However antidofaminergicheskoy activity is also connected and the development of its side effects (extrapyramidal syndrome, movement disorders and hyperprolactinemia).
Antidofaminergicheskaya periciazine activity is moderate, so he has a moderate antipsychotic effect with moderate severity of extrapyramidal disorders. Due to blocking effect periciazine on adrenergic receptors of the reticular formation of the brain and central histamine receptors, the drug has a clear sedative effect, which may also be desirable clinical effect, especially when angry, irritable and anger kinds of passion, and the aggressiveness of the decrease is not accompanied by the appearance of dullness and lethargy. In trenbolone acetate cycle comparison with chlorpromazine periciazine it has a more pronounced antiserotoninovym, antiemetic and central sedative action, but less pronounced antihistamine activity.
Periciazine reduces aggressiveness, irritability, disinhibition, so that it is effective in disorders of behavior. Due to the normalizing effect on the behavior of periciazine called “corrector behavior.”
Blockade of peripheral H 1 histamine receptors causes the anti-allergic effect of the drug. Blockade of peripheral adrenergic structures manifested its hypotensive action. In addition, the drug has holinoliticheskoy activity.
Following oral administration periciazine well absorbed, but, like other phenothiazine derivatives undergoes extensive first-pass metabolism in the intestine and / or liver and thus its ingestion concentration of unchanged periciazine in plasma is lower than when the / m and varies widely .
After ingestion periciazine 20 mg (2 capsules), the maximum plasma concentration is reached within 2 hours and 150 ng / ml (410 nmol / l).
Relationship to plasma proteins is 90%. Periciazine penetrates rapidly into the tissue, as can easily pass through the blood-tissue barriers including the blood brain barrier and.
Most periciazine metabolized in the liver by hydroxylation and conjugation. Metabolites excreted in bile can be re-absorbed in the intestine. The half-life of 12-30 hours periciazine; elimination of metabolites is even longer. Conjugated metabolites are excreted in the urine, and the remainder of the drug and its metabolites -. The bile and feces
Elderly patients metabolism and excretion slows phenothiazines.
- Acute psychotic trenbolone acetate cycle disorders.
- Chronic psychotic disorders such as schizophrenia, chronic neshizofrenicheskie delusional disorders: paranoid delusional disorder, chronic hallucinatory psychoses (for the treatment and prevention of relapse).
- Anxiety, agitation, aggressive or dangerous impulsive behavior (as a complementary drug for short-term treatment of these conditions).Contraindications
- Periciazine hypersensitivity and / or other ingredients of the formulation.
- Angle-closure glaucoma.
- Urinary retention amid prostate diseases.
- Agranulocytosis in history.
- Porphyry history.
- Concomitant therapy dopaminergic agonists: levodopa, amantadine, apomorphine, bromocriptine, cabergoline, entacapone, lisuride, pergolide, piribenidilom, pramipexole, quinagolide, ropinirole, except for their use in patients with Parkinson’s disease (see section “Interaction with other medicinal products”). .
- Vascular insufficiency (collapse).
- Acute poisoning substances depressing the central nervous system, or coma.
- Heart failure.
- Myasthenia heavy psevdoparaliticheskaya (Goldflam disease).
- Children’s age (for a given dosage form)With careful preparation should be used in the following groups of patients:
- in patients with predisposing factors for the development of ventricular arrhythmias (patients with cardiovascular disease, congenital long interval QT, bradycardia, hypokalemia, hypomagnesemia, starving and / or alcohol abuse, receiving concomitant therapy with drugs able to prolong the QT interval and / or induce bradycardia less than 55 beats per minute, to slow intracardiac conduction, or change the electrolyte composition of the blood), as the phenothiazine antipsychotics in very rare cases may cause prolongation of the interval QT (this effect is dose-dependent) and increase the risk of serious ventricular arrhythmias, including bidirectional ventricular tachycardia type “pirouette”, which can be life-threatening (sudden death);
- in patients with renal and / or hepatic impairment (risk of accumulation of the drug);
- in elderly patients (there is an increased susceptibility to the development of postural hypotension, excessive hypotensive and sedative effects, the development of extrapyramidal disorders, hyperthermia in hot and hypothermia in cold weather, constipation, paralytic ileus and urinary retention in diseases of the prostate, there is a risk of accumulation of the drug from -this decreased hepatic and renal function);
- in patients with cardiovascular disease (because of possible danger to them and hinidinopodobnyh hypotensive effects of the drug’s ability to cause tachycardia);
- in elderly patients with dementia and patients with risk factors for stroke (in elderly patients with dementia there was a threefold increase in the incidence of stroke);
- in patients with risk factors for thromboembolism (see. sections on “Side effects”, “Special instructions”).
- in patients with epilepsy do not receive adequate anticonvulsant therapy (neuroleptics of the phenothiazine group decrease seizure threshold);
- in patients with Parkinson’s disease;
- in patients with hyperthyroidism (increased risk of agranulocytosis periciazine when used in combination with drugs for the treatment of hyperthyroidism);
- in patients with blood picture changes (increased risk of leucopenia or agranulocytosis);
- in patients with breast cancer (in connection with the possibility of an increase in the blood prolactin level of disease progression).Pregnancy and lactation
It is desirable to maintain the mental health of the mother during pregnancy to prevent decompensation. If in order to maintain mental balance needed drug therapy, it must begin and continue at an effective dose throughout pregnancy. Experimental studies in animals have not revealed teratogenic effects periciazine. Studies periciazine teratogenic effects in humans have not been conducted, there is no data on the impact of admission periciazine during pregnancy on the development of the fetal brain, but the analysis of the pregnancies, which proceeded at a reception periciazine showed his lack of specific teratogenic effects. Thus, the risk of teratogenic effects of the drug, if he exists, is not significant.
The appointment periciazine during pregnancy is possible, but every time it is necessary to compare the benefits to the mother and the risk to the fetus. . It is advisable to limit the duration of the appointment of the drug during pregnancy
In rare cases it was reported about the appearance of these disorders in newborns whose mothers received long-term treatment with high doses of periciazine:
- tachycardia, hyperexcitability, abdominal distension, meconium discharge of the delay trenbolone acetate cycle associated with the action of the drug atropine, which can be potentiated in the event of combination with corrective antiparkinsonian means oppressive cholinergic transmission in the central nervous system;
- extrapyramidal disorder (muscular hypertonicity, tremors);
If possible, at the end of pregnancy, it is desirable to reduce the doses of periciazine and correcting its antiparkinsonian agents capable of potentiating the action of atropine neuroleptics.In infants should monitor the status and function of the nervous system of the gastrointestinal tract.Lactation
In the absence of data on the penetration of the drug in breast milk is not recommended for breast-feeding during treatment.
Dosage varies considerably depending on the indication and the patient’s condition. Doses must be individualized. If the patient’s condition allows, the treatment should begin with low doses, which can then be gradually increased. Always use the minimum effective dose.
The daily dose should be divided into 2 or 3 doses and most of the dose must always be taken in the evening.
In adults, the daily dose can range from 30 mg to 100 mg.
The maximum daily dose is 200 mg. The treatment of acute and chronic psychotic disorders The initial daily dose is 70 mg divided into 2-3 doses). The daily dosage can be increased by 20 mg weekly until the optimum effect (on average up to 100 mg per day). In exceptional cases, the daily dose may be increased to 200 mg. Correction of behavior initial daily dose is 10-30 mg. Treatment of elderly patientsDoses are reduced by 2-4 times.Side effects
Trenbolone acetate cycle is generally well tolerated, however, in some cases, there may be the following adverse reactions, the occurrence of which may be as dependent and does not depend on the magnitude of the received dose in the latter case be the result of increased individual patient sensitivity. On the side of the central the nervous system . Sedation or drowsiness, more pronounced at the beginning of treatment and usually pass after a few days . Apathy, anxiety, mood changes in some cases, possible paradoxical effects: insomnia, agitation, sleep inversion, increased aggressiveness and increased psychotic symptoms. Extrapyramidal disorders ( often arising from the use of the drug in high doses):
- acute dystonia or dyskinesia (spasmodic torticollis, oculogyric crises, lockjaw itp) arising usually within 4 days after the start of treatment or dose increase;
- Parkinson’s disease, which occurs more frequently in elderly patients and / or after long-term treatment (weeks or months) and partially eliminated in the appointment of anticholinergic antiparkinsonian and manifests the appearance of one or more of the following symptoms: tremor (very often the only manifestation of Parkinson’s disease) rigidity, akinesia in combination with or without muscle hypertonicity it;
- late dyskinesia or dystonia, usually (but not always) resulting in long-term treatment and / or application of the drug at high doses, and are able to occur even after cessation of treatment (when they occur anticholinergic antiparkinsonian agents have no effect, and can cause deterioration);
- akathisia, usually observed after administration of high initial doses.
Ventilatory depression (possibly in patients with predisposing factors to the development of respiratory depression, for example in patients receiving other medications that can depress respiration, elderly patients, and the like). From the autonomic
- Anticholinergic effects (dry mouth, paresis of accommodation, urinary retention, constipation, paralytic ileus). On the part of the cardiovascular system
- Lowering blood pressure, usually postural hypotension (usually occurs in elderly patients and patients with a reduction in circulating blood volume, especially at the beginning of treatment and when using a high initial dose).
- Arrhythmias, including atrial arrhythmias, atrioventricular block, ventricular tachycardia, including potentially fatal ventricular tachycardia type “pirouette”, the more likely when using high doses (see sections “Contraindications”, subsection “With care”; “. Interaction with other drugs means “;” Special instructions “).
- ECG changes, usually minor: lengthening of the interval QT, depression of segment ST, the appearance of U wave and T wave changes
- In the application of neuroleptics observed cases of thromboembolism, including pulmonary embolism (sometimes fatal) and cases of deep vein thrombosis (see. Section “Special instructions”). Endocrine and metabolic disorders (often arising from the use of the drug in high doses)
- Hyperprolactinemia, which can lead to amenorrhea, galaktoree, gynecomastia, impotence, frigidity.
- The increase in body weight.
- Disorders of thermoregulation.