Trifluoperazine

Intramuscular
Acute psychosis

Oral
Psychoses

Oral
Nausea and vomiting

Oral
Short-term management of anxiety

Should be taken with food. May be taken w/ food to decrease GI upset; do not take w/in 2 hr of antacids.

Preexisting CNS depression and coma; bone marrow depression, blood dyscrasias, liver disease, hypersensitivity to phenothiazines, prolactin dependent tumours. Pregnancy (1^st trimester), lactation.

Cardiovascular disease, epilepsy, angle-closure glaucoma, exposure to extreme temperatures, elderly, parkinson's disease, myasthenia gravis, benign prostatic hyperplasia, DM, renal amd hepatic impairment. Discontinue trifluoperazine at least 48 hr before myelography and do not resume for at least 24 hr after procedure. Do not use trifluoperazine in control of nausea and vomiting occurring either prior to myelography or postprocedure with metrizamide. Pregnancy.

Drowsiness, dry mouth, blurred vision, dizziness, sedation, antimuscarinic affects, postural hypotension, akathisia, muscle weakness, anorexia, insomnia, rash, amenorrhoea, fatigue, increased prolactin levels, extrapyramidal side effects.
Potentially Fatal: Neuroleptic malignant syndrome, blood dyscrasias.

Symptoms: extrapyramidal side effects, CNS depression, somnolence, agitation, restlessness, convulsions, ECG changes, cardiac arrhythmias, fever, autonomic reactions such as hypotension, dry mouth and ileus. Management: Treatment is symptomatic and supportive. Maintain an open airway as dysphagia and respiratory difficulty may occur in severe overdosage. Gastric lavage may be performed. Do not induce emesis as dystonic reaction of the head or neck may develop and this may lead to aspiration of vomitus. Extrapyramidal symptoms may be treated with anti-parkinsonism drugs, barbiturates, or diphenhydramine hydrochloride. If pressor agents are required, norepinephrine bitartrate and phenylephrine HCl may be used but not epinephrine. This is because trifluoperazine may reverse the usual elevating action of these agents and cause a further drop in blood pressure. Haemodialysis is not likely to be useful.

Increased CNS depression with CNS depressants such as opiates or other analgesics, barbiturates or other sedatives, general anaesthetics, or alcohol. Increased risk of side effects with drugs with antimuscarinic properties e.g. TCA, antiparkinsonian drugs. Antagonised effects of dopaminergic drugs such as levodopa. Increased risk of hypotension with antihypertensives, trazodone. Reverses antihypertensive effect of guanethidine. Increased risk of severe extrapyramidal side-effects or severe neurotoxicity with lithium. Possible decrease in absorption with antacids.

Description: Trifluoperazine inhibits dopamine D₂ receptors in the brain. It has weak anticholinergic and sedative effects but strong extrapyramidal and antiemetic effects. It controls severely disturbed, agitated or violent behaviour but may also be used for nonpsychotic anxiety.
Pharmacokinetics:
Absorption: Readily absorbed from GI tract. Peak plasma concentrations: 1.5-6 hr. Bioavailability: subject to interindividual variation.
Distribution: Protein binding: highly bound. Distributed into breast milk.
Excretion: Terminal half life: 22 hr.

Oral:
Psychoses: Store at 15-30°C
Nausea and vomiting: Store at 15-30°C.
Short-term management of anxiety: Store at 15-30°C.

Antipsychotics