Home Drug Guide Thiothixene Hydrochloride

Drug Guide

Generic Name

Thiothixene Hydrochloride

Brand Names Navane, Thiothixene Hydrochloride Intensol

Classification

Therapeutic: Antipsychotic, Typical

Pharmacological: Thioxanthene derivative, dopamine D2 receptor antagonist

FDA Approved Indications

  • Schizophrenia

Mechanism of Action

Thiothixene hydrochloride blocks dopamine D2 receptors in the brain, reducing psychotic symptoms. It also exerts some anticholinergic, antihistaminic, and alpha-adrenergic blocking effects.

Dosage and Administration

Adult: Typical starting dose is 2-5 mg 2-3 times daily; doses may be titrated based on response and tolerance, up to 30-60 mg daily in divided doses.

Pediatric: Safety and efficacy in children have not been established.

Geriatric: Use with caution; start at lower doses due to increased sensitivity to side effects.

Renal Impairment: Adjust dosage as needed; no specific guidelines, monitor response and side effects.

Hepatic Impairment: Use with caution; hepatic metabolism may be impaired, necessitating lower doses.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; crosses blood-brain barrier.

Metabolism: Extensively metabolized in the liver via CYP450 enzymes.

Excretion: Excreted mainly in urine and feces.

Half Life: Approximately 4-6 hours, but active metabolites may prolong effects.

Contraindications

  • Coma or severe CNS depression
  • Congenital or acquired QT prolongation

Precautions

  • History of hypersensitivity to thiothixene or other phenothiazines, elderly patients with dementia-related psychosis, Parkinson's disease, electroconvulsive therapy, history of seizures, cardiovascular disease, liver impairment, following recent myocardial infarction. Use cautiously in pregnancy and lactation.

Adverse Reactions - Common

  • Drowsiness, sedation (Common)
  • Dry mouth (Common)
  • Extrapyramidal symptoms (EPS) (Common)
  • Weight gain (Common)

Adverse Reactions - Serious

  • QT prolongation, Torsades de Pointes (Serious)
  • Neuroleptic Malignant Syndrome (NMS) (Rare)
  • Seizures (Uncommon)
  • Agranulocytosis (Rare)

Drug-Drug Interactions

  • Other CNS depressants, anticholinergic drugs, drugs prolonging QT interval, antihypertensives

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor mental status, baseline ECG, blood counts, and weight. Observe for extrapyramidal symptoms and signs of NMS.

Diagnoses:

  • Risk of falls, ineffective coping, risk of NMS, impaired urinary elimination.

Implementation: Administer with food to decrease GI irritation; monitor for adverse effects; adjust dosage based on response.

Evaluation: Assess for therapeutic response and side effects; ensure patient adherence and safety.

Patient/Family Teaching

  • Do not operate machinery until you know how this medication affects you.
  • Attend regular follow-up appointments.
  • Report signs of allergic reactions, movement disorders, or signs of serious side effects like fever, muscular rigidity.
  • Avoid alcohol and CNS depressants.

Special Considerations

Black Box Warnings:

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

Genetic Factors: Potential variability in metabolism due to CYP450 polymorphisms.

Lab Test Interference: May cause false positives in certain psychiatric or drug screenings.

Overdose Management

Signs/Symptoms: Drowsiness, severe hypotension, respiratory depression, extrapyramidal symptoms, seizures, QT prolongation.

Treatment: Supportive care, activated charcoal if ingested recently, ECG monitoring, correction of electrolyte imbalances, and specific interventions for cardiac arrhythmias.

Storage and Handling

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

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

🛡️ 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.