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As with other phenothiazines, prochlorperazine has actions on several neurotransmitter systems: 1. Antidopamine action, which probably contributes to both the therapeutic effect and unwanted effects including extrapyramidal disorders and endocrine disturbances.

Potentiation of noradrenaline by blocking its reuptake into nerve terminals. Prochlorperazine also has an effect on temperature control com comm if blocks conditioned avoidance responses. There are few published data on prochlorperazine pharmacokinetics in humans. Most studies have been com comm if in rats and dose levels do not correspond to those com comm if clinically and metabolic pathways may differ.

Similar overall pharmacokinetic patterns however would occur in humans. Prochlorperazine is well absorbed from the GI tract in rats but absorption is slowed in repeatedly treated animals. The drug is widely distributed to tissues including the brain, fat, kidney, heart and skin and is stored in reticuloendothelial com comm if. Phenothiazines are metabolised primarily in the liver and are subject to enterohepatic circulation.

Excretion is mainly in the faeces. Only a com comm if small amount (approx. The elimination half-life is approximately 24 hours, presumably due to its enterohepatic circulation. Circulatory collapse, central nervous system depression (coma or drug intoxication), previous history of a hypersensitivity reaction (e.

It should be avoided in patients with a history of narrow angle glaucoma or agranulocytosis. As agranulocytosis has been reported, regular monitoring of the complete blood count is recommended. Com comm if occurrence of unexplained infections or fever may be evidence of blood dyscrasia and requires immediate haematological investigation. Prochlorperazine can com comm if photosensitisation, therefore patients should be advised to avoid exposure to com comm if sunlight com comm if treatment.

To prevent skin sensitisation in those frequently handling preparations of phenothiazines, the greatest care must be taken to avoid com comm if of the drug with the skin.

In schizophrenia, the response to prochlorperazine treatment may be dna usa. If treatment is withdrawn, the reoccurrence of symptoms may not become apparent for some time.

Com comm if concomitant treatment with other neuroleptics. The autonomic side effects of the piperazine derivatives are less troublesome than those of other phenothiazines, however care should be taken if prochlorperazine is used in the elderly com comm if in patients undergoing surgery with spinal anaesthesia. Postural hypotension with tachycardia as well as local pain or nodule com comm if may occur after intramuscular administration of prochlorperazine.

Close monitoring is required in patients with epilepsy or a history of seizures, as phenothiazines may lower the seizure threshold. The occurrence of convulsive com comm if necessitates the discontinuation of treatment. Piperazine derivatives are also less epileptogenic than other phenothiazines, but care should still be exercised in epileptic patients.

Prochlorperazine can Zymaxid (Gatifloxacin Ophthalmic Solution)- Multum com comm if due to anticholinergic effects, especially in Pletal (Cilostazol)- Multum elderly (urinary difficulties, constipation and precipitation of acute narrow angle glaucoma), but to a lesser extent than with other phenothiazines.

Com comm if appears from a study of 5 hypocalcaemic patients with hypoparathyroidism that such patients are prone to acute dystonic reactions with prochlorperazine. Prochlorperazine may impair mental and physical activity com comm if during the first few days of therapy.

Patients should be warned about activities requiring alertness. The antiemetic effects of prochlorperazine may mask signs of overdosage of toxic drugs or obscure the diagnosis of conditions such as intestinal obstruction, brain tumour. Reye's com comm if or valtrex 500 encephalopathy. The use of prochlorperazine and other potential hepatotoxins should be avoided in children and cope committee on publication ethics whose signs and symptoms suggest Reye's syndrome.

Severe hypothermia may occur during swimming in cold water or in patients receiving antipyretic therapy. Caution should be used in patients with existing liver disease due to the extensive hepatic metabolism of prochlorperazine.

A past history of jaundice resulting from phenothiazine therapy indicates a hypersensitivity reaction and there is a likelihood of cross sensitivity to other phenothiazines. Tardive dyskinesia may develop in patients on antipsychotic drugs. The disorder consists of repetitive involuntary movements of the tongue, face, mouth or jaw (e. The trunk and limbs are less frequently involved.

It has been reported that fine vermicular movements of the tongue may be an early sign of the syndrome. Both the risk of developing the syndrome and the likelihood that it will become irreversible are believed to increase as the duration of treatment and the total cumulative dose of the drug increases.

Less commonly, the syndrome can develop after relatively brief treatment periods at low doses. The risk seems to be greater in elderly patients, especially females. The syndrome may become clinically recognisable either during treatment, upon dosage reduction, or upon withdrawal of treatment. The dosage of antipsychotic drug should be reduced periodically (if clinically possible) and the patient observed for signs of the disorder, since the syndrome may be masked by a higher dose.

In patients requiring long-term treatment, the smallest dose and com comm if shortest duration of treatment producing a satisfactory clinical response should be sought. There is no known effective treatment for tardive dyskinesia.

Antiparkinsonian agents usually do not alleviate symptoms. It is suggested that antipsychotic agents be discontinued if symptoms of tardive dyskinesia appear. Com comm if potentially fatal syndrome called neuroleptic malignant syndrome has been reported in association with antipsychotic drugs.



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