Home Drug Guide Triflupromazine Hydrochloride

Drug Guide

Generic Name

Triflupromazine Hydrochloride

Brand Names Vesprin

Classification

Therapeutic: Antipsychotic, typical (first-generation antipsychotic)

Pharmacological: Phenothiazine class

FDA Approved Indications

  • Schizophrenia
  • Other psychotic disorders

Mechanism of Action

Triflupromazine works by antagonizing dopamine D2 receptors in the brain, leading to a reduction in psychotic symptoms. It also possesses antihistaminic, anticholinergic, and antiadrenergic properties.

Dosage and Administration

Adult: Dosage varies; typically 25-75 mg/day in divided doses, adjusted based on response and tolerability.

Pediatric: Use in children is limited; dosing should be individualized and monitored closely.

Geriatric: Start at lower doses due to increased sensitivity; monitor for extrapyramidal symptoms and sedation.

Renal Impairment: Use with caution; no specific adjustments established, monitor closely.

Hepatic Impairment: Use with caution; consider dose reduction and close monitoring.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Extensively metabolized in the liver via oxidative pathways.

Excretion: Excreted mainly in urine as metabolites; some fecal excretion.

Half Life: Approximately 20-30 hours.

Contraindications

  • Known hypersensitivity to phenothiazines or other components
  • Coma
  • Bone marrow suppression

Precautions

  • History of seizure disorders
  • Cardiovascular diseases
  • Leukopenia or blood dyscrasias
  • Pregnancy category C; use only if potential benefit justifies risk
  • Lactation: Caution; may pass into breast milk

Adverse Reactions - Common

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

Adverse Reactions - Serious

  • Extrapyramidal symptoms (EPS) (Serious)
  • Tardive dyskinesia (Serious)
  • Neuroleptic malignant syndrome (NMS) (Serious)
  • Blood dyscrasias (Serious)
  • QT prolongation / arrhythmias (Serious)

Drug-Drug Interactions

  • CNS depressants (additive sedative effects)
  • Other QT-prolonging agents
  • Anticholinergic drugs (potentiation of anticholinergic side effects)

Drug-Food Interactions

  • Caution with alcohol, which may increase sedation and risk of hypotension

Drug-Herb Interactions

  • No well-documented interactions; caution with herbal products affecting CYP enzymes

Nursing Implications

Assessment: Monitor mental status, blood pressure, signs of EPS, and cardiac rhythm.

Diagnoses:

  • Risk of movement disorders
  • Risk for falls
  • Potential for sedation

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

Evaluation: Assess effectiveness in symptom control; monitor for adverse reactions.

Patient/Family Teaching

  • Take medication exactly as prescribed; do not stop abruptly.
  • Rise slowly to minimize orthostatic hypotension.
  • Report signs of EPS, NMS, or unusual movements promptly.
  • Avoid alcohol and depressants.

Special Considerations

Black Box Warnings:

  • Elderly patients with dementia-related psychosis are at increased risk of death.

Genetic Factors: CYP2D6 activity may influence drug metabolism; poor metabolizers may experience increased effects.

Lab Test Interference: None significant.

Overdose Management

Signs/Symptoms: Sedation, hypotension, extrapyramidal symptoms, QT prolongation, coma.

Treatment: Supportive care; administer activated charcoal if early; manage hypotension with fluids, treat arrhythmias; consider physostigmine for anticholinergic toxicity under specialist guidance.

Storage and Handling

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

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

🛡️ 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.