TYPICAL ANTIPSYCHOTICS.pptx

Pharmacology

1. ANTIPSYCHOTIC DRUGS ROLL NO; 40,41

2. OBJECTIVES Classification Mechanism of action Pharmacological action Pharmacokinetics Uses Adverse effects

3. CLASSIFICATION

4. MECHANISM OF ACTION

5. PHARMACOLOGICAL ACTION Chlorpromazine CNS: Reduce irritational behaviour,aggressiveness and agitation. Reduce psychotic symptomatology. ANS: Alpha adrenergic blocking activity. Weak anti-cholinergic action. LOCAL ANAESTHETIC: Potent action but has irritant action.

6. CVS: Produce hypotension due to central and peripheral action in sympathetic tone. complication;reflex bradycardia ENDOCRINE: Increase prolactin release. Gynecomastia and galactorrhea can occur.

7. PHARMACOKINETICS: Oral and parenteral doses are available. Oral doses peak at 1 1/2 hours intramuscular doses peak at 30 mins Highly bound to plasma as well as tissues protien . Metabolites are excreted in bile and urine. Divided doses followed by whole doses to avoid adverse effect

8. CHLORPROMAZINE: Oral dose:300-1000mg/day IM:50-100mg/day TRIFLUPROMAZINE: ORAL:100-400mg/day IM:30-60mg/day THIORIDAZINE: Oral:300-600mg/day RISK:Eye damage in long term use

9. TRIFLUOPERAZINE: 15-50mg/day(oral) 1-5mg(IM) FLUPHENAZINE: 2-20mg/day(oral) More extra pyramidal side effects and tardive dyskinesia

10. BUTYROPHENONES: Haloperidol: High potency and most widely typical antipsychotic drug Features: Very high incidence of extrapyramidal adverse effects and tardive dyskinesia Does not cause weight gain Preffered drug for acute schizophrenia,Huntingtons disease , Tourette’s syndrome 5-30 mg/day oral,5-10 mg(IM)

11. T rifluperidol : 0.5-8.0mg/day oral 2.5-5.0mg(IM) THIOXANTHINE: Flupenthixol : Infrequently used now Indicated in Schizophrenia and aphathetic patient 3-18 mg/day (oral)

12. Other Heterocyclic compounds: Pimozide: Selective DA antagonist with little alpha adrenergic or cholinergic blocking activity Used in Tourett’s syndrome 4-20 mg/day (oral) Loxapine : 25-250 mg/day (oral)

13. USES: ORGANIC PSYCHIATRIC DISORDERS Haloperidol: Delerium ,Dementia , Delerium tremors NON ORGANIC PSYCHOTIC DISORDERS: Schizophrenia Acute psychoses Mania Bipolar disorders Delusional disorders

14. MEDICAL DISORDERS: Haloperidol: Huntington’s chorea, Gilles de la Tourette syndrome Chlorpromazine: Intractable hiccups NEUROTIC AND OTHER PSYCHIATRIC DISORDER: Severe anxiety disorder Refractory obscessive compulsive disorder Anorexia nervosa

15. ADVERSE EFFECTS : CNS: Drowsiness , Lethargy CVS: Postural hypotension , Palpitation Anticholinergic : Dry mouth , Blurred vision Metabolic Disturbance: Blood sugar elevation Extrapyramidal effect: Acute dystonia, Parkinsonism , Akathesia , Neuroleptic malignant syndrome ,Tardive dyskinesia Weight gain