Thioxanthenes (Systemic)Always consult flupenthixol decanoate overdose healthcare provider to ensure the flupenthixol decanoate overdose displayed on this page applies to your personal circumstances. The easiest way to lookup drug information, identify winstrol v doi, check interactions and set up your own personal medication records. Available for Android and iOS devices. Subscribe to decanoqte email notifications whenever new articles are published. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
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Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records.
Available for Android and iOS devices. Subscribe to receive email notifications whenever new articles are published. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. To view content sources and attributions, please refer to our editorial policy. We comply with the HONcode standard for trustworthy health information - verify here. Thioxanthenes Systemic This monograph includes information on the following: CN Commonly used brand name s: Another commonly used name is flupentixol.
For a listing of dosage forms and brand names by country availability, see Dosage Forms section s. Antipsychotic— Indications Accepted Psychotic disorders treatment —Indicated for management of primary and secondary symptoms of psychotic disorders. Antipsychotic—Thioxanthenes are thought to benefit psychotic conditions by blocking postsynaptic dopamine receptors in the brain. They also produce an alpha-adrenergic blocking effect and depress the release of most hypothalamic and hypophyseal hormones.
However, the concentration of prolactin is increased due to blockade of prolactin inhibitory factor PIF , which inhibits the release of prolactin from the pituitary gland. Antiemetic—Chlorprothixene also inhibits the medullary chemoreceptor trigger zone to produce an antiemetic effect. Sedative—Chlorprothixene is also thought to cause an indirect reduction of stimuli to the brain stem reticular system to produce a sedative effect.
Late phase—Approximately 34 hours. Thiothixene—1 to 3 hours. Chlorprothixene—Intramuscular, up to 12 hours. Chlorprothixene and thiothixene—Primarily renal. Flupenthixol—Primarily fecal; some renal. Pregnancy— Studies in humans have not been done. Animal studies have shown no birth defects caused by thioxanthenes. Breast-feeding It is not known if thioxanthenes are distributed into breast milk.
Caution is advised since pharmacologically related phenothiazines are distributed into breast milk, causing an increased risk of tardive dyskinesia and possible drowsiness in the nursing infant. Adolescents should be monitored very carefully during parenteral therapy with thioxanthenes because they tend to experience a higher incidence of hypotensive and extrapyramidal reactions than do adults. These patients usually require a lower initial dosage and a more gradual titration of dose.
Elderly patients appear to be more prone to orthostatic hypotension, and exhibit an increased sensitivity to the anticholinergic and sedative effects of neuroleptics. They are also more prone to develop extrapyramidal side effects, such as tardive dyskinesia and parkinsonism. The signs of tardive dyskinesia are persistent, difficult to control, and, in some patients, appear to be irreversible.
There is no known effective treatment. Careful observation during treatment for early signs of tardive dyskinesia and dosage adjustment of the thioxanthene may prevent a more severe manifestation of the syndrome.
Dental The peripheral anticholinergic effects of thioxanthenes may decrease or inhibit salivary flow, especially in middle-aged or elderly patients, thus contributing to the development of caries, periodontal disease, oral candidiasis, and discomfort.
Extrapyramidal reactions induced by thioxanthenes will result in increased motor activity of the head, face, and neck.
Occlusal adjustments, bite registrations, and treatment for bruxism may be made less reliable. If leukopenia or thrombocytopenia occurs, dental work should be deferred until blood counts have returned to normal, and patients should be instructed in proper oral hygiene, including caution in use of regular toothbrushes, dental floss, and toothpicks.
Combinations containing any of the following medications, depending on the amount present, may also interact with this medication. Although not all of the following interactions have been documented specifically for thioxanthenes, a potential exists for their occurrence because of the close similarity of the pharmacological effects of thioxanthenes with those of phenothiazine medications.
Except under special circumstances, this medication should not be used when the following medical problems exist: A few cases of sudden death have been reported in patients who were receiving phenothiazine derivatives. However, there is no definite evidence that the phenothiazines are causative agents. Dystonic reactions appear most often in children and young adults; usually appear early in treatment and may subside within 24 to 48 hours after medication has been discontinued.
Parkinsonian extrapyramidal effects may be seen in the first few days of treatment, but frequency usually increases with increase of dosage; may be more frequent in elderly patients and older children.
Tardive dyskinesia is initially dose related, but may increase with long-term treatment and total cumulative dose; may persist after discontinuation of thioxanthenes. Heat stroke may occur in environmental conditions of high heat and high humidity. Adequate interior temperature control air-conditioning must be maintained for institutionalized patients during hot weather because of the increased risk of heat stroke and neuroleptic malignant syndrome NMS.
Along with the overt signs of skeletal muscle rigidity, hyperthermia, autonomic dysfunction, and altered consciousness, differential diagnosis may reveal leukocytosis to 26, cells per cubic millimeter , elevated liver enzymes, and elevated creatine phosphokinase CPK.
For more information on the management of overdose or unintentional ingestion, contact a Poison Control Center see Poison Control Center Listing. Clinical effects of overdose The following effects have been selected on the basis of their potential clinical significance possible signs and symptoms in parentheses where appropriate —not necessarily inclusive: Not attempting to induce emesis because a dystonic reaction of the head and neck may develop that could result in aspiration of vomitus.
Administering activated charcoal slurry. Digitalizing for cardiac failure. Benztropine or diphenhydramine may be administered to manage acute parkinsonian symptoms. Patients in whom intentional overdose is known or suspected should be referred for psychiatric consultation.
After a favorable psychiatric response is noted within several days to several months , that dosage should be continued for about 2 weeks, then gradually decreased to the lowest level that will maintain an adequate clinical response. Abrupt withdrawal may cause some patients on high or long-term dosage to experience transient dyskinetic signs, nausea, vomiting, gastritis, trembling, and dizziness.
For parenteral dosage forms only Because hypotension is a common side effect of thioxanthenes, parenteral administration should be used only for patients who are bedfast or for appropriate acute, ambulatory patients who can be closely monitored. A possible exception may be those patients who are dose-stabilized on the extended-action injectable form. Patient should remain lying down for at least half an hour after injection to avoid possible hypotensive effects.
Effects of the extended-action injectable form may last for up to 3 weeks. The precautions and side effects information applies during this period of time. For treatment of adverse effects Neuroleptic malignant syndrome NMS: Treatment is essentially symptomatic and supportive and may include: Bromocriptine 5 to 7. Many authorities advise that the only appropriate treatment of extrapyramidal symptoms is reduction of the antipsychotic dosage, if possible.
Oral antidyskinetic agents such as trihexyphenidyl 2 mg three times a day , or benztropine, may be effective in treating more severe parkinsonism and acute motor restlessness but should be used sparingly, and then usually for no longer than 3 months.
Milder effects may be treated by adjusting dosage. However, in the elderly patient, the use of amantadine to mg at bedtime minimizes the severe anticholinergic effects that may occur with other antidyskinetics. May be treated with antidyskinetic agents, or with propranolol 30 to mg a day ; nadolol 40 mg a day ; pindolol 5 to 60 mg a day ; lorazepam 1 or 2 mg two or three times a day: Acute dystonic postures or oculogyric crisis may be relieved by parenteral administration of benztropine 2 mg intramuscularly , or diphenhydramine 50 mg intravenously or intramuscularly , or diazepam 5 to 7.
Dosage adjustments of the thioxanthene may control these effects, and discontinuation may reverse severe symptoms. Tardive dyskinesia or tardive dystonia: No known effective treatment. Dosage of thioxanthene should be lowered or medication discontinued, if clinically feasible, at earliest signs of tardive dyskinesia or tardive dystonia, to prevent possible irreversible effects. What Is Gene Therapy? How Does It Work? Want to Quit Smoking? Crysvita Crysvita burosumab-twza is a fibroblast growth factor 23 FGF23 blocking antibody for the Tavalisse Tavalisse fostamatinib is an oral spleen tyrosine kinase SYK inhibitor for the treatment of Symfi Symfi efavirenz, lamivudine and tenofovir disoproxil fumarate is a three-drug combination of a Ilumya Ilumya tildrakizumab-asmn is a humanized, anti-ILp19 monoclonal antibody for the treatment of