Drugs Blog

Type of Drug:

Atypical antipsychotic.

How the Drug Works:

Atypical anti psychotics act upon several neurotransmitter systems, including antagonism at one or more types of dopamine receptors, antagonism at alphacadrenergic receptors, and activity at muscarinic, histamine H1 , or nicotinic receptors.

Uses:

For the treatment of schizophrenia.

Olanzapine: For the short-term treatment of acute manic episodes associated with Bipolar I disorder.

Precautions:

Tardive dyskinesia: InvOluntary and uncontrollable movements may develop in patients treated with antipsychotic drugs. Occurrence is high­Specially women. However, it is impossible to predict which patients are likely to develop the syndrome. The risk of developing these involuntary movements and the likelihood they will become permanent are increased with long-term use and with high doses. However, it is possible to develop these symptoms after short­term treatment at low doses. The syndrome is characterized by rhythmical, involuntary movements of tongue, face, mouth, or jaw (eg, protrusion of toQue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs. Fine worm-like movement of the tongue may be an early sign of the syndrome. If the medication is stopped at this time, the syndrome may not develop further. There is no known treatment for established cases of tardive dyskinexia, although the syndrome may stop, partially or completely, if the drug is Withdrawn. Antipsychotic treatment, however, may suppress or partially suppress the signs and symptoms of the syndrome and thereby possibly mask the underlying disease process. The effect that symptomatic suppression has upon the long-term course of the syndrome is unknown.

Neuroleptic Malignant Syndrome (NMS): Is a potetially fatal syndrome oscillated with antipsychotic drugs. Symptoms Include fever, muscle rigidity, altered mental abilities, irregular pulse and blood pressure, increased heart rate, sweating, and irregular heart rhythm.

Seizures: Seizures have occurred during therapy with some antipsychotic agents. The likelihood of seizure becomes greater at higher doses.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits out­weigh the possible hazards to the fetus.

Breastfeeding: It is not known if these drugs are excreted in breast milk. Do not use breastfeed while taking one of these drugs.

Children: Safety and effectiveness of loxapine in patients younger than 16 years of age have not been established. Safety and effectiveness of clozapine, olanzapine, and quetiapine have not been established.

Lab Tests: Lab tests will be required to monitor therapy. Tests include blood counts and liver function.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-cOunter or prescription medications or dietary supplements with these drugs. Doses of one or both drugs may need t o be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with these drugs:

• Anticholinergics (eg, diphenhydramme)
• Antihypertensives (eg, methyldopa)
• Dopamine agonists (eg, bromo criptine)
• Phonyton (eg, Dilantin)

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy and individual susceptibility. Possible side effects include:

Circulatory System: Increased heart rate; changes in blood pressure; chest pain; abnormal blood counts; increased cholesterol levels.

Nervous System: Drowsiness; dizziness; agitation; confusion; seizures; aggressiveness; amnesia; anxiety; disturbed sleep; personality disorder; restlessness; rigidity; slurred speech; stuttering; fainting; tremor.

Digestive Tract: Constipation; dry mouth; stomach pain; diarrhea; nausea; vomiting; increased appetite.

Respiratory System: Coughing; difficulty breathing; runny nose; nasal; gestion; upper respiratory tract infection.

Other: Rash; orthostatic hypotension (dizziness or light-headednes that occurs when rising quickly from a seated or lying position); prolontion erection; Parkinson-like symptoms; Neuroleptic Malignant Syndromo; dive dyskinesia; dry skin; toothache; premenstrual syndrome; swelling of the arms or legs; joint, muscle, or back pain; twitching; sore thronl; weakness; fever; sweating; visual disturbances; weight gain; false­positive pregnancy tests.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor.
• Orally-disintegrating tablets – Peel back foil blister; do not push tablet through the foil. Using dry hands, remove and place the entire tablet in your mouth. The tablet will dissolve with or without liquid.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, con­tact your doctor or pharmacist.
• May take several weeks before maximum benefit is obtained.
• May cause drowsiness, dizziness, or seizures. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
• Orthostatic hypotension (dizziness or drowsiness when rising quickly from a seated or lying position) may occur. Avoid sudden changes in posture.
• Notify your doctor immediately if you experience abnormal or impaired vision, lethargy, weakness, sore throat, general body discomfort, mucous membrane ulcerations, flu-like symptoms, tremor, muscle twitching or stiffness, or yellowing of the skin or eyes (jaundice).
• Use caution in hot weather. These drugs may increase the possibility of heat stroke. Avoid overheating and dehydration.
• Avoid consuming alcoholic beverages and other mental depressants (eg, narcotics, antihistamines) while taking this medicine.
• Inform your doctor if you are pregnant, become pregnant, plan on becoming pregnant, or are breastfeeding.
• Lab tests will be required to monitor therapy. Be sure to keep appointments.
• Store at controlled room temperature (59° to 86°F). Protect from light and moisture.

Type of Drug:

Typical (conventional) antipsychotic.

How the Drug Works:

The exact mechanism is not known. Drugs of this type usually work by altering nerve transmission in the brain.

Uses:

For the management of the manifestations of psychotic mental disorders

Precautions:

Neuroleptic Malignant Syndrome (NMS): NMS is a potentially fatal syndrome associated with antipsychotic drugs. Symptoms include fever, muscle rigidity, altered mental abilities, irregular pulse and blood pressure, increased heart rate, sweating, and irregular heart rhythm.

Tardive dyskinesia: Involuntary and uncontrollable movements may develop in patients treated with antipsychotic drugs. Occurrence is highest in the elderly, especially women. However, it is impossible to predict which patients are likely to develop the syndrome. The risk of developing these involuntary movements and the likelihood they will become permanent are increased with long-term use and with high doses. However, it is possible to develop these symptoms after short­term treatment at low doses. The syndrome is characterized by rhythmical, involuntary movements of tongue, face, mouth, or jaw (eg, protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs. Fine worm-like movement of the tongue may be an early sign of the syndrome. If the medication is stopped at this time, the syndrome may not develop further. There is no known treatment for established cases of tardive dyskinexia, although the syndrome may stop, partially or completely, if the drug is withdrawn. Antipsychotic treatment, however, may suppress or partially suppress the signs and symptoms of the syndrome and thereby may possibly mask the underlying disease process. The effect that symptomatic suppression has upon the long-term course of the syndrome is unknown.

Pregnancy: There are no adequate and well controlled studies in pregnant women. Use only if clearly needed and potential benefits outweigh the possible risks to the fetus.

Breastfeeding: It is not known if thiothixene appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness in children younger than 12 years of age have not been established.

Lab Tests: Lab tests or exams may be required to monitor treatment. Tests include blood and liver tests and periodic eye exams.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over-the-counter or prescription medications or dietary supplements with this drug. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with this drug:

• alcohol atropine (eg, lsopto Atropine)
• barbiturates (eg, phenobarbital)
• benztropine (eg, Cogentin)
• bromocriptine (Parlodel)
• chloroquine (eg, Aralen)
• guanadrel (eg, Hylorel)
• guanethidine (eg, Ismelin)
• levodopa (eg, Larodopa)
• lithium (eg, Eskalith)
• phenytoin (eg, Dilantin)
• propranolol (eg, Inderal)
• trazodone (eg, Desyrel)

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors, including dose, duration of therapy and individual susceptibility. Possible side effects include:

Digestive Tract: Indigestion; stomach pain; constipation; appetite changes; diarrhea; nausea; vomiting.

Nervous System: Altered mental status; orthostatic hypotension (dizzines or light-headedness when rising quickly from a sitting or lying position); fainting; drowsiness; impaired judgment, thinking or motor skills; head­ache; restlessness; agitation; light-headedness; sleeplessness; seizures.

Circulatory System: Rapid heartbeat; changes in blood pressure; pounding in the chest (palpitations); abnormal blood counts.

Other: Rash; fever; muscle rigidity; sweating; acute kidney failure; involuntary and uncontrollable movements (eg, protrusion of tongue, puffing of cheeks; puckering of mouth, chewing movements); lens problems; dry mouth; weakness; weight gain; tight muscles; joint pain; swelling of arms and legs; lactation; moderate breast enlargement (women); absence of menstruation; increased or decreased blood sugar; blurred vision; nasal congestion; increased salivation; impotence; increased thirst; itching; sensitivity to light.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose is missed or if it is necessary to establish a new dosage schedule, con­tact your doctor or pharmacist.
• May cause dizziness, light-headedness, or fainting, especially when rising or standing and during the first 3 to 5 days. If these symptoms should occur, sit or lie down and contact your doctor. Use caution while driving or performing hazardous tasks requiring alertness, coordination, or physical dexterity.
• Do not take other medications without your doctor’s approval. This includes nonprescription medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
• Avoid alcohol and other mental depressants (eg, narcotics, tranquilizers, antihistamines) while you are taking this medicine.
• Inform your doctor if you are pregnant, become pregnant, are planning to become pregnant, or are breastfeeding.
• Avoid overheating and dehydration.
• Lab tests may be required to monitor treatment. Be sure to keep appointments.
• Store at a controlled room temperature (59 to 77°F).