended in patients at risk.

Diagnoses:

  • Risk for injury related to extrapyramidal symptoms or sedation
  • Impaired glucose tolerance or risk for diabetes

Implementation: Administer with food if GI upset occurs; monitor EPS regularly; educate patient about symptoms of NMS and tardive dyskinesia.

Evaluation: Assess effectiveness in reducing psychotic symptoms; monitor for adverse effects; adjust dosage as needed.

Patient/Family Teaching

  • Do not discontinue abruptly to avoid withdrawal symptoms.
  • Report signs of movement disorders, fever, or muscle rigidity immediately.
  • Be aware of potential drowsiness; avoid driving or operating machinery until response is known.
  • Avoid alcohol and other CNS depressants.

Special Considerations

Black Box Warnings:

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

Genetic Factors: Genetic variability may influence metabolism and response.

Lab Test Interference: May cause elevations in liver enzymes, blood glucose, and lipid levels.

Overdose Management

Signs/Symptoms: Extrapyramidal symptoms, hypotension, sedation, seizures, coma

Treatment: Supportive care; activated charcoal if ingestion recent; cardiovascular monitoring; consider use of benzodiazepines for agitation; physostigmine may be considered for anticholinergic toxicity under specialist guidance.

Storage and Handling

Storage: Store at room temperature, protected from light and moisture

Stability: Stable for 2-3 years if 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.