Aminazin 25mg Danapha medicine for schizophrenia (500 tablets)

chlorpromazine is an antidepressant on the central nervous system, which has the effect of alpha adrenergic and cholinergic resistance. Chlorpromazine inhibits dopamine and prolactin release inhibitors, thus stimulating prolactin release. Increasing dopamine rotation in the brain.

chlorpromazine has anti -vomiting, anti -itching, serotonin blockers, weak antihistamines and mild anti -blockage. Chlorpromazine also has the effect of inhibiting the center of regulation of the body temperature, relieving pain and muscle relaxation.

chlorpromazine alpha adrenergic blockers causes vasodilation, hypotension, heart beating fast, reducing saliva secretion and gastric juice.

pharmacokinetic

absorption

chlorpromazine is quickly absorbed through the gastrointestinal tract but is significantly metabolized in the intestine and liver. After drinking, the peak concentration in plasma is achieved after about 1-4 hours. The oral absorption fluctuates and not completely about 10 - 80 % of the oral dose into the circulatory system. The peak concentration in plasma varies from the individuals.

distribution

Widely distributed into the body's tissues, overcome the blood -brain barrier and achieve a higher brain concentration in plasma. The average distribution of chlorpromazine is quite large, ranging from 10 - 35 l/kg (average 22 l/kg). High protein ratio (90 - 99 %).

chlorpromazine has been detected in urine up to a year after stopping medication in chronic treatment.

transformation

Chloropromazine metabolism is very complicated. There are more than 150 metabolites and half of them are detected in blood and urine. The metabolism is mainly in the liver, including methyl separation, nitrogen oxidation, sulfur oxidation, amino reducing and conjugate. Clinically significant metabolites are 7 - hydroxychlorpromazine, 3 - Hydroxy chlorpromazine, desmethylchlorpromazine and chlorpromazine n -olite, all have biological activity; and chlorpromazine sulphoxid, without biological activity. Chlorpromazine is almost completely metabolized, less than 1 % excreted through the urine in the form of constant.

Serum concentration reaches the treatment level of about 100 - 300 ng/ml and the concentration of toxicity appears about 750 ng/ml but monitoring the routine serum concentration is not necessary. Serum concentration in chronic doses may be lower than the concentration achieved when using acute doses.

Elimination

chlorpromazine and its metabolites are eliminated through the urine, a small amount through feces and very little amount through sweat, hair.

The average amount of excretion in urine for 24 hours is about 43 - 65 % daily. Half of the lifetime of the drug has a great difference between patients. There may be various elimination stages, about 2-3 hours early, about 15 hours of intermediaries, the final stage of up to 60 days.

Notice the physician unwanted effects when using Aminazin.

Precautions when using

Blood test: There has been a report of granulocytes but rarely, especially in the first 3 months of treatment. Platelets, hemolytic anemia rarely occur. Patients should immediately notify the doctor if there is a fever, sore throat or any infection. Stop treatment if there is a blood disorder in the later stage.

Malignant neuroleptic syndrome: When there is an unspecified cause of hypertension, it is necessary to stop treating because this may be a sign of malignant neurolithic sedation (pale, lower body heat, autonomy neurological disorders). Signs of autonomy neurological disorders are to increase sweat, irregular blood pressure occurs before increasing body temperature.

Phenothiazine can cause a QT range, thus causing serious ventricular tachycardia, which can die. The risk of extending the QT distance increases when the patient has a slow heart rate, hypokalemia, prolonging the congenital QT or suffering. If possible, it is necessary to conduct evaluation to eliminate risk factors before sedative treatment and evaluate during treatment.

If clinical assessment is possible, it is necessary to eliminate the factor that supports the onset of ventricular arrhythmia before taking the drug including: the heart rate slower than 55 beats/minute, hypokalemia, prolonged congenital QT, or continuous treatment with the drug causing these conditions.

Except for emergency, it is recommended to evaluate ECG in patients using sedatives.

Except for special cases, do not use chlorpromazine in Parkinson patients.

Simultaneous use of chlorpromazine with lithium, other QT extended drugs, Parkinson's dopamine anti -Dopamine drugs are not recommended. Parkinson's medication should not be used regularly because of increasing the chlorpromazine anti -chlorpromazine resistance, which seriously causes side effects and reduces the effectiveness of chlorpromazine treatment.

Use cautiously in patients at risk of thrombosis because of death reports in patients with venous thromboembolism using anti -psychotic drugs.

Use cautiously in patients at risk of stroke.

Elderly patients with intellectual decline: Elderly patients with mental illness related to intellectual dementia are treated with anti -psychotic drugs at risk of increased death.

Light sensitive reactions may occur, many cases of skin rash and other reactions including diverse skin and rash pink have been reported. Advise patients who are taking excessive pills.

There have been reports on cases of high fever or lower body heat, common at medium or high doses. In the elderly or under the thyroid defect, the more susceptible to body heat.

Hyperglycemia or glucose intolerance has been reported in patients using chlorpromazine. Hematoma monitoring should be monitored during treatment in patients with diabetes or at risk of diabetes.

Objects need to be closely monitored when using chlorpromazine:

Epilepsy: It is necessary to stop taking the drug if the seizure occurs.

Elderly patients: Due to sensitivity to the effects of lowering hypotension, pain relief, and foreign tower. Chronic constipation (risk of bowel obstruction), prostate hypertrophy can occur.

Patients with cardiovascular disease: The drug can cause tachycardia, hypotension.

Patients with severe liver failure or kidney failure: There is a risk of drug accumulation.

Patients with prolonged treatment should be recommended for eye and hematology.

Advise patients not to use alcohol during treatment.

chlorpromazine rarely causes jaundice related to congestion in sub -bile, some cases showing fever and eosinophilia. This reaction is all stopped using the drug, very rare reports on the progression of liver disease. In most cases, jaundice appears from 1-4 weeks after the beginning of treatment. Chlorpromazine treatment should be stopped and not used again.

Constipation, heavy, large, large colon has been reported, signs of intestinal obstruction may be obscured by the anti -vomiting effect of chlorpromazine. The appearance of intestinal paralysis, manifested by abdominal pain and abdominal distention, must be considered as an emergency.

Aminazin suspension symptoms include nausea, vomiting and insomnia are rarely described after a sudden suspension of high doses of chlorpromazine. Need to stop the drug gradually.

Chlorpromazine pills are not used to treat behavioral disorders associated with intellectual decline.

Lactose -containing drugs, patients with rare genetic problems such as congenital galactosemia disorders, glucose or galactose intolerance syndrome, lactase deficiency, galactose intolerance or lapp lactase deficiency should not be used.

Aminazin contains sugar, patients with rare genetic problems are absorbed in Glucose-Galactose should not use this drug.

The drug contains starch starter, used in patients with fat diarrhea (gluten -sensitive intestinal disease). Patients allergic to wheat should not be used.

The drug contains erythrosin, which can cause some allergic reactions.

Using drugs for women during pregnancy and lactation

Pregnancy

There is no teratogenic effect when exposed to chlorpromazine during pregnancy but there is evidence of harmful effects on animals, so avoid taking medication during pregnancy unless the doctor's consideration is necessary. Advise the mother to keep psychological balance during pregnancy. If treatment is necessary, it is necessary to be effective with effective dose; During pregnancy.

Babies exposed to chlorpromazine in the last 3 months of pregnancy are at risk of foreign tower symptoms and/or cessation syndrome, different in terms of level and postpartum time. There has been a stimulating report, tremor, hypotension, leukemia, respiratory failure, so careful monitoring of infants should be monitored.

Breastfeeding period

Because chlorpromazine secretes milk into milk that is likely to cause dangerous harmful reactions to breastfeed, so if the mother should stop breastfeeding when the mother should stop breastfeeding.

The effect of the drug on the ability to drive and operate machinery

Because Aminazin medicine reduces alertness, can cause chicken sleep, should not drive or operate machinery while using the drug.

Drug interaction

Dopamine drew (Quinagolid, Cabergolin), excluding Parkinson's treatment: Contraindicated use with chlorpromazine because of the antagonistic between dopamine and sedative medicine.

Uncountable coordination

Parkinson's dopamin agreement (Amantadin, Bromocriptin, Cabergolin, Levodopa, Lisurida, Pergolid, Piribedil, Ropinirol): There is an antagonistic between Parkinson's treatment and sedative.

Levodopa: Antagonism between Levodopa and sedative, it is necessary to recommend the lowest dosage of each drug in Parkinson patients.

The drug extends the QT interval: Concentrated with chlorpromazine and drugs that extend the QT interval such as anti -arrhythmia, other anti -psychotic drugs, electrolyte imbalance drugs increase the risk of arrhythmia.

Alcohol: Alcohol increases the sedative effect of anti -psychotic drugs, should avoid drinking alcohol while being treated with chlorpromazine.

Lithium: Concomitant use with sedative can cause increased lithium concentration in the blood, which can increase toxicity to nerves.

Caution should be careful

Diabetes treatment: Precautions when combined with high doses of chlorpromazine (100 mg/day), because it can increase blood sugar levels (due to insulin secretion). Prior notice to patients and advise patients to increase blood and urine self -test. If necessary, adjust the dose of diabetes treatment during and after treatment with anti -psychotic drugs.

Antacuvenosis: Slows chlorpromazine absorption, does not simultaneously use chlorpromazine and antacids, can be used for 2 hours apart.

The combination should be considered

High blood pressure medication: Increasing the effect of hypertension, which can cause vertical hypotension. Phenothiazine increases the effectiveness of hypotension of anesthesia and calcium channel blockers. Severe hypotension can occur when concurrent chlorpromazine and angiotensin enzyme inhibitors.

Atropine and derivative: Imipramine antidepressants, Histamine III receptor antagonists, cholinergic resistance, Parkinson's anti -Parkinson, anti -spasms, dyopyramids increase Atropine side effects such as urinary retention, constipation, mouth dryness.

Other central neurological inhibitors: Morphin, barbiturat, benzodiazepine, other Benzodiazepin, anti -blood pressure anxiety drugs that can increase the inhibition of the central nervous system. Respiratory inhibitors can occur.

The effect of some drugs may be antagonistic by chlorpromazine, including amphetamine, clonidin, Guathenidin, adrenalin.

Chlorpromazine anti -disorder anti -disorder effects can be reduced, some drugs may affect the absorption of sedatives such as antacids, Parkinson's anti -acid drugs.