Raiyyan Tahsan

Raiyyan Tahsan
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Pharmacology Case No12. Drug Parkinsonism.

যেসব Drug গুলো Parkinsonism করতে পারে

Anti-Phychotic (Neuroleptic drugs:-

Chlorpromazine (Tab1:- Opsonil 200 mg As a Chlorpromazine Hydrochloride AS A Anti-emetic drugs, Phenothiazine drugs, Phenothiazine related drugs)

Indications of (Tab1:- Opsonil 200 mg As a Chlorpromazine Hydrochloride AS A Anti-emetic drugs, Phenothiazine drugs, Phenothiazine related drugs)

Opsonil is indicated in the following conditions:

  • Schizophrenia and other psychoses (especially paranoid), mania and hypomania.
  • In anxiety psychomotor agitation excitement, violent or dangerously impulsive behaviour. Opsonil is used as an adjunct in the short-term management of these conditions.
  • Intractable hiccup.
  • Nausea and vomiting of terminal illness (where other medicines have failed or are not available).

Childhood schizophrenia and autism.

Haloperidol (Halopid)

Tablet 2:-Halopid 5mg (AS A Haloperidol AS A Butyrophenone drugs, Drugs used in tremor, tics & related disorder).

Indications of Tablet 2:-Halopid 5mg (AS A Haloperidol AS A Butyrophenone drugs, Drugs used in tremor, tics & related disorder).

In low doses-

  • nervousness, anxiety states and associated psychic disorders as irritability gressiveness, psychic lability and insomnia
  • functional disorders caused by anxiety states such as trembling, thorax oppression, gastrointestinal hypermotility and digestive disorders
  • tics and stuttering
  • nausea and vomiting

In higher doses-

  • psychomotor agitation in mania, dementia, acute and chronic schizophrenia, alcoholism
  • delusions and hallucinations in acute and chronic schizophrenia, acute confusion
  • choreatic movements
  • behavior and character disorders in children
  • tics and stuttering
  • vomiting
  •  

Dopaminergic neuron blocker

Resepine

Tetrabenazine(Benazin)

Tablet 3:Ticstop 12.5mg (AS A Tetrabenazine AS a Atypical neuroleptic drugs).

Indications of Tablet 3:Ticstop 12.5mg (AS A Tetrabenazine AS a Atypical neuroleptic drugs).

 

Ticstop is indicated for the treatment of chorea associated with Huntington’s disease,

Metoclopramide(Metocol)

Tablet 4:- Nutramid 10 mg (AS A Metoclopramide Hydrochloride AS A Anti-emetic drugs, Prokinetic drugs).

Indications of Tablet 4:- Nutramid 10 mg (AS A Metoclopramide Hydrochloride AS A Anti-emetic drugs, Prokinetic drugs).

Nutramid nasal spray: This is a dopamine-2 (D2) antagonist indicated for the relief of symptoms in adults with acute and recurrent diabetic gastroparesis.

Nutramid tablet:

  • This is indicated in the treatment for 4 to 12 weeks of symptomatic, documented gastroesophageal reflux in adults who fail to respond to conventional therapy.
  • Relief of symptoms in adults with acute and recurrent diabetic gastroparesis.

Nutramid Injection:

  • Diabetic Gastroparesis (Diabetic Gastric Stasis): Nutramid Injection is indicated for the relief of symptoms associated with acute and recurrent diabetic gastric stasis.
  • The Prevention of Nausea and Vomiting Associated with Emetogenic Cancer Chemotherapy: Nutramid Injection is indicated for the prophylaxis of vomiting associated with emetogenic cancer chemotherapy.
  • The Prevention of Postoperative Nausea and Vomiting: Nutramid Injection is indicated for the prophylaxis of postoperative nausea and vomiting in those circumstances where nasogastric suction is undesirable.
  • Small Bowel Intubation: Nutramid Injection may be used to facilitate small bowel intubation in adults and pediatric patients in whom the tube does not pass the pylorus with conventional maneuvers.
  • Radiological Examination: Nutramid Injection may be used to stimulate gastric emptying and intestinal transit of barium in cases where delayed emptying interferes with radiological examination of the stomach and/or small intestine.

Alfa-Methyl dopa

Tablet 5: Co-Dopa CR (200mg+50mg) (Levodopa +Carbidopa) (AS A Antiparkinson drugs.)

Indications of Tablet 5: Co-Dopa CR (200mg+50mg) (Levodopa +Carbidopa) (AS A Antiparkinson drugs.)

 

Idiopathic Parkinson’s disease, in particular to reduce off-period in patients who previously have been treated with levodopa/decarboxylase inhibitors, or with levodopa alone and who have experienced motor fluctuations.

Valproic Acid(Sodium Valproate)

Tablet 6:-Valoate CR 200mg (AS A Sodium Valproate AS A Primary anti-epileptic drugs)

Indications of Tablet 6:-Valoate CR 200mg (AS A Sodium Valproate AS A Primary anti-epileptic drugs)

 

Valoate CR is indicated for the treatment of all types of epilepsy, e.g.

  • Partial seizures
  • Absence seizures (petit mal)
  • Generalized tonic-clonic seizures (grand mal)
  • Myoclonic seizures
  • Atonic seizures
  • Mixed seizures that include absence attack
  • Prophylaxis of febrile convulsion
  • Prophylaxis of post-traumatic epilepsy.

Valoate CR is also indicated in the treatment of bipolar disorder & prophylaxis of migraine.

এই ড্রাগ গুলো Parkinsonian Syndromeকরতে পারে Usually after 3 month*

Parkinsonism এর 1st line treatment হিসেবে (Levodopa +carbidopa ) use করা হয়✔️Why combo?

Dopamin BBB ক্রস করতে পারে না।

Parkinsonism এ মুলত Basal ganglia তে Dopamin এর activity কমে যায় ।আর Dopamin যেহেতু BBB ক্রস করতে পারে না .তাই Prodrug হিসেবে Dopamin এর সাথে levodopa use করা হয়।

কিন্তু এই levodopa ভাই আবার BBB ক্রস করার আগেই Peripheral Dopa Decarboxylase enzyme দিয়ে Dopamin হয়ে যায়.! So নো থেরাপিউটিক Effect!

এইজন্য Levodopa এর সাথে Carbidopa combination use করা হয়,, যাতে এটা Peripheral dopa decarboxylase enzyme কে inhibit করে & Dopamine কে Peripheral Conversion হতে দেয় না + Peripheral Metabolism কমায় ! & Increase CNS availability of L-Dopa

Contraindications of L-Dopa.

• Psychotic Pt

• Angle closure Glacucoma

• PUD

•Melanoma

Raiyyan Tahsan ❤️ Date :-14-01-2025 Tuesday Time:-2-22-45 pm

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