antipsycho & alcohol

7/30/2019 Antipsycho & Alcohol

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Antipsychoticsand

AlcoholDr. Rathnakar U.P.

MD.DIH.PGDHM


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Use of Ethyl alcohol Antiseptic: 70% alcohol is used as an antiseptic. Trigeminal and other neuralgias :

Injection of alcohol directly into nerve trunks relieves pain bydestroying them. Prevent bedsores: Alcohol is used locally to prevent bedsores in bedridden patients. Methanol poisoning :

Ethanol competes with methanol for metabolic enzymes andsaturates them. Hence, prevents the formation of toxicmetabolites of methanol (formaldehyde and formic acid).

Fever: Alcoholic sponges are useful to reduce body temperature.


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RUG TREATMENT OF CHRONIC ALCOHOLISM

1. Psychotherapy, occupational therapy and rehabilitation.2. Drug therapy

a. Disulphiram (alcohol aversion therapy): It causes aversion to alcohol.


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Methanol

Methanol is a mild CNS depressant. It is metabolized to formaldehyde and formic acid Cause metabolic acidosis and injury to the retina. Metabolic acidosis is due to formic acid, and it also

causes dimness of vision, retinal damage andblindness.

The signs and symptoms of methanol poisoningare nausea, vomiting, abdominal pain, headache,vertigo, confusion, hypotension, convulsions andcoma.


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Dark room Stomach wash-NaHCO3

i.v.NaHco3 Ethyl alcohol, Fomepazole


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Dr.U.P.RathnakarMD. DIH. PGDHM

Antipsychotics


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Antipsychotics

Classical:

PhenothiazinesChlorpromazine

TriflupromazineHaloperidol,

Atypical

Clozapine Risperidone Olanzapine


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Chlorpromazine[CPZ]MOA & Pharmacological

actions Beneficial D2 Blockade

ADEs D2 Blockade

Anticholinergic Adrenergic block Direct on heart H1 Block

Beneficial Antipsychotic effect

ADEs Extrapyramidal effect Galactorrhoea,

Gynaecomastia

Dryness Hypotension Arrhythmia Weight gain, sedation


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CPZ-actions

In Normal person: Indifference to

surroundings, Psychomotor

slowing, Drowsiness,

Unpleasant effects- Neuroleptic

syndrome*

In psychotics Reduces irrational

behavior Aggression and

agitation Psychotic symptoms

Sedation-Tolerancedevelops


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ADEs effects of CPZ

Extrapyramidal effectsParkinsonism

Acute muscle dystonia Akathisia Malignant neuroleptic syndrome

Tardive dyskinesia Other ADEs

Cholestatic jaundice, Agranulocytosis,

Myocarditis, dryness of mouth, wt gain


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Uses of antipsychotics

Psychoses[Schizophrenia]

a. Atypical

preferred[Less adverseeffects, more effectivein negative symptoms]

Antiemetic Intractable hiccough Mania


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Antipsychotics

Classical

More action on DAreceptors

Effective in positivesymptoms

More adverse effects

Atypical

Less. More in 5HT

Effective in negativesymptoms

Less ADEs

antipsycho & alcohol

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