ANTIPARKINSONIAL AGENTS
In clinical practice anticholinergic drugs, amantadine and the antihistamines have their primary use as treatments for medication induced movements disorders , particularly neuroleptic-induced parkinsonism ,acute dystonia & medication tremor.
ANTICHOLINERGICS
. Trihexyphenidyl
. Benztropine
. Biperiden
DOPAMINERGIC AGENTS
. Bromocriptine
.Carbidopa/Levodopa
MONOAMINE OXIDASE TYPE B INHIBITORS
. Selegiline
TRIHEXYPHENIDYL (ARTANE, TRIHEXANE,TRIHEXY,PACITANE)
INDICATION
. Drug-induced parkinsonism
MECHANISM OF ACTION
It acts by increasing the release of dopamine from presynatic vesicles , blocking the reuptake of dopamine into presynaptic nerve terminals or by exerting an agonist effect on postsynaptic dopamine receptors Trihexyphenidyl reaches peak plasma concentrations in 2-3 hours after oral administration & has duration of action up to 12 hours .
Dosage
1-2 mg per day orally initially ,maximum dose up to 15mg /day in divided doses
SIDE EFFECT
Dizziness, nervousness, drowsiness, weakness, headache, confusion, blurred vision ,mydriasis, tachycardia, orthostatic hypotension, dry mouth, nausea, constipation, vomiting, urinary retention & decreased sweating.
NURSE'S RESPONSIBILITIES
. Assess parkinsonian & extrapyramidal symptoms . Medication should be tapered gradually .
. Caution patient to make position changes slowly to minimize orthostatic hypotension .
. Instruct the patient about frequent rinsing of mouth & good oral hygiene .
. Caution patient that this medication decreases perspiration & over-heating may occur during hot weather .
ANTABUSE DRUGS
Disulfiram is an important drug in this class & is used to ensure abstinence in the treatment of alcohol dependence. Its main effect is produce a rapid & violently unpleasant reaction in a person who ingests even a small amount of alcohol while taking disulfiram .
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