Generic name:chlorpromazine Brand name:Thorazine Preparations: PO 10-25mg 2=4 times daily; may increase every 3-4 days (usual

dose is 200ng/day; up to 1g/day) CLASSIFI-CATION: Antipsychotics ACTION: • Block dopamine receptors in the brain; also alter dopamine release and turnover. • Prevention of seizures INDICATION / USES: •Acute and chronic psychoses, particularly when accompanied by increased psychomotor activity. Nausea and vomiting. • Also used in the treatment of intractable hiccups. COMMON ADVERSE EFFECTS: •CNS: neuroleptic malignant syndrome, sedation, extrapyramidal reactions, tardive dyskinesia •CV: hypotension (increased with IM, IV) •EENT: blurred vision, dry eyes, lens opacities • GI: constipation, dry mouth, anorexia, hepatitis, ileus • GU: urinary retention • Hematologic: agranulocytosis, leukopenia • Skin: photosensitivity, pigment changes, rashes CONTRA-INDICATIONS: • Hypersensitivity. •Cross-sensitivity may exist among phenothiazines. Should not be used in narrow-angle glaucoma. •Should not be used in patients who have CNS depression. NURSING CONSIDERATIONS: • Assess mental status prior to and periodically during therapy.

• Monitor BP and pulse prior to and frequently during the period of dosage adjustment. May cause QT interval changes on ECG. • Observe patient carefully when administering medication, to ensure that medication is actually taken and not hoarded. •Monitor I&O ratios and daily eight. Assess patient for signs and symptoms of dehydration. • Monitor for development of neuroleptic malignant syndrome (fever, respiratory distress, tachycardia, seizures, diaphoresis, hypertension or hypotension, pallor, tiredness, severe muscle stiffness, loss of bladder control. Report symptoms immediately. May also cause leukocytosis, elevated liver function tests, elevated CPK. • Advise patient to take medication as directed. Take missed doses as soon as remembered, witih remaining doses evenly spaced through out the day. May require several weeks to obtain desired effects. Do not increase dose or discontinue medication without consulting health care professional. Abrupt withdrawal may cause dizziness, nausea, vomiting, GI upset, trembling, or uncontrolled movements of mouth, tongue or jaw.

Stelazine (trifluoperazine) Generic name: Trifluoperazine Available strengths: 1 mg, 2 mg, 5 mg, 10 mg tablets; 10 mg/mL oral concentrate Available in generic: Yes Drug class: First-generation (conventional) antipsychotic General Information Stelazine (trifluoperazine) belongs to a class of antipsychotics known as the firstgeneration antipsychotics, sometimes referred to as conventional or typical antipsychotics. The first-generation antipsychotics represent an older class of antipsychotics that have been the standard for treating psychotic disorders for many decades. When compared with a newer class of second-generation antipsychotics, these earlier antipsychotics are referred to as typical or conventional because they lack the wider spectrum of therapeutic activity. The first-generation antipsychotics are also more likely to induce side effects that cause movement disorders, such as extrapyramidal symptoms (EPS) and tardive dyskinesia (TD), than the newer antipsychotics. Stelazine is a high-potency antipsychotic, relative to low-potency first-generation antipsychotics

such as Thorazine (chlorpromazine) and Mellaril (thioridazine). Stelazine is moderately sedating and less likely to lower blood pressure. Like other high-potency antipsychotics such as Haldol (haloperidol) and Prolixin (fluphenazine), Stelazine frequently induces EPS. Common Side Effects Patients taking Stelazine may experience sedation and drowsiness accompanied by fatigue. Sedation may be useful early on in therapy to lessen agitation and help the patient sleep, but as acute symptoms improve, this side effect may become bothersome, interfering with daily activities. Over time, most patients develop tolerance to the side effects of the medication. Daytime sedation may be minimized by taking a larger proportion of the divided dosage at bedtime and a small dose in the morning. Stelazine may induce side effects known as extrapyramidal symptoms. Adverse Reactions and Precautions Stelazine may cause drowsiness and sedation and impair physical coordination and mental alertness. Patients should avoid potentially dangerous activities, such as driving a car or operating machinery, until they are sure that these side effects will not affect their ability to perform these tasks. Stelazine may enhance ultraviolet light absorption in the skin—a reaction known as photosensitivity and predispose the person to sunburn. Patients should avoid prolonged exposure to sunlight, use sunscreen, and wear protective clothing until tolerance is developed to the medication. Nursing Considerations • Do not discontinue your medication without consulting your physician. • If you miss a dose, take it as soon as possible. If it is close to your next scheduled dose, skip the missed dose and continue on your regular dosing schedule, but do not take double doses. • Stelazine may be taken with or without food. • Stelazine may cause sedation and drowsiness, especially during initiation of therapy, and impair your alertness. Use caution when driving or performing tasks that require alertness. • Stelazine may enhance ultraviolet light absorption and increase the risk of sunburn. Use a sunscreen and avoid excessive exposure to sunlight. • Store the medication in its originally labeled, light-resistant container, away from heat and moisture. Heat and moisture may precipitate breakdown of your medication.

5mg. dysphagia. leucopenia. constipation. •EENT: blurred vision. 10mg CLASSIFICATION: Antipsychotics ACTION: • Alters the effects of dopamine in the CNS • Also has anticholinergic and alpha-adrenergic blocking activity. disorganized thinking • severe anxiety • seizures COMMON ADVERSE EFFECTS: •CNS: extrapyramidal symptom such as muscle rigidity or spasm. agranulocytosis .• Keep your medication out of reach of children. seizures. arrhythmias. •CV: tachycardia. orthostatic hypertension.5mg. drooling. vomiting. weight gain. shuffling gait. Generic name: haloperidol Brand name: Haldol Preparations: Tablets: 0. • GU: urinary frequency. gynecomastia • Hematologic: anemia. • Diminished signs and symptoms of psychoses INDICATION / USES: •Organic Psychoses • acute psychotic symptoms • Relieve hallucinations. akathisia. amenorrhea. enuresis. urine retention. 2mg. posture leaning forward. 1mg. tardive dyskinesia. anorexia. impotence. delusions. diarrhea. hypertension. nausea. masklike facial appearance. headache. glaucoma • GI: dry mouth.

tiredness. • Monitor BP and pulse prior to and frequently during the period of dosage adjustment. •Monitor I&O ratios and daily eight. dermatitis. pallor. severe muscle stiffness. GI upset. May cause QT interval changes on ECG. • Advise patient to take medication as directed. Generic Name: Thioridazine. Abrupt withdrawal may cause dizziness. tachycardia. witih remaining doses evenly spaced through out the day. or uncontrolled movements of mouth. Assess patient for signs and symptoms of dehydration. tongue or jaw. Do not increase dose or discontinue medication without consulting health care professional. elevated liver function tests. nausea. Thioridazine hydrochloride Product Name: Melleril Indication of Melleril: Melleril is used to treat psychotic disorders unresponsive to at least 2 other antipsychotics. vomiting. trembling. May also cause leukocytosis. Report symptoms immediately. elevated CPK. • Observe patient carefully when administering medication. Action of Melleril: . Take missed doses as soon as remembered. • Monitor for development of neuroleptic malignant syndrome (fever. to ensure that medication is actually taken and not hoarded.• Skin: rash. May require several weeks to obtain desired effects. diaphoresis. hypertension or hypotension. loss of bladder control. phtosensitivity CONTRA-INDICATIONS: • seizure disorder • glaucoma • elderly clients NURSING CONSIDERATIONS: • Assess mental status prior to and periodically during therapy. respiratory distress. seizures.

Antagonise D2 receptors resulting in anti-psychotic effects. amenorrhoea or infertility) Uncommon side effects of Melleril: Allergic reactions Pigmentary changes of skin or eyes Corneal and lens opacities Hypothermia Hyperthermia SIADH Diseases treated by Melleril: Tardive Dyskinesia Treatments associated with Melleril: Conventional Antipsychotics (Conventional Antipsychotics) . tachycardia. including relief from symptoms such as hallucinations. Orthostatic hypotension Sedation Extrapyramidal effects (Parkinsonism. gynaecomastia. Tardive Dyskinesia) Hyperprolactinaemia (may result in galactorrhoea. nausea. blurred vision. Dose advice of Melleril: Adult: 50-600mg daily in 3 divided doses. urinary hesitancy. Dystonias. delusions or abnormal behaviour/thought. increased intraocular pressure. constipation. sexual adverse effects. Maximum 800mg daily for up to 4 weeks. Akathisia. Schedule of Melleril: S4 Common side effects of Melleril: Anticholinergic effects: dry mouth.

GENERIC NAME: Diazepam BRAND NAME: Valium CLASSIFICATION: Antianxiety agents. probably by potentiating GABA. .Skeletal muscle relaxant .Produces skeletal muscle relaxation by inhibiting spinal polysynaptic afferent pathways. an inhibitory neurotransmitter.Has anticonvul-sant properties due to enhanced presynaptic inhibi-tion.Therapeutic effects: (1) Relief of Anxiety (2) Sedation (3) Amnesia (4) Skeletal muscle relaxant (5) Decreased seizure activity INDICATION: -Adjunct in the management of: 1) Anxiety 2) Preoperative sedation 3) Conscious sedation . anticonvulsants. sedative/hyptonics.Provides light anesthesia and anterograde amnesia .Depress the CNS. .Treatment of status epilepticus/ uncontrolled seizures . skeletal muscle relaxants (centrally acting) DOSAGE: 10 mg IM MECHANISM OF ACTION: .

.Comatose patients .Cross-sensitivity with other benzodiazepines may occurs .GI: 1) constipation 2) diarrhea .CNS: 1) dizziness 2) drowsiness 3) lethargy 4) hangover 5) headache 6) depression .RESP: 1) respiratory depression .Hypersensitivity .CV: 1) hypotension .Management of the symptoms of alcohol withdrawal CONTRAINDICATIONS: .Pre-existing CNS depression .Uncontrolled severe painUse cautiously in: 1) Hepatic dysfunction 2) Severe renal impairment 3) History of suicide attempt or drug dependence SIDE EFFECTS/ ADVERSE EFFECTS: .EENT: 1) blurred vision .

RR prior to periodically throughout therapy and frequently during IV therapy.Prolonged high-dose therapy may lead to psychological or physical dependence.Monitor BP.Assess IV site frequently during administration. duration and location of seizure activity.Effectiveness of therapy can be demonstrated by decrease anxiety level.3) nausea 4) vomiting .Caution patient to avoid taking alcohol or other CNS depressants concurrently with this medication.LOCAL: 1) pain (IM) 2) phlebitis (IV) 3) venous thrombosis .DERM: 1) rashes . Generic Name and Formulations: . . The initial dose of diazepam offers seizure control for 15-20 min after administration. . . . inject deeply into deltoid muscle for maximum absorption. diazepam may cause phlebitis and venous thrombosis. If IM route is used. . PR.MISC: 1) physical & psychological depen-dence 2)tolerance NURSING IMPLICATIONS/RESPONSIBILITIES: . control of seizures. Observe depressed patients closely for suicidal tendencies. .Observe and record intensity.IM injections are painful and erratically absorbed. Restrict amount of drug available to patient. decreased tremulousness.

Warnings/Precautions: Drug or alcohol abuse. Adverse Reactions: Drowsiness. Depression. 10mg. Children's Dose for LIBRIUM: <6yrs: not recommended. nursing mothers: not recommended. Tablets COMPOSITION: Each EQUANIL tablet contains meprobamate 400 mg. jaundice. Avoid other psychotropics. Interactions: Potentiates CNS depression with alcohol. Indications for LIBRIUM: Anxiety. Debilitated. Monitor blood counts and liver function. ≥6yrs: 5mg 2–4 times daily. CNS depression. Renal or hepatic disease. May increase to 10mg 2–3 times daily. EQUANIL® Tablets EQUANIL® L. Severe: 20–25mg 3–4 times daily. Each EQUANIL L. ataxia.A. Adult Dose for LIBRIUM: Mild to moderate: 5–10mg 3–4 times daily. Variable effects with anticoagulants. Elderly. 25mg. abuse potential. . confusion. edema. Psychosis. rash. tablet contains meprobamate 400 mg as a slow release tablet.Chlordiazepoxide HCl 5mg. Suicidal tendencies. Change dose gradually. extrapyramidal effects.A. blood dyscrasias. Therapy for >4 months. memory impairment. paradoxical excitement. Porphyria. other CNS depressants. caps. Epilepsy. Pharmacological Class: Benzodiazepine. Pregnancy. Elderly or debilitated: 5mg 2–4 times daily.

2. Meprobamate undergoes extensive metabolism in the liver with 10 to 20% of the drug eliminated unchanged via the kidneys. the remainder is excreted as hydroxymeprobamate and as the glucoronide. but is not clear whether the drug induces the enzymes responsible for its own metabolism. Pharmacokinetics: Meprobamate is well absorbed from the gastrointestinal tract.2-di-(carbamoyl-oxymethyl)-pentane EQUANIL L. CONTRA-INDICATIONS: Acute intermittent porphyria and allergic or idiosyncratic reactions to meprobamate or related compounds. has not been assessed by systematic clinical studies. there is little binding to plasma protein.A. PHARMACOLOGICAL CLASSIFICATION: Category A. meprobamate is 2.Chemically. Meprobamate can induce some hepatic microsomal enzymes.A. The physician should reassess periodically the usefulness of the drug for the individual patient.6 Tranquillizers PHARMACOLOGICAL ACTION: EQUANIL (meprobamate) is a carbamate derivative which has been shown to have effects at multiple sites in the central nervous system including the thalamus and limbic system. in long-term use. The effectiveness of EQUANIL and EQUANIL L. tablets contain TARTRAZINE. as an adjunct in the treatment of various disease states in which anxiety and tension are manifested. that is. mebutamate or carbromal. WARNINGS: . more than 4 months. such as carisoprodol. The drug is widely distributed in the body. INDICATIONS: For the relief of anxiety and tension.

Doses greater than 2 400 mg/day are not recommended. hypotensive crises. psychological dependence. transient ECG changes. overstimulation. EQUANIL L. as well as avoidance of prolonged administration. caution should be exercised in the administration to patients with . fast EEG activity. Nursing consideration: The least effective dose should be administered. usually. Gastrointestinal: Nausea. weakness. The usual dose of children ages 6-12 years is 100-200 mg two to three times daily. tablets: Usual adult dose is 1 tablet twice daily.Addiction potential: Physical dependence. greater than recommended doses is manifested by ataxia. especially for alcoholics and other patients with a known propensity for taking excessive quantities of drugs. and vertigo. various forms of arrhythmia. careful supervision of dose and amounts prescribed is advised. paradoxical excitement. Not recommended for children under 6 years. paresthesias. impairment of visual accommodation. ataxia. headache. vertigo. syncope. Therefore. SIDE-EFFECTS AND SPECIAL PRECAUTIONS: SIDE-EFFECTS: Central nervous system: Drowsiness. to avoid its excess accumulation. tachycardia. euphoria. Meprobamate is metabolized in the liver and excreted by the kidney. vomiting. slurred speech. diarrhoea. Other: Exacerbation of porphyric symptoms. particularly to elderly and/or debilitated patients in order to preclude oversedation.A. Chronic intoxication from prolonged ingestion of. and abuse have occurred. DOSAGE AND DIRECTIONS FOR USE: EQUANIL tablets: Usual adult dose is 1 200-1 600 mg/day in divided doses. Cardiovascular: Palpitation. dizziness. slurred speech.

Careful monitoring of urinary output is necessary and caution should be taken to avoid overhydration. KNOWN SYMPTOMS OF OVERDOSAGE AND PARTICULARS OF ITS TREATMENT: Suicidal attempts with meprobamate have resulted in drowsiness. The drug should be prescribed cautiously and in small quantities to patients with suicidal tendencies. General supportive measures should be employed along with gastric lavage. Meprobamate occasionally may precipitate seizures in epileptic patients. Diuresis. Usage in Pregnancy and Lactation: See “WARNINGS”. fluids should be administered. appropriate caution should be exercised with patients who take more than one of these agents simultaneously. 25mg. peritoneal dialysis. ataxia.V. have been attributed to incomplete gastric emptying and delayed absorption. after initial recovery. I. Relapse and death. Some suicidal attempts have been fatal. and an adequate airway maintained. Additive Effects: Since CNS-suppressant effects of meprobamate and alcohol or meprobamate and other psychotropic drugs may be additive. having the word “WYETH’ impressed on both halves of the scored face and the letter “W”within a shield impressed on the other face. and respiratory collapse. 50mg. stupor.compromised liver or kidney function. shock. and haemodialysis have been used successfully. flat tablets with bevelled edges containing not more than a slight characteristic odour. Addiction potential: See “WARNINGS”. tabs. Mood disorders Clinical Charts: Overactive Bladder & Urinary Incontinence Treatments . TOFRANIL Rx Generic Name and Formulations: Imipramine HCl 10mg. lethargy. IDENTIFICATION: EQUANIL tablets are white. Usage in children: See “WARNINGS”. coma. vasomotor. osmotic (mannitol) diuresis.

Hyperthyroidism. Paralytic ileus. anticholinergic effects. Adolescents or elderly: initially 30–40mg/day.C). Children's Dose for TOFRANIL: Not recommended. edema. Warnings/Precautions: Urinary retention. phenothiazines. Antagonized by barbiturates. Adult Dose for TOFRANIL: Initially 75mg/day. convulsions. blood dyscrasias (discontinue if occurs). clonidine. changes in blood sugar. max 200mg/day. Adverse Reactions: Drowsiness. Suicidal tendencies. SSRIs. max 100mg/day. Nursing mothers: not recommended. See Also: TOFRANIL-PM Pharmacological Class: Tricyclic. nausea. extrapyramidal symptoms. Glaucoma. Mania/hypomania. phenytoin. increased perspiration. Pregnancy (Cat. CYP2D6 inhibitors. monitor plasma levels with cimetidine. Renal or hepatic disorders. ECT. quinidine). Interactions: Hyperpyretic crisis. death with MAOIs. Diabetes. Bipolar disorder. Epilepsy. carbamazepine. Acute post-MI. type 1C antiarrhythmics (eg. Increased cardiovascular effects with methylphenidate. fatigue. hypo. Contraindications: During or within 14 days of MAOIs. hyperpyrexia with anticholinergics. rash. jaundice. arrhythmias. sympathomimetics. Psychosis. Cardiovascular disease. headache. Blocks guanethidine. photosensitivity.Mood Disorder Treatments Psychiatric Disorders Resource Center » Indications for TOFRANIL: Depression. . Potentiated by methylphenidate. CNS overstimulation. Potentiates alcohol.or hypertension. CNS depressants.

The patient should also be warned about the possibility of hypotension and faintness. By increasing the amount of monoamines in the brain. Likewise.Marplan . It also is useful in the treatment of panic disorder and the phobic disorders. neck stiffness. Patients should also be cautioned not to take concomitant medications. and atypical depression. i. Patients should be warned against eating the foods listed under CONTRAINDICATIONS while on Marplan therapy and should also be told not to drink alcoholic beverages. It is thought that depression may be linked to an imbalance of chemicals within the brain. Depression is a complicated disease that is not fully understood. This results in an increased amount of active monoamines in the brain. or vomiting. and liver. as well as drowsiness sufficient to impair performance of potentially hazardous tasks. including convulsions and death. They should be advised not to consume excessive amounts of caffeine in any form. palpitation and or tachycardia. dysthymic disorder. When depression occurs. Marplan prevents monoamine oxidase from breaking down the monoamines. In a single study. they should inform their physicians and their dentist about the use of Marplan. This is especially true in patients . the imbalance of chemicals thought to be caused by depression is altered. hay fever. Marplan for patients Patients should be instructed to report promptly the occurrence of headache or other unusual symptoms. Concomitant use of Isocarboxazid and other psychotropic agents is generally not recommended because of possible potentiating effects. These chemicals are called monoamines. a sense of constriction in the throat or chest.. without the advice of a physician. Marplan Interactions Isocarboxazid should be administered with caution to patients receiving Antabuse (disulfiram. such as driving a car or operating machinery. whether prescription or over-the. e. or weight-reducing preparations.counter drugs such as cold. there may be a decrease in the amount of chemicals released from nerve cells in the brain. Pharmacology: Marplan is a non-selective hydrazine monoamine oxidase (MAO) inhibitor used to treat depression.General Information: An MAO inhibitor that is effective in the treatment of major depression. In vivo and in vitro studies demonstrated inhibition of MAO in the brain. Monoamines are broken down by a chemical called monoamine oxidase. rats given high intraperitoneal doses of an MAO inhibitor plus disulfiram experienced severe toxicity. Wyeth-Ayerst Laboratories). nausea. This helps relieve the symptoms of depression. dizziness. heart. sweating.

the physician wishing to terminate treatment with Isocarboxazid and begin therapy with another agent should allow for an interval of 10 days. sedative or anesthetic drugs. diuretic. and this should be borne in mind when another drug is prescribed following Isocarboxazid. sympathomimetics (including amphetamines). buspirone HCL. antihistaminic. buproprion HCL.who may subject themselves to an overdosage of drugs. hypertension. careful consideration should be given to the pharmacology of all agents to be used. The monoamine oxidase inhibitory effects of Isocarboxazid may persist for a substantial period after discontinuation of the drug. antihypertensive. Contraindicated Patient Populations Hypersensitivity Pheochromocytoma Liver Disease Renal Impairment ArtanePronunciation Generic Name: trihexyphenidyl (Oral route) Schizophrenia Commonly used brand name(s) In the U. Marplan Contraindications Marplan (isocarboxazid) should not be administered in combination with any of the following: MAO inhibitors or dibenzazepine derivatives. or history of headache. Marplan (isocarboxazid) should not be administered to any patient with a confirmed or suspected cerebrovascular defect or to any patient with cardiovascular disease. dextromethorphan. some central nervous system depressants (including narcotics and alcohol). Artane Trihexane Tritane Available Dosage Forms: . cheese or other foods with a high tyramine content. If combination therapy is needed. To avoid potentiation. or excessive quantities of caffeine.S.

Before Using Artane In deciding to use a medicine. Extended Release Elixir Therapeutic Class: Antiparkinsonian Pharmacologic Class: Anticholinergic Uses For Artane Trihexyphenidyl is used alone or together with other medicines (e. this medicine allows more normal movements of the body as the disease symptoms are reduced. the following should be considered: Allergies Pediatric Geriatric Interactions with Medicines Although certain medicines should not be used together at all. By improving muscle control and reducing stiffness. When you are taking this medicine. in other cases two different medicines may be used together even if an interaction might occur. your doctor may want to change the dose.Tablet Capsule. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using this medicine with any of the following medicines is not recommended.. or other precautions may be necessary. For this medicine. Your doctor may decide not to treat you with this medication or change some of the other .g. In these cases. the risks of taking the medicine must be weighed against the good it will do. it is especially important that your healthcare professional know if you are taking any of the medicines listed below. This is a decision you and your doctor will make. levodopa) to treat Parkinson's disease.

May make these conditions worse. your doctor may change the dose or how often you use one or both of the medicines. or tobacco. Please read with care. Proper Use of trihexyphenidyl This section provides information on the proper use of a number of products that contain trihexyphenidyl. and do not take it for a longer time than your doctor ordered. Potassium Using this medicine with any of the following medicines may cause an increased risk of certain side effects.medicines you take. especially: Bowel or stomach blockage or Enlarged prostate or Glaucoma or Hypertension (high blood pressure) or Urinary blockage—Use with caution. If both medicines are prescribed together. Effects may be increased because of slower removal of the medicine from the body. Kidney disease or Liver disease—Use with caution. . Do not take more of it. Take this medicine every day exactly as ordered by your doctor in order to improve your condition as much as possible. Betel Nut Chlorpromazine Haloperidol Perphenazine Interactions with Food/Tobacco/Alcohol Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. alcohol. Discuss with your healthcare professional the use of your medicine with food. Make sure you tell your doctor if you have any other medical problems. Other Medical Problems The presence of other medical problems may affect the use of this medicine. do not take it more often. It may not be specific to Artane. but using both drugs may be the best treatment for you. Using alcohol or tobacco with certain medicines may also cause interactions to occur.

and direct light. Children—Use and dose must be determined by your doctor. given in divided doses 3 or 4 times per day. Dosing The dose of this medicine will be different for different patients. if it is almost time for your next dose. skip the missed dose and go back to your regular dosing schedule. If your dose is different. For oral dosage form (elixir or tablets): For Parkinson's disease: Adults—At first. away from heat. Ask your healthcare professional how you should dispose of any medicine you do not use. given in divided doses 3 or 4 times per day. The following information includes only the average doses of this medicine. the time allowed between doses. moisture. Keep out of the reach of children. For side effects caused by other medicines: Adults—5 to 15 milligrams (mg) per day. However. . Storage Store the medicine in a closed container at room temperature. the dose is usually not more than 15 mg per day. and the length of time you take the medicine depend on the medical problem for which you are using the medicine. Follow your doctor's orders or the directions on the label. Keep from freezing. Do not keep outdated medicine or medicine no longer needed. However.You may take this medicine before or after food. The amount of medicine that you take depends on the strength of the medicine. Also. Missed Dose If you miss a dose of this medicine. Children—Use and dose must be determined by your doctor. take it as soon as possible. although it is usually taken with meals. the number of doses you take each day. do not change it unless your doctor tells you to do so. 1 milligram (mg) once a day. Your doctor may increase your dose as needed. Do not double doses.

check with your medical doctor or dentist. Check with your doctor right away if you have blurred vision or any change in vision while taking this medicine. or other precautions may be necessary. including tooth decay. in other cases two different medicines may be used together even if an interaction might occur.S. Trihexyphenidyl may increase your risk of having glaucoma. and throat. In these cases. Interactions with Medicines Although certain medicines should not be used together at all. Trihexyphenidyl may cause dryness of the mouth. and fungus infections. Cogentin Available Dosage Forms: Solution Tablet Therapeutic Class: Antiparkinsonian Pharmacologic Class: Anticholinergic This medicine is available only with your doctor's prescription. or use a saliva substitute. gum disease.Precautions While Using Artane It is important that your doctor check your progress at regular visits to allow changes in your dose and to check for any unwanted effects. your doctor may want to change the dose. your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor). if your mouth continues to feel dry for more than 2 weeks. However. For temporary relief of mouth dryness. Continuing dryness of the mouth may increase the chance of dental disease. use sugarless candy or gum. melt bits of ice in your mouth. Before using this medicine. nose. . CogentinPronunciation Generic Name: benztropine (Oral route) BENZ-troe-peen Commonly used brand name(s) In the U.

especially: Enlarged prostate or Glaucoma or Paralytic ileus (bowel blockage) or Psychosis (mental disorder) or Tachycardia (fast heartbeat) or Urinating problems (e. Other Medical Problems The presence of other medical problems may affect the use of this medicine. alcohol. Glaucoma. Discuss with your healthcare professional the use of your medicine with food. Make sure you tell your doctor if you have any other medical problems. angle-closure or . urinary retention)—Use with caution. or tobacco. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. it is especially important that your healthcare professional know if you are taking any of the medicines listed below. painful or difficult urination. Betel Nut Chlorpromazine Haloperidol Interactions with Food/Tobacco/Alcohol Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur.g. May make these conditions worse.When you are taking this medicine.. Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Your doctor may increase your dose as needed. and the length of time you take the medicine depend on the medical problem for which you are using the medicine. do not change it unless your doctor tells you to do so. The following information includes only the average doses of this medicine. the number of doses you take each day. Find out More! Vicks. Where hope happens. Dosing The dose of this medicine will be different for different patients. The amount of medicine that you take depends on the strength of the medicine. If your dose is different. 0.Tardive dyskinesia (movement disorder)—Should not be used in patients with this condition. . Children 3 years of age and above—Use and dose must be determined by your doctor. Follow your doctor's orders or the directions on the label.ph/Philippines Schizophrenia Alternative Mental Health Care. Ads by Google Rejoice Shampoo Quality Shampoo for All Hair Types. Learn more at Rejoice Facebook Facebook. Children below 3 years of age—Use is not recommended.com/RejoicePhilippines Vicks Philippines Get relief from cold & flu Symptoms with Vicks. The dose is usually not more than 6 mg. Also. For oral dosage form (tablets): For Idiopathic parkinsonism: Adults—At first.5 to 1 milligram (mg) at bedtime. the time allowed between doses.com.

or trouble in thinking or seeing clearly. away from heat. Children 3 years of age and above—Use and dose must be determined by your doctor. Children below 3 years of age—Use is not recommended. Ask your healthcare professional how you should dispose of any medicine you do not use. 0. Storage Store the medicine in a closed container at room temperature. However. well-coordinated. For Postencephalitic parkinsonism: Adults—At first. Do not double doses. skip the missed dose and go back to your regular dosing schedule. Children 3 years of age and above—Use and dose must be determined by your doctor. Precautions While Using Cogentin It is important that your doctor check your progress at regular visits to allow changes in your dose and to check for any unwanted effects. Do not stop taking this medicine without first checking with your doctor. 1 to 4 milligrams (mg) once or twice a day. or able to think or see well.For Parkinson-like symptoms caused by other medicines: Adults—At first. moisture. Your doctor may increase your dose as needed. Your doctor . Benztropine may cause dizziness. and direct light. Keep out of the reach of children. Missed Dose If you miss a dose of this medicine. Your doctor may increase your dose as needed. Keep from freezing.5 to 2 milligrams (mg) at bedtime. take it as soon as possible. trouble in controlling movements. use machines. Do not keep outdated medicine or medicine no longer needed. Make sure you know how you react to this medicine before you drive. or do other jobs that require you to be alert. Children below 3 years of age—Use is not recommended. The dose is usually not more than 6 mg. if it is almost time for your next dose.

may want you to gradually reduce the amount you are using before stopping completely. place. and time constipation decrease in frequency of urination decrease in urine volume . Other changes might be confusion. Some examples of CNS depressants are antihistamines or medicine for hay fever. worsening of depression. and unusual excitement. sedatives. or anesthetics. suicidal thoughts. or sleeping medicine. other allergies. a medicine may cause some unwanted effects. Although not all of these side effects may occur. prescription pain medicine or narcotics. muscle relaxants. This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). or irritability. tranquilizers. causing your body temperature to increase. This medicine may make you sweat less. check with your doctor. or colds. visual hallucinations (seeing things that are not there). if they do occur they may need medical attention. since overheating may result in heat stroke. including some dental anesthetics. Cogentin Side Effects Along with its needed effects. Some changes that have occurred in people receiving this medicine are like those seen in people who drink too much alcohol. be sure to discuss it with your doctor. Use extra care to avoid becoming overheated during exercise or hot weather while you are taking this medicine. Check with your doctor immediately if any of the following side effects occur: Incidence not known Abdominal or stomach cramps or pain aggressive and violent behavior being forgetful bloating burning while urinating confusion about identity. Check with your medical doctor or dentist before taking any of the above while you are taking this medicine. nervousness. If you have concerns about this. barbiturates. medicine for seizures. If you develop any unusual or strange thoughts and behavior while receiving benztropine. This medicine may cause muscle weakness.

clammy skin . pounding.diarrhea difficult or painful urination difficulty in passing urine (dribbling) difficulty with speaking difficulty with swallowing discouragement dizziness dry mouth extremely high fever or body temperature fast. shallow breathing fast. weak heartbeat feeling sad or empty fever headache hot. or irregular heartbeat or pulse fast. dry skin irritability lack of appetite lack of sweating listlessness loss of interest or pleasure mood or mental changes muscle cramps muscle weakness nervousness numbness of the fingers pale.

or legs shakiness and unsteady walk sweating tearing .seeing things that are not there thirst tiredness trouble concentrating trouble with sleeping vomiting Get emergency help immediately if any of the following symptoms of overdose occur: Symptoms of overdose Blindness blurred vision change in consciousness cold clammy skin decreased vision dizziness eye pain holding false beliefs that cannot be changed by fact lightheadedness loss of consciousness muscle weakness nausea or vomiting no breathing nosebleeds numbness or tingling in the face. arms.

These side effects may go away during treatment as your body adjusts to the medicine. It is a white. or other problems with muscle control or coordination unusual excitement. AKINETON® Tablets biperiden hydrochloride DESCRIPTION Each AKINETON Tablet for oral administration contains 2 mg biperiden hydrochloride. Other ingredients may include corn syrup. Each 1 mL AKINETON Ampule for intramuscular or intravenous administration contains 5 mg biperiden lactate in an aqueous 1.unsteadiness.4 percent sodium lactate solution. odorless powder. It is stable in air at normal temperatures. crystalline. Biperiden is (alpha)-5-Norbornen-2-yl-(alpha)-phenyl-1-piperidine propanol. AKINETON is an anticholinergic agent. nervousness. The structual formula is: INDICATIONS AND USES . your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. trembling. lactose. or restlessness vision problems wheezing Some side effects may occur that usually do not need medical attention. If you notice any other effects. Also. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Incidence not known Enlarged pupils loss of appetite skin rash weight loss Other side effects not listed may also occur in some patients. slightly soluble in water and alcohol. magnesium stearate. potato starch and talc. No added preservative.

As an adjunct in the therapy of all forms of parkinsonism (idiopathic. . some antisecretory. 2 mg each. The parenteral form of AKINETON is an effective and reliable agent for the treatment of acute episodes of extrapyramidal disturbances sometimes seen during treatment with neuroleptic agents. embossed on one face with a triangle. Akathisia. akinesia. light-resistant container as defined in USP. arteriosclerotic) Control of extrapyramidal disorders secondary to neuroleptic drug therapy (e. excursions permitted to 15. Dispense in tight. AKINETON possesses nicotinolytic activity. oculogyric crisis. antispasmodic and mydriatic effects. phenothiazines) DOSAGE AND ADMINISTRATION Drug-Induced Extapyramidal Symptoms: Oral: One tablet one to three times daily.30C (59-86F) [see USP Controlled Room Temperature]. postencephalitic. Parkinsonism is thought to result from an imbalance between the excitatory (cholinergic) and inhibitory (dopaminergic) systems in the corpus striatum. Parkinsons Disease: Oral: The usual beginning dose is one tablet three or four times daily. white. The dosage should be individualized with the dose titrated upward to a maximum of 8 tablets (16 mg) per 24 hours.. therefore. HOW SUPPLIED AKINETON (biperiden hydrochloride) Tablets. In addition. which then restores the balance. CLINICAL PHARMACOLOGY AKINETON is a weak peripheral anticholinergic agent. It has. dyskinetic tremors.g. The mechanism of action of centrally active anticholinergic drugs such as AKINETON is considered to relate to competitive antagonism of acetylcholine at cholinergic receptors in the corpus striatum. bisected on the reverse and imprinted with the number 11. Bottles of 100 NDC # 49884-693-01 Storage: Store at 25C (77F). rigor.

See OVERDOSAGE section for signs and symptoms of the central anticholinergic syndrome. these drug-induced disturbances are rapidly brought under control.0 mL) into the sacrospinalis muscles and intradermally (0. urinary retention. A reduction in rapid eye movement (REM) sleep. With parenteral AKINETON. postural hypotension. Pharmacokinetics and Metabolism: Only limited pharmacokinetic studies of biperiden in humans are available The serum concentration at 1 to 1.5 mL) into the shaved abdominal skin. disturbed behavior may been seen.2 ng/mL) could be determined up to 48 hours after dosing. No change in GH. it can be avoided by administering the drug during or after meals. but does involve hydroxylation. A case of generalized choreic movements has been reported in a Parkinson's disease patient when biperiden was added to carbidopa/ levodopa. In normal volunteers a single 10 mg intravenous dose of biperiden seemed to cause a transient rise in plasma cortisol and prolactin. blurred vision. 87% of the drug had been absorbed. Mild transient postural hypotension and bradycardia may occur. These side effects can be minimized or avoided by slow intravenous administration. this can usually be maintained with oral doses which may be given with tranquilizer therapy in psychotic and other conditions requiring an uninterrupted therapeutic program.spasmodic torticollis.25 mL) and subcutaneously (0. DRUG INTERACTIONS Drug Interactions: The central anticholinergic syndrome can occur when anticholinergic agents such as AKINETON are administered concomitantly with drugs . euphoria or disorientation.5 hours following a single. FSH. Biperiden lactate (10 mg/mL) was not irritating to the tissue of rabbits when injected intramuscularly (1. Plasma levels (0. has been reported. SIDE EFFECTS Atropine-like side effects such as dry mouth. or TSH levels were seen. drowsiness. LH. Subsequently. agitation. constipation. If gastric irritation occurs following oral administration. and for treatment. The central anticholinergic syndrome can occur as an adverse reaction to properly prescribed anticholinergic medication. and profuse sweating are markedly reduced or eliminated. The metabolism of AKINETON is also incompletely understood.1-0. 4 mg oral dose was 4-5 ng/mL. There usually are no significant changes in blood pressure or heart rate in patients who have been given the parenteral form of AKINETON. characterized by increased REM latency and decreased percentage of REM sleep. No local tissue reactions have been reported following intramuscular injection. Six hours after an oral dose of 250 mg/kg in rats.

the central anticholinergic syndrome can occur as an adverse reaction to properly prescribed anticholinergic medication. AKINETON should be given to a pregnant woman only if clearly needed. Nursing Mothers: It is not known whether this drug is excreted in human milk. the phenothiazines and other antipsychotics. It is also not known whether AKINETON can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Pregnancy: Pregnancy Category C. drowsiness may occur. Also. certain narcotic analgesics such as meperidine. Because many drugs are excreted in human milk.. certain narcotic analgesics such as meperidine. PRECAUTIONS Drug Interactions: The central anticholinergic syndrome can occur when anticholinergic agents such as AKINETON are administered concomitantly with drugs that have secondary anticholinergic actions. and for treatment. Occasionally. although it is more frequently due to overdosage. though no prohibitive rise in intraocular pressure has been noted following either oral or parenteral administration. the consumption of alcohol should be avoided during AKINETON therapy. euphoria. agitation and disturbed behavior have been reported in susceptible patients. and antihistamines. and antihistamines. See OVERDOSAGE section for signs and symptoms of the central anticholinergic syndrome. WARNINGS Isolated instances of mental confusion. certain antiarrhythmics such as the quinidine salts. tricyclic antidepressants. Caution should be observed in patients with manifest glaucoma. e.g.that have secondary anticholinergic actions. tricyclic antidepressants. As with other drugs acting on the central nervous system. Animal reproduction studies have not been conducted with AKINETON. the phenothiazines and other antipsychotics.g. epilepsy or cardiac arrhythmia should be given this drug with caution. caution should be exercised when AKINETON is administered to a nursing woman. and patients who drive a car or operate any other potentially dangerous machinery should be warned of this possibility. e. certain antiarrhythmics such as the quinidine salts. See OVERDOSAGE section for signs and symptoms of the central anticholinergic syndrome. and for treatment. Patients with prostatism. . It may also result from concomitant administration of an anticholinergic agent and a drug that has secondary anticholinergic actions (see Drug Interactions and OVERDOSAGE sections)..

Correct diagnosis depends upon recognition of the peripheral signs of parasympathetic blockade including dilated and sluggish pupils. tachycardia. additional injections may be required every one or two hours to maintain control. paranoia. and cardiac and respiratory arrest and death. fluid volume replaced and acid-base balance maintained. Since physostigmine is rapidly destroyed. Frequent monitoring of clinical signs should be done. decreased bowel sounds. anxiety. Phenothiazines are contraindicated because the toxicity may be intensified due to their antimuscarinic action. facial flushing. incoherence. combativeness. 1 mg (half this amount for children or elderly) may be given intramuscularly or by slow intravenous infusion. agitation. Hyperpyrexia must be reversed. decreased secretions of the mouth. foul-smelling breath. ataxia. disorientation. and seizures may be present. so the patient should be carefully observed for 8 to 12 hours following the last relapse. dry skin. illusions. gastric lavage or other measures to limit absorption should be instituted. a reversal of the toxic effects occur or excessive cholinergic signs are seen. Delirium. elevated temperature. The relapse intervals tend to lengthen as the toxic anticholinergic agent is metabolized. coma. Neuropsychiatric signs such as delirium. artificial respiration or vasopressor agents may be necessary. and bronchi. hallucinations. CONTRAINDICATIONS . Treatment: Treatment of acute overdose revolves around symptomatic and supportive therapy. The condition can progress to stupor. Urinary catheterization may be necessary. an additional 1 mg dose may be given. If indicated. paralysis.Pediatric Use: Safety and effectiveness in children have not been established. If AKINETON was administered orally. and supraventricular tachycardia (not ventricular tachycardias or conduction defects) seem to respond. and urinary retention. confusion. cardiac arrhythmias. A small dose of diazepam or a short acting barbiturate may be administered if CNS excitation is observed. this may be repeated until a total of 4 mg has been administered. coma. Routine use of physostigmine for overdose is controversial. Respiratory support. hallucinations. loss of memory. causing coma. hyperactivity. nose. If there is no response within 20 minutes. pharynx. warm. OVERDOSE Signs and Symptoms: Overdosage with AKINETON produces typical central symptoms of atropine intoxication (the central anticholinergic syndrome).

1) Hypersensitivity to biperiden 2) Narrow angle glaucoma 3) Bowel obstruction 4) Megacolon .

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