2010/06/06

TRIHEXYPHENIDYL

Pharmacological action

Antiparkinsonian agent. Has a strong central anticholinergic effects of n-and m-peripheral anticholinergic effect. The central action helps to reduce or eliminate the motor disorders associated with extrapyramidal disorders.

In Parkinson's disease reduces the tremor, to a lesser extent, affects the rigidity and bradykinesia.

Has antispasmodic effect, which is associated with anticholinergic activity and direct miotropnym action.


Statement

Parkinsonism (idiopathic, postentsefalitny, atherosclerotic, due to side effects of drugs, as monotherapy and in combination with levodopa), Parkinson's disease, Little, spastic paralysis, associated with lesions of the extrapyramidal system.


Dosage regimen

Set individually. The initial dose is 0.5-1 mg / day. Then, if necessary, every 3-5 days, gradually increase the dose of 1-2 mg to achieve an optimal therapeutic effect, the multiplicity of reception - 3-5 times / day.

When hyperptyalism before treatment Trihexyphenidyl should be taken after meals. With the development in the treatment of dryness of the oral mucosa Trihexyphenidyl appointed before eating (if no nausea).

Maximum dose: when administered a single dose - 10 mg daily - 20 mg.


Side effect

From the CNS: headache, irritability, delirium, hallucinations, mental disorientation (especially in patients with atherosclerosis).

Effects due to the anticholinergic activity: dryness of the oral mucosa, blurred vision, increased intraocular pressure, constipation, difficulty urinating, tachycardia.

Allergic reactions: skin rash.

Other: purulent parotitis (due to xerostomia).


Contraindications

Urinary retention, prostate adenoma, glaucoma, atrial fibrillation, obstructive diseases of the digestive tract, pregnancy.


Application of pregnancy and breastfeeding

Trihexyphenidyl is contraindicated in pregnancy.


Cautions

Precautions are used for diseases of the heart, kidney or liver disease, arterial hypertension. Patients aged 60 years dosage Trihexyphenidyl exercise extreme caution because of the high likelihood of hypersensitivity reactions.

During treatment should regularly monitor the intraocular pressure.

Prolonged treatment of the intensity of adverse reactions caused by anticholinergic activity Trihexyphenidyl, usually decreases, possibly the development of drug dependence.

With simultaneous use of Trihexyphenidyl with levodopa dosing regimen required correction.

Effects on ability to drive vehicles and management mechanisms

During the period of Trihexyphenidyl is not recommended to engage in activities that require a high concentration of attention and quickness of psychomotor reactions.


Drug Interactions

With simultaneous use of agents possessing anticholinergic effects, may enhance their anticholinergic effect.

When applied simultaneously with levodopa decreases absorption and C max of levodopa in blood plasma.

When applied simultaneously with reserpine antiparkinsonian action Trihexyphenidyl reduced because drained reserves of catecholamines in the CNS. As a result, cholinergic neurons are activated, and the syndrome of parkinsonism increases.

With the simultaneous use may decrease the concentration of chlorpromazine in plasma, related, apparently, in violation of absorption from the gastrointestinal tract.