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Showing posts with the label Psychopharmacology

Clinical Vignette: Preventing Complication in A Man with Agitation

Clinical Vignette: Preventing Complication in A Man with Agitation A 30-year-old man, who is a heavy alcohol drinker, presented to the emergency department with agitation, altered sensorium, marked tremors, visual hallucinations. On assessment, he is unaware of the time, place, and person. His blood pressure and pulse were 160/11 and 115/min on arrival but fluctuated on monitoring. A GP had given him haloperidol IM and diazepam IV to control his behavioral disturbance.  What treatment-complication could arise? a)        Seizures b)       Over-sedation c)        Respiratory depression d)       Arrhythmia e)        Worsening agitation Benzodiazepines for the Treatment of Catatonia Safest Treatment Option for Delirium Tremens WHO Alcohol Withdrawal Treatment Guidelines

Interactions of clozapine

Interactions of Clozapine The cytochrome P450 system of enzymes in the liver inactivates and removes the toxic substances, including drugs, from the body. These enzymes include CYP 2D6, 2C9, 2C19, and 1 A2. But certain drugs can inhibit or induce these enzymes themselves. Some SSRIs are potent inhibitors of an individual or multiple hepatic cytochrome P450 (CYP) pathways and the magnitude of these effects is dose-related. Several clinically significant drug interactions can, therefore, be predicted. For example, fluvoxamine is a potent inhibitor of CYP1A2 which can result in increased theophylline serum levels, fluoxetine is a potent inhibitor of CYP2D6 which can cause increased seizure risk with clozapine, and paroxetine is a potent inhibitor of CYP2D6 which can cause treatment failure with tamoxifen (a prodrug), leading to increased mortality. Escitalopram has the least impact on these enzymes. QID: 20200407130027659