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Antipsychotics and Alcohol

Dr. Rathnakar U.P.


MD.DIH.PGDHM

ALCOHOLS (ETHANOL AND METHANOL)


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 by destroying them. Prevent bedsores: Alcohol is used locally to prevent bedsores in bedridden patients. Methanol poisoning : Ethanol competes with methanol for metabolic enzymes and saturates them. Hence, prevents the formation of toxic metabolites of methanol (formaldehyde and formic acid). Fever: Alcoholic sponges are useful to reduce body temperature.

DRUG TREATMENT OF CHRONIC ALCOHOLISM 1. Psychotherapy, occupational therapy and rehabilitation. 2. Drug therapy a. Disulphiram (alcohol aversion therapy): It causes aversion to alcohol.

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 and blindness.

The signs and symptoms of methanol poisoning are nausea, vomiting, abdominal pain, headache, vertigo, confusion, hypotension, convulsions and coma.

METHANOL POISONING (METHYL ALCOHOL POISONING)

METHANOL POISONING (METHYL ALCOHOL POISONING)


Dark room Stomach wash-NaHCO3 i.v.NaHco3 Ethyl alcohol, Fomepazole

Antipsychotics

Dr.U.P.Rathnakar
MD. DIH. PGDHM

Antipsychotics

Classical: Phenothiazines Chlorpromazine Triflupromazine Haloperidol,

Atypical Clozapine Risperidone Olanzapine

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

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-Tolerance develops

ADEs effects of CPZ

Extrapyramidal effects
Parkinsonism Acute muscle dystonia Akathisia Malignant neuroleptic syndrome Tardive dyskinesia Other ADEs Cholestatic jaundice, Agranulocytosis, Myocarditis, dryness of mouth, wt gain

Uses of antipsychotics
Psychoses [Schizophrenia] a. Atypical preferred[Less adverse effects, more effective in negative symptoms] Antiemetic Intractable hiccough Mania

Antipsychotics
Classical More action on DA receptors Effective in positive symptoms More adverse effects Atypical Less. More in 5HT Effective in negative symptoms Less ADEs