Home Drug Guide Triflupromazine

Drug Guide

Generic Name

Triflupromazine

Brand Names Vesprin

Classification

Therapeutic: Antipsychotic, typical (phenothiazine derivative)

Pharmacological: Dopamine receptor antagonist

FDA Approved Indications

  • Schizophrenia
  • Nausea and vomiting (off-label)

Mechanism of Action

Blocks dopamine D2 receptors in the brain, reducing hallucinations, delusions, and nausea.

Dosage and Administration

Adult: Dosage varies based on condition; typically 25-50 mg 2-3 times daily, adjustable based on response.

Pediatric: Use is not well-established; consult specific guidelines.

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

Renal Impairment: Adjust dose as necessary; consult clinician.

Hepatic Impairment: Use with caution; monitor for increased effects.

Pharmacokinetics

Absorption: Well absorbed from gastrointestinal tract.

Distribution: Wide distribution; crosses blood-brain barrier.

Metabolism: Hepatic via CYP enzymes.

Excretion: Primarily renal.

Half Life: Approximately 10-20 hours, varies among individuals.

Contraindications

  • Comatose states
  • Bone marrow suppression
  • Known hypersensitivity to phenothiazines

Precautions

  • Use with caution in elderly, those with cardiovascular disease, those with Parkinson's disease, or history of seizure disorders.

Adverse Reactions - Common

  • Sedation (Common)
  • Dry mouth (Common)
  • Dizziness (Common)

Adverse Reactions - Serious

  • Extrapyramidal symptoms (EPS) (Less common)
  • Neuroleptic malignant syndrome (NMS) (Rare)
  • QT prolongation and arrhythmias (Rare)

Drug-Drug Interactions

  • CNS depressants
  • Levodopa and dopamine agonists (antagonistic effects)
  • Other drugs prolonging QT interval

Drug-Food Interactions

  • Alcohol may enhance sedative effects

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor mental status, extrapyramidal symptoms, cardiovascular status.

Diagnoses:

  • Risk for falls due to sedation or orthostatic hypotension.
  • Impaired physical mobility due to EPS.

Implementation: Administer with meals to decrease GI effects; monitor for side effects.

Evaluation: Assess therapeutic response and side effects regularly.

Patient/Family Teaching

  • Advise to avoid alcohol and CNS depressants.
  • Report any signs of EPS, NMS, or allergic reactions.
  • Explain the importance of adherence and regular follow-up.

Special Considerations

Black Box Warnings:

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

Genetic Factors: Patients with CYP2D6 poor metabolizer status may experience increased plasma levels.

Lab Test Interference: May cause false-positive for certain drug screens.

Overdose Management

Signs/Symptoms: Excess sedation, hypotension, extrapyramidal symptoms, coma.

Treatment: Supportive care, activated charcoal if within a short time of ingestion, symptomatic management, and potentially IV fluids and medications for severe reactions.

Storage and Handling

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

Stability: Stable under recommended conditions.

🛡️ 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.