Haloperidol + Benzhexol Pharmacology
Haloperidol + Benzhexol
Haloperidol
In Tourette syndrome the mechanism of action is not known. It has many central and peripheral effects. It produces antiemetic effects and alpha and ganglion blockade and counteracts histamine and serotonin mediated activity.
Anaesthetic adjuncts: It is used as anaesthetic adjunct since it allays anxiety, smoothen induction and produce antiemetic action.
2.Extrapyramidal reactions
3.Leucopenia
4.Restlessness
5.Seizure
6.Weight gain
7.Muscle stiffness
8.Nausea
9.Blurred vision
10.Lethargy
11.Gynecomastia
12.Dystonia
13.Tremor
2.Parkinson`s disease
3.Depression
4.Comatose
2.Renal impairment
3.Cardio vascular diseases
4.Epilepsy
5.Narrow angle glaucoma
6.Parkinsonism
7.Urinary retention
8.Thyrotoxicosis
9.Slowly withdraw the drug with caution
CHILDREN below 3 years: contraindicated
2.Tourette`s syndrome
3.Hiccups
4.Severe tics
Almunium Salts: Decrease efficacy. Antacids should be given 1 hour before or 2 hours after haloperidol.
Anticholinergics: Decrease efficacy and increase the anticholinergic side effects of haloperidol.
Barbiturates: Decreases efficacy.
Barbiturate anaesthetics: Increase frequency and severity of neuromuscular excitation and hypotension.
Bromocriptine: Efficacy decreased by haloperidol.
Charcoal: Prevents absorption of haloperidol.
Epinephrine, Norepinephrine: Pressor effect decreased, peripheral vasoconstrictive effect antagonised.
Lithium: Disorientation, unconsciousness and extra-pyramidal symptoms.
Meperidine: Excessive sedation and hypotension.
TCAs: Serum concentration increased by haloperidol.
Valproic acid: Efficacy potentiated.
Propranolol: Increased plasma levels of both drugs.
MAOIs: Additive orthostatic hypotensive effect.
Lab. Tests: Pregnancy tests: False positive results.
Plasma bound iodine (PBI): Increase in PBI occurs.
Initial dose: 0.5 - 5 mg 2 or 3 times a day then dose can be gradually decreased or increased to 100 mg / day based on patient`s response.
Maintenance dose: 5 - 10 mg daily.
Anxiety: 1 mg / day in 2 divided doses
Hiccups: 4.5 mg / day in 3 divided doses
Tourette`s syndrome and severe tics: Initial dose of 0.5 to 1.5 mg three times daily and dose can be increased up to about 10 mg daily may be needed in Tourette`s syndrome.
In palliative care, haloperidol has been given in a dose of 1 to 3 mg every 8 hours by mouth for the treatment of restlessness and confusion.
Children: Initial dose: 25 - 50 mg / kg body weight / day in 2 divided doses
Maximum dose: 10 mg / day
Benzhexol
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