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Antihistamines, Decongestants, and Expectorants during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Terfenadine (Seldane) is a medication derived from butyrophenone. Butyrophenone derivatives are diverse, and range from antihistamines to antipsychotics. The frequency of birth defects among 134 infants born following first trimester exposure to terfenadine was not increased (Schick et al., 994). In a large review, the frequency of birth defects was not increased among 2,194 infants exposed to terfenadine during embryogenesis (Gilbert et al., 2005; see Table 11.3).
Gilles de la Tourette’s syndrome
Published in David Enoch, Basant K. Puri, Hadrian Ball, Uncommon Psychiatric Syndromes, 2020
David Enoch, Basant K. Puri, Hadrian Ball
The management of Gilles de la Tourette’s syndrome requires an eclectic approach involving a combination of drug therapy and psychological intervention. The following regime is recommended:Initially a trial of butyrophenones (or other antipsychotics or possibly SSRI antidepressants) in conjunction with supportive psychotherapy.The treatment of any associated disorders, e.g. depression or obsessive-compulsive features.If the above fails to achieve adequate symptom relief, consider the addition of a course of behavioural therapy.
Diseases of the Nervous System
Published in George Feuer, Felix A. de la Iglesia, Molecular Biochemistry of Human Disease, 2020
George Feuer, Felix A. de la Iglesia
Several drugs cause side effects in the nervous system. These include drugs affecting mood and consciousness, several antibiotics, antiparasitics, and other drugs.40,42,151,189,242,375,492,513,536,546 Among the mood modifying drugs, major tranquilizers exert actions on the extrapyramidal motor system and evoke behavioral and autonomic effects often blending with their therapeutic properties.541 Especially in elderly patients, the side effects of phenothiazines, thioxanthenes, and butyrophenones are associated with hallucinations, impaired autonomic reflexes, and extrapyramidal syndromes including parkinsonism, tardive dyskinesia, and acute dystonic reactions.15 Acute dystonic reactioins occur shortly after initiating treatment. Parkinsonian syndromes develop gradually after prolonged treatment and can be reversed by reducing the antipsychotic agent or by using an antiparkinsonian drug.
Pharmacological management of cannabinoid hyperemesis syndrome: an update of the clinical literature
Published in Expert Opinion on Pharmacotherapy, 2022
Guillermo Burillo-Putze, John R. Richards, Consuelo Rodríguez-Jiménez, Alejandro Sanchez-Agüera
Haloperidol is a butyrophenone antipsychotic primarily used in psychiatry. However, it is also an effective antiemetic from its antagonism of chemoreceptor trigger zone dopaminergic D2 receptors [114]. Several cases of resolution of acute CHS symptoms after administration of haloperidol, at intravenous and intramuscular doses between 2.5 and 5 mg, have been reported [115,116]. Another mechanism could be tied to haloperidol’s sedative properties, which counter excessive sympathetic nervous system stimulation [64,65]. Haloperidol injection is not FDA-approved for intravenous administration. Although it is recommended to be administered intramuscularly, if given intravenously, an ECG should be monitored for QT prolongation and arrhythmias. However, in the systematic review by Beach et al., no clear evidence was found to suggest that intravenous application carries greater risk for QT prolongation or torsades de pointes than other antipsychotics [117].
Description of Adverse Events in a Cohort of Dance Festival Attendees with Stimulant-Induced Severe Agitation Treated with Dissociative-Dose Ketamine
Published in Prehospital Emergency Care, 2021
Matt S. Friedman, David Saloum, Astrid Haaland, Jefferson Drapkin, Antonios Likourezos, Reuben J. Strayer
Although traditional pharmacologic treatment of undifferentiated agitation in the prehospital environment includes butyrophenone neuroleptics such as haloperidol (12), as well as benzodiazepines such as midazolam, there is no consensus regarding the optimal agent or combination of agents (13). Use of benzodiazepines is limited by variable onset of action, unpredictable efficacy, and safety concerns such as the risk of respiratory depression that is heightened when the patient has consumed other sedatives such as alcohol. The sedative effects of haloperidol are comparatively delayed, especially when given by the intramuscular route, and may not be apparent until more than 20 minutes after IM injection (12). Both haloperidol and droperidol cause QT interval prolongation and carry an FDA warning around the risk of torsades de pointes (14, 15). Though evidence attests to their overall safety (16, 17), providers may also hesitate to use antipsychotics to treat undifferentiated agitation for concerns of lowering seizure threshold (18) or decreasing heat dissipation (19).
Comparison of psychotropic medication use in the Baltic countries
Published in Nordic Journal of Psychiatry, 2020
Jaanus Harro, Kaire Aadamsoo, Ly Rootslane, Ott Laius, Aet O’Leary, Virginija Adomaitiene, Biruta Kupca, Andres Lehtmets, Alvydas Navickas, Elmars Rancans, Maris Taube, Elmars Terauds, Kadri Pops
Gradual increase in the use of antipsychotics since the emergence of the second generation drugs is a world-wide phenomenon [23,24]. This is reflected in the presented statistics for the Baltics where the growth in the consumption of second generation antipsychotics in the period of observation has brought the antipsychotic use to the level of Nordic countries. As throughout the transition period the Baltic Countries have related closely with Nordic countries, and while the level of economic development still differs it is of primary relevance to compare psychotropic drug use with this region. Economic factors may have only limited effect on drug consumption measures and have not prevented the increase in antipsychotic use elsewhere [24]. Apparently antipsychotics are used at the level corresponding to essential need, and where economic factors may weigh in this could be represented in relatively higher use of butyrophenones as in the case of Latvia.