Trifluoperazine Hydrochloride
(trye-floo-oh-per′a-zeen)
Novoflurazine, Terfluzine
Classification: ANTIPSYCHOTIC; PHENOTHIAZIDE
Therapeutic: ANTIPSYCHOTIC
Prototype: Chlorpromazine
Pregnancy Category: C
ACTION & THERAPEUTIC EFFECT
Phenothiazine with antipsychotic effects thought
to be related to blockade of postsynaptic dopamine receptors in the brain. Effectiveness indicated by increase in mental
and physical activity.
Management of schizophrenia, short term for
anxiety.
Hypersensitivity to phenothiazines or sulfites;
comatose states; CNS depression; ethanol intoxication; blood dyscrasias;
hematologic disease, bone marrow depression; dementia related psychosis in
older adults; preexisting liver disease; lactation.
Previously detected breast cancer; history of QT
prolongation; significant cardiac disease or pulmonary disease; compromised
respiratory function; seizure disorders; impaired liver function; pregnancy
(category C); children younger than 6 y.
Adult: PO 1–2 mg b.i.d., may increase up to 20 mg/day
Child (6–12 y): PO 1 mg 1–2 ×day,
may increase up to 15 mg/day
Adult: 1–2 mg 1–2 × day (max:6 mg/day)
- Crush tablet and give with fluid or mix with
food if patient will not or cannot swallow pill.
- Store in light-resistant container at 15°–30° C
(59°–86° F) unless otherwise directed.
CNS: Drowsiness,
insomnia, dizziness, agitation, extrapyramidal
effects, neuroleptic malignant syndrome. Special
Senses: Nasal congestion, dry mouth, blurred
vision, pigmentary retinopathy. Hematologic: Agranulocytosis. Skin: Photosensitivity,
skin rash, sweating. GI: Constipation.
CV: Tachycardia, hypotension. Respiratory: Depressed
cough reflex. Endocrine: Gynecomastia, galactorrhea.
Drug: Alcohol and other CNS
DEPRESSANTS add to CNS depression. Herbal: Kava may increase
risk and severity of dystonic reactions.
Absorption: Well
absorbed from GI tract. Onset: Rapid onset. Peak: 2–3 h. Duration: Up to 12 h.
Metabolism: In liver. Elimination: In bile and
feces.
Black Box Warning
Trifluoperazine has been associated with increased risk of
mortality in older adults with dementiarelated psychosis.
Assessment
& Drug Effects
- Monitor HR and BP. Hypotension is a common
adverse effect.
- Hypotension and extrapyramidal effects
(especially akathisia and dystonia) are most likely to occur in patients
receiving high doses or in older adults. Withhold drug and notify prescriber if
patient has dysphagia, neck muscle spasm, or if tongue protrusion occurs.
- Monitor I&O ratio and bowel elimination
pattern. Check for abdominal distention and pain. Encourage adequate fluid intake as prophylaxis for constipation and xerostomia.
- Agitation, jitteriness, and sometimes insomnia
may simulate original psychotic symptoms. These adverse effects may disappear spontaneously.
- Expect maximum therapeutic response within 2–3
wk after initiation of therapy.
- Monitor lab tests: Periodic CBC and serum
prolactin, especially with prolonged therapy.
Patient & Family Education
- Take drug as prescribed; do not alter dosing
regimen or stop medication without consulting prescriber.
- Consult prescriber about use of any OTC drugs
during therapy.
- Do not take alcohol and other depressants during
therapy.
- Avoid potentially hazardous activities such as
driving or operating machinery, until response to drug is known.
- Cover as much skin surface as possible with
clothing when you must be in direct sunlight. Use an SPF higher than 12
sunscreen on exposed skin.
- Urine may be discolored or reddish brown and
this is harmless.
Good ye chaheye
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