Home Drug Guide Thiethylperazine Maleate

Drug Guide

Generic Name

Thiethylperazine Maleate

Brand Names Torecan

Classification

Therapeutic: Anti-emetic, Antipsychotic

Pharmacological: Phenothiazine derivative

FDA Approved Indications

Nausea and vomiting

Mechanism of Action

Thiethylperazine acts by blocking dopamine receptors in the brain's chemoreceptor trigger zone, thereby reducing nausea and vomiting.

Dosage and Administration

Adult: 25-50 mg orally 3-4 times daily, with adjustments based on response.

Pediatric: Not generally recommended for pediatric use due to limited safety data.

Geriatric: Start at lower end of dosing range; monitor closely for side effects.

Renal Impairment: Adjust dose based on renal function; consult specific guidelines.

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

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses blood-brain barrier.

Metabolism: Hepatic metabolism via CYP enzymes.

Excretion: Primarily renal.

Half Life: Approximately 12-15 hours.

Contraindications

Severe CNS depression
Comicted Enterocolitis
Comatose states

Precautions

History of extrapyramidal symptoms
Lower seizure threshold
Use with caution in Parkinson's disease, elderly, and those with cardiovascular disease.

Adverse Reactions - Common

Drowsiness (Common)
Dry mouth (Common)
Dizziness (Common)

Adverse Reactions - Serious

Extrapyramidal reactions (Less common)
Agranulocytosis (Rare)
QT prolongation and arrhythmias (Rare)

Drug-Drug Interactions

Other CNS depressants
Anticholinergic drugs
QT prolonging drugs

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for extrapyramidal symptoms, sedation, cardiac rhythm, blood counts.

Diagnoses:

Risk for injury related to extrapyramidal reactions or sedation.
Impaired mobility.

Implementation: Administer as prescribed. Monitor vital signs and mental status.

Evaluation: Assess efficacy in reducing nausea and observe for adverse reactions.

Patient/Family Teaching

Take medication exactly as prescribed.
Report any unusual movements or symptoms.
Caution about operating machinery until response is known.

Special Considerations

Black Box Warnings:

Potential for tardive dyskinesia with long-term use.

Genetic Factors: None specific.

Lab Test Interference: None.

Overdose Management

Signs/Symptoms: Extrapyramidal symptoms, sedation, hypotension, confusion.

Treatment: Supportive care, maintain airway, monitor cardiac status, and use antiparkinsonian agents if extrapyramidal symptoms are severe.

Storage and Handling

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

Stability: Stable for 24 months when stored properly.