Description overdue on

Antipsychotic neuroleptic . Antipsychotic effect is achieved by blockade of dopamine D2 receptors Mesocortical and mesolimbic system. Antipsychotic influence is evident in the elimination of delusion, hallucinations   and other positive symptoms of psychosis. Chlorpromazine promotes relief of various kinds of agitation, reduces the severity of psychotic fear, aggression. Sedation is achieved adrenoceptor blockade reticular Pharmacy, located in the brain stem. The drug inhibits the conditioned reflex activity (especially motor-defensive receptors), reduces the spontaneous motor activity, reduces sensitivity to exogenous and endogenous stimuli stored in the mind relaxes the skeletal muscles. Appointment of large doses may cause drowsiness. The blockade of dopamine D2 receptors in the vomiting center in the trigger zone And blockade of the vagal nerve in the digestive tract provide antiemetic effect. Chlorpromazine has little effect on M-cholinergic receptors, a pronounced effect observed in the alpha-adrenergic receptors. The drug is able to completely eliminate the effects caused by   epinephrine . Hypothermic effects provided by blockade of dopamine receptors located in the hypothalamus. The drug increases the heart rate, lowers blood pressure, has a strong kataleptogennoe impact Weak antihistamine effect, reduces the permeability of the capillary walls. In intramuscular sedation develops within 15 minutes after oral administration - after 2 hours. Tolerance to hypotensive and sedative effect develops within 1 week. When administered orally, an antipsychotic effect was observed on day 4-7. The maximum expression of the therapeutic effect lasts from 6 weeks up to six months. Chlorpromazine available in tablet dosage form, as a solution, drops.

Indications:

In psychiatric practice Chlorpromazine is used to treat   psychomotor agitation schizophrenia . The drug is prescribed for chronic psychosis, with hypomanic excitation, acute delirium, psychopathy, insomnia, anxiety, mental illness, followed by agitation, anxiety, fear. Chlorpromazine is used in alcoholic psychosis When hard hiccups " indomitable "Vomiting, nausea. When persistent pain medication enhances effect of analgesic drugs. Chlorpromazine prescribed for diseases associated with increased muscle tone:   (combination therapy with barbiturates), after previous cerebrovascular events. Earlier Aminazin used in the "political" mixtures (for artificial hypothermia). In anesthesia medication prescribed to potentiate general anesthesia for premedication . In dermatological practice, the drug is used for itching dermatoses . The drug is prescribed in the treatment of acute "intermittent" porphyria .

Contraindications:

ulcerative lesions of the digestive tract . Because of the risk of hepatotoxic reactions Aminazin alcoholism prescribed with caution. In breast cancer, pathological changes in the blood in prostatic hyperplasia When the form-closure glaucoma, Parkinson's disease, myxedema, epilepsy, vomiting, cachexia, Reye's syndrome, in elderly patients Aminazin used with caution.

Side effect:

In the early stages of therapy is marked dryness of the mouth, hypersomnia , Paresis of accommodation, constipation, dizziness, eating disorders, tachycardia, severe form of orthostatic hypotension, decreased potency, urinary retention, sleep disorders, allergic reactions, frigidity, drop in blood pressure. Long-term therapy is chlorpromazine neuroleptic depression , Convulsions language of the neck muscles, floor of the mouth, extrapyramidal disorder , Akathisia, Akinetes-rigid phenomenon, a belated reaction to stimuli, mental changes, , Hypercoagulability, inhibition of bone marrow hematopoiesis, heart rhythm abnormalities, cholestatic jaundice, gynecomastia, giperplolaktinemiyu , Galactorrhea, pigementatsiyu skin, oliguria, diarrhea, vomiting, neuroleptic malignant syndrome. by intravenous infusion - phlebitis .

Overdose:

Manifested blurred vision, hyperreflexia or areflexia . There is also cardiotoxic effects a shock, a drop in blood pressure, Development Heart Failure , Arrhythmias, heart failure, ventricular fibrillation, changes in the QRS complex of the electrocardiogram. The neurotoxic effects manifested by coma, stupor, drowsiness, disorientation , Seizures, confusion, agitation, respiratory depression, pulmonary edema, vomiting, muscle rigidity, hypothermia or hyperpyrexia . Enterosorbents assignment is required, gastric lavage. With the development of arrhythmia intravenous phenytoin, in the formation of heart failure recommended appointment cardiac glycosides . In the fall of blood pressure intravenously infused vasopressors (phenylephrine, norepinephrine). Diazepam is shown in the development of seizures. Parkinsonism effective diphenhydramine, difeniltropin. During the five days required control over the work of the cardiovascular system, respiratory system, mandatory counseling therapist. Dialysis   not proved effective.

Mode of application:

Aminazin taken orally, intramuscularly, intravenously .  The initial daily dose in psychiatric practice - 25-100mg (1-4 admission) .  Gradually increase the amount of drug every 3-4 days at 25-50 mg to achieve the desired effect .  With anxiety before surgery medication is prescribed for 2-3 hours before surgery .  In pediatric practice are used only special, form of the drug for children .  .  Prior to intramuscular injection of medicament solution is diluted with 2-5 ml of procaine (0, 25-0, 5%) or sodium chloride 0, 9% .  Chlorpromazine is administered by deep intramuscular injection .  Before surgery in patients with anxiety drug is administered intramuscularly per 0, 55 mg per 1 kg of weight for 2 hours before the intended surgery .  When tetanus is administered intramuscularly 0, 55mg / kg every 8 hours, the infusion rate of 1 mg / 2 minutes .

Special instructions:

Chlorpromazine therapy requires control pulse, blood pressure, work hepatic, renal systems. To prevent a sharp drop in blood pressure after intravenous and intramuscular injections of the patient lay on the couch for 1, 5-2 hours. In view of the fact that the drug may cause photosensitization It advised to avoid UV rays exposure. No admission of ethanol during therapy. Required to completely eliminate the probability of hitting chlorpromazine on the mucous membranes, skin. The drug affects the control of motor vehicles.

Drug Interactions:

Chlorpromazine may weaken the effect of the drug vasoconstrictor ephedrine . Some displays ototoxicity   (expressed vertigo, tinnitus) when taking ototoxic medication may be masked during treatment with chlorpromazine. The drug reduces the severity of the effect protivoparkinsonicheskogo   levodopa   (as a result of the blockade of dopamine receptors). A similar effect is observed when taking clonidine, amphetamine guanetidina. The drug enhances the effect of other anticholinergic drugs, but the decrease of its own antipsychotic effects. The drug is compatible with antidepressants , Antipsychotics, anxiolytics. We do not recommend prolonged use of antipyretics, analgesics because of the risk Hyperthermia . The risk of developing   It increases considerably with the combination therapy with tricyclic antidepressants, MAO inhibitors, manprotilinom. Preparations lithium, antiparkinsonian agents, antacid medications interfere with the absorption of chlorpromazine.