NAMA : JALALUDIN LANSAL

NIM : G 701 16 261

KELAS :A

JURUSAN/FAKULTAS : FARMASI/FMIPA

TUGAS : BHS. INGGRIS (MENCARI MATERI TENTANG FARMASI VERSI BHS.

INGGRIS)

Drug Interactions
Antipsychotics produce more important pharmacodynamic than pharmacokinetic interactions
because of their multiple effects.

Additive effects may occur when these drugs are combined with others that have sedative
effects, α-adrenoceptor–blocking action, anticholinergic effects, and—for thioridazine and
ziprasidone— quinidine-like action. A variety of pharmacokinetic interactions have been
reported, but none are of major clinical significance.

Overdoses

Poisonings with antipsychotic agents (unlike tricyclic antidepressants) are rarely fatal, with the
exception of those due to mesoridazine and thioridazine. In general, drowsiness proceeds to
coma, with an intervening period of agitation. Neuromuscular excitability may be increased and
proceed to convulsions. Pupils are miotic, and deep tendon reflexes are decreased. Hypotension
and hypothermia are the rule, although fever may be present later in the course. The lethal effects
of mesoridazine and thioridazine are related to induction of ventricular tachyarrhythmias.
Patients should be given the usual “ABCD” treatment for poisonings (see C hapter 58) and
treated supportively. Management of overdoses of thioridazine and mesoridazine, which are
complicated by cardiac arrhythmias, is similar to that for tricyclic antidepressants (see Chapter
30 ).

Psychosocial Treatment & Cognitive Remediation

Patients with schizophrenia need psychosocial support based around activities of daily living,
including housing, social activities, returning to school, obtaining the optimal level of work they
may be capable of, and restoring social interactions. Unfortunately, funding for this crucial
component of treatment has been minimized in recent years. Case management and therapy
services are a vital part of the treatment program that should be provided to patients with
schizophrenia. Firstepisode patients are particularly needful of this support because they often
deny their illness and are noncompliant with medication.

Benefits & Limitations of Drug Treatment

As noted at the beginning of this chapter, antipsychotic drugs have had a major impact on
psychiatric treatment. First, they have shifted the vast majority of patients from long-term
hospitalization to the community. For many patients, this shift has provided a better life under
more humane circumstances and in many cases has made possible life without frequent use of
physical restraints. For others, the tragedy of an aimless existence is now being played out in the
streets of our communities rather than in mental institutions. Second, these antipsychotic drugs
have markedly shifted psychiatric thinking to a more biologic orientation. Partly because of
research stimulated by the effects of these drugs on schizophrenia, we now know much more
about central nervous system physiology and pharmacology than was known before the
introduction of these agents. However, despite much research, schizophrenia

remains a scientific mystery and a personal disaster for the patient. Although most schizophrenic
patients obtain some degree of benefit from these drugs—in some cases substantial benefit—
none are made well by them.

REFERENSI : Katzung G Bertram, Susan B Masters, Anthony J. Trevor, BASIC & CLINICAL
PHARMACOLOGY, Mc Graw Hill Medical, New York.