Zuklopentyksol
When ATH:
N05AF05
Pharmacological action.
Neuroleptic, antipsychotic, sedation.
Application.
Pills: schizophrenia (acute and chronic) and other psychotic disorders, especially hallucinations, paranoid delusions and thought disorder; state of agitation, increased anxiety, hostility, aggressiveness; maniakalynaya phase maniakalyno-depressivnogo psychosis; mental retardation, combined with psychomotor agitation, agitation and other behavioral disorders; senile dementia with paranoid ideas, disorientation, behavioral problems, confusion.
Solution for injection: the initial treatment of acute psychoses, including chronic psychosis manic exacerbation, especially in patients with agitation, concern, hostility or aggression.
Depot: maintenance treatment of schizophrenia and paranoid psychosis.
Contraindications.
Hypersensitivity, acute alcohol poisoning, ʙarʙituratami, opiatami, coma, dysfunction of the hematopoietic system, pheochromocytoma, pregnancy, lactation.
Restrictions apply.
Convulsions, progressive liver disease, kidney, cardiovascular diseases (incl. arrhythmia, severe hypotension, orthostatic dysregulation krovobrascheniya), lesions of the brain stem, incl. Parkinson's disease, prolaktinzavisimye tumor.
Pregnancy and breast-feeding.
Use during pregnancy and lactation is possible, if the effect of therapy outweighs the potential risk to the fetus (Experiments on animals showed embryotoxic and teratogenic effects, studies in humans have not been conducted) and newborn (in the body of the child receives less 1% dose, mother received).
Side effects.
From the nervous system and sensory organs: extrapyramidal disorder (muscle rigidity (24%), Hypo- or akinesia (17%), tremor (17%), dystonia (14%), motor akathisia and hyperkinesia), arising mainly early in treatment, with high doses or with a sharp increase in the dose; dizziness (17%); drowsiness, ccomodation (10%); in rare cases - neuroleptic malignant syndrome (hyperthermia, muscle stiffness, akinesia, autonomic dysfunction, impairment of consciousness up to coma); tardive dyskinesia and early, provocation epileptiform seizures, anxiety, excitation, headache, depression, delirium syndrome (especially in combination with anticholinergics), attack of angle-closure glaucoma.
Cardio-vascular system and blood: tachycardia, orthostatic hypotension, conduction disorders, ≥1% - violation of hematopoiesis (eg, agranulocytosis), in rare cases - vein thrombosis of the lower extremities and pelvis.
From the respiratory system: laryngeal edema, asthma, bronchopneumonia.
From the digestive tract: dry mouth (23%), constipation, paralytic ileus, minor transient changes in liver function tests, cholestatic hepatitis, jaundice.
Metabolism: weight gain, glucose metabolism disorders.
With the genitourinary system: urinary retention, menstrual disorders, sexual disorders.
For the skin: rash, эritema, itching.
Other: lupus-like syndrome, fatigue (especially at the beginning of treatment), swelling of the brain, increased secretion of saliva and sweat glands, galactorrhea.
Cooperation.
Deprimiruyuschie potentiates the activity of barbiturates, trankvilizatorov, alcohol, glycine etc.. Metoclopramide, bromopride, alizoprid and piperazine increases the risk of extrapyramidal disorders. Reduces the effectiveness of dopamine receptor agonists (levodopa, bromocriptine, amantadin). It weakens the hypotensive effect of guanethidine, clonidine and methyldopa. It enhances the effect of anticholinergics. Barbiturates and carbamazepine accelerates metabolism of neuroleptics. Propranolol, tricyclic antidepressants, drugs increase the concentration of lithium in serum zuclopenthixol (mutually), while the use of drugs lithium may develop neurotoxic symptoms. The simultaneous use of epinephrine leads to a sharp drop in blood pressure. When combined with a polypeptide antibiotic possible dampening effect on the respiratory center.
Overdose.
Symptoms: hypersomnia, impairment of consciousness up to coma, convulsions, extrapyramidal disorders, hypotension, shock, Hypo- or hyperthermia.
Treatment: gastric lavage, monitoring of vital signs, symptomatic and supportive therapy.
Do not use epinephrine, tk. this may lead to a further decrease in blood pressure. In convulsions may use diazepam, for the relief of extrapyramidal disorders used biperiden.
Dosing and Administration.
Inside, / m. Dose selected individually. Inside - 10-50 mg / day, the usual initial dose is 20 mg / day (It may then be increased to 10-20 mg every 2-3 days until 75 mg / day or more); maintenance dose - 20-40 mg / day; with mental retardation with agitation - 6-20 mg / day (up to 25-40 mg / day); with senile disorders with agitation and confusion - 6.2 mg / day at night (up to 10-20 mg / day).
/ M (injection) - 50-150 mg once, if required repeated injections carried out in 2-3 days (not less than one day), the maximum total dose per course - 400 mg; maintenance therapy is recommended tablet form: 2-3 days after the final injection (100 mg) appointed 40 mg orally in divided doses, or depot form (simultaneously with the final injection (100 mg) 200-400 mg is administered a depot formulation; Injection depot forms and can be mixed in the same syringe).
A depot form - 200-400 mg (1-2 ML) every 2-4 weeks, 250-750 mg (0,51.5 ml) every 1-4 weeks. Switching from tablets to form a depot formulation is carried out under the scheme: daily dose tablets (mg) x 8 = Depot / m 1 once every 2 Sun.
Precautions.
To prevent withdrawal symptoms the dose should be reduced gradually. In chronic liver damage prescribe lower doses. The emergence of extrapyramidal disorders requires a reduction of dose and destination antiparkinsonian. The development of neuroleptic malignant syndrome necessitates immediate abolition of zuclopenthixol and supportive and symptomatic therapy. With the development of cholestatic hepatitis zuclopenthixol therapy should be discontinued. During treatment excludes alcohol intake. Should not be used during the drivers of vehicles and people, skills relate to the high concentration of attention.
Cautions.
Chance of a false positive pregnancy test.
