Home Drug Guide Trifluoperazine Hydrochloride

Drug Guide

Generic Name

Trifluoperazine Hydrochloride

Brand Names Stelazine

Classification

Therapeutic: Antipsychotic, typical

Pharmacological: Phenothiazine antipsychotic

FDA Approved Indications

  • Schizophrenia
  • Short-term treatment of hyperactivity in children

Mechanism of Action

Trifluoperazine works by blocking dopamine receptors in the brain, particularly D2 receptors, reducing psychotic symptoms.

Dosage and Administration

Adult: Initial dose: 1-2 mg 2-3 times daily; titrate based on response, typically up to 10-15 mg daily in divided doses.

Pediatric: Use is primarily for behavioral disturbances; dosing varies, usually starting at 0.5-1 mg twice daily, titrated cautiously.

Geriatric: Start at lower doses (e.g., 0.5-1 mg daily) due to increased sensitivity and risk of adverse effects.

Renal Impairment: Adjust dosing as necessary; limited data, monitor closely.

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

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses blood-brain barrier.

Metabolism: Primarily hepatic via CYP450 enzymes.

Excretion: Renal and biliary pathways.

Half Life: Approximately 14-20 hours.

Contraindications

  • Comcomitant use with other central nervous system depressants or Parkinson’s disease.

Precautions

  • Use cautiously in elderly, Parkinson’s disease, seizure history, cardiac conduction abnormalities.
  • Pregnancy category C; use only if clearly needed.

Adverse Reactions - Common

  • Extrapyramidal symptoms (dystonia, Parkinsonism) (Common)
  • Sedation (Common)
  • Dizziness (Common)
  • Dry mouth (Common)

Adverse Reactions - Serious

  • Neuroleptic malignant syndrome (Rare)
  • QT prolongation and arrhythmias (Rare)
  • Blood dyscrasias (Rare)

Drug-Drug Interactions

  • CNS depressants, anticholinergic drugs, other dopamine antagonists.

Drug-Food Interactions

  • Alcohol may enhance sedative effects.

Drug-Herb Interactions

  • Potential interactions with herbs affecting CYP450 enzymes.

Nursing Implications

Assessment: Monitor mental status, extrapyramidal symptoms, vital signs, and ECG (for QT prolongation).

Diagnoses:

  • Risk for falls due to sedation or orthostatic hypotension.
  • Risk of extrapyramidal symptoms.

Implementation: Administer with food to minimize GI irritation; observe for adverse effects; adjust dose as needed.

Evaluation: Assess therapeutic response and adverse effects regularly.

Patient/Family Teaching

  • Avoid alcohol and other CNS depressants.
  • Report any signs of abnormal movements, fever, or irregular heartbeat.
  • Take medication exactly as prescribed.

Special Considerations

Black Box Warnings:

  • Increase risk of death in elderly patients with dementia-related psychosis.

Genetic Factors: CYP450 polymorphisms may affect metabolism.

Lab Test Interference: May cause false-positive for urinary catecholamines.

Overdose Management

Signs/Symptoms: Sedation, hypotension, extrapyramidal symptoms, possibly coma.

Treatment: Supportive care, activated charcoal if ingestion is recent, vasopressors for hypotension, bromocriptine or diphenhydramine for extrapyramidal symptoms.

Storage and Handling

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

Stability: Stable for 2-3 years 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.