Phenothiazines Health Dictionary

Chorea, or St Vitus’s dance, is the occurrence of short, purposeless involuntary movements of the face, head, hands and feet. Movements are sudden, but the affected person may hold the new posture for several seconds. Chorea is often accompanied by ATHETOSIS, when it is termed choreoathetosis. Choreic symptoms are often due to disease of the basal ganglion in the brain. The withdrawal of phenothiazines may cause the symptoms, as can the drugs used to treat PARKINSONISM. Types of chorea include HUNTINGTON’S CHOREA, an inherited disease, and SYDENHAM’S CHOREA, which is autoimmune. There is also a degenerative form – senile chorea.... chorea

Linn.

Family: Boraginaceae.

Habitat: The Mediteranean region, Europe and Asia.

English: Borage, Cow's Tongue Plant.

Unani: Gaozabaan (Onosma bracteatum Wall. has also been equated with Gaozabaan).

Action: Fresh herb (compounded with water)—refreshing, restorative and nervine tonic. Leaves and flowers—diuretic, febrifuge, expectorant, demulcent, emollient; promote the activity of kidneys; alleviate pulmonary affections.

The drug strengthens adrenal glands and is given for stress, mental exhau- sion and depression; provides support to stomach and intestines in cases of infection and toxicity. Used as a tonic to counteract the lingering effects of steroid therapy. Seeds relieve irritable bowel syndrome and regulate menstruation.

The leaves contain lycopsamine and supindine viridiflorate as the predominant unsaturated pyrrolizidine alkaloids. Due to low concentration of these alkaloids Borage is not toxic.

The drug contains potassium and calcium, combined with mineral acids. The fresh juice affords 30%, the dried herb 3% of nitrate of potash. The stems and leaves supply much saline mucilage. These saline qualities are mainly responsible for the wholesome invigorating properties of Borage.

Borage imparts pleasant flavour and cooling effect to beverages. In India, squashes and syrups, sold during summer, contain Borage extract.

Borage contains ascorbic acid (38 mg/100 g). Flowers contain cholin, glucose, fructose, amino acids, tannin (about 3%). Seeds contain protein (20.9%) and an oil (38.3%). The seed oil is one of the important sources of gamma-linoleic acid and linoleic acid. Borage oil, combined with Evening Primrose oil, is used in hypercholes- terolaemia.

Borage seed oil is used for rheumatoid arthritis, atopic eczema, infantile seborrhoeic dermatitis, neurodermati- tis, also for PMS and for preventing heart disease and stroke. Only UPA (unsaturated pyrrolizidine alkaloids) free oil is given internally.

Listed by German Commission E among unapproved herbs.

It has been suggested that borage not be used with drugs known to lower the seizure threshold such as tricyclic an- tidepressants and phenothiazines due to GLA content (only borage seed oil contains significant amounts of GLA). (Francis Brinker.)... borago officinalis

One of the butyrophenone group of drugs used to treat patients with psychoses (see PSYCHOSIS). Its action is similar to that of the PHENOTHIAZINES. It is also used in depot form, being administered by deep intramuscular injection for maintenance control of SCHIZOPHRENIA and other psychoses. The drug may help to control tics and intractable hiccups.... haloperidol

See PHENOTHIAZINES.... perphenazine

Prolactin is the pituitary hormone (see PITUITARY GLAND) which initiates lactation. The development of the breasts during pregnancy is ascribed to the action of OESTROGENS; prolactin starts them secreting. If lactation does not occur or fails, it may be started by injection of prolactin.

The secretion of prolactin is normally kept under tonic inhibition by the secretion of DOPAMINE which inhibits prolactin. This is formed in the HYPOTHALAMUS and secreted into the portal capillaries of the pituitary stalk to reach the anterior pituitary cells. Drugs that deplete the brain stores of dopamine or antagonise dopamine at receptor level will cause HYPERPROLACTINAEMIA and hence the secretion of milk from the breast and AMENORRHOEA. METHYLDOPA and RESERPINE deplete brain stores of dopamine and the PHENOTHIAZINES act as dopamine antagonists at receptor level. Other causes of excess secretion of prolactin are pituitary tumours, which may be minute and are then called microadenomas, or may actually enlarge the pituitary fossa and are then called macroadenomas. The most common cause of hyperprolactinaemia is a pituitary tumour. The patient may present with infertility – because patients with hyperprolactinaemia do not ovulate – or with amenorrhea and even GALACTORRHOEA.

BROMOCRIPTINE is a dopamine agonist. Treatment with bromocriptine will therefore control hyperprolactinaemia, restoring normal menstruation and ovulation and suppressing galactorrhoea. If the cause of hyperprolactinaemia is an adenomatous growth in the pituitary gland, surgical treatment should be considered.... prolactin

n. a writhing involuntary movement especially affecting the hands, face, and tongue. It is usually a form of *cerebral palsy. It impairs the child’s ability to speak or use his hands; intelligence is often unaffected. Such movements may also be caused by drugs used to treat *parkinsonism or by the phenothiazines (see also dyskinesia). —athetotic adj.... athetosis

n. a group of involuntary movements that appear to be a fragmentation of the normal smoothly controlled limb and facial movements. They include *chorea, *dystonia, *athetosis, and those involuntary movements occurring as side-effects to the use of levodopa and the phenothiazines (see tardive dyskinesia).... dyskinesia

a condition characterized by involuntary repetitive movements of the facial muscles and the tongue, usually resembling continued chewing motions, and the muscles of the limbs. It is associated with long-term medication with certain antipsychotic drugs, especially the *phenothiazines, and occurs predominantly in older patients.... tardive dyskinesia

Inadequate sexual response may be due to a lack of sexual desire (LIBIDO) or to an inadequate performance; or it may be that there is a lack of satisfaction or ORGASM. Lack of sexual desire may be due to any generalised illness or endocrine disorder, or to the taking of drugs that antagonise endocrine function (see ENDOCRINE GLANDS). Disorders of performance in men can occur during arousal, penetration and EJACULATION. In the female, DYSPAREUNIA and VAGINISMUS are the main disorders of performance. DIABETES MELLITUS can cause a neuropathy which results in loss of erection. IMPOTENCE can follow nerve damage from operations on the PROSTATE GLAND and lower bowel, and can be the result of neurological diseases affecting the autonomic system (see NERVOUS SYSTEM). Disorders of satisfaction include, in men, impotence, emission without forceful ejaculation and pleasureless ejaculation. In women such disorders range from the absence of the congestive genital response to absence of orgasm. Erectile dysfunction in men can sometimes be treated with SILDENAFIL CITRATE (Viagra®), a drug that recent research suggests may also be helpful to women with reduced libido and/or inability to achieve orgasm.

Sexual dysfunction may be due to physical or psychiatric disease, or it may be the result of the administration of drugs. The main group of drugs likely to cause sexual problems are the ANTICONVULSANTS, the ANTIHYPERTENSIVE DRUGS, and drugs such as metoclopramide that induce HYPERPROLACTINAEMIA. The benzodiazepine TRANQUILLISERS can reduce libido and cause failure of erection. Tricyclic ANTIDEPRESSANT DRUGS may cause failure of erection and clomipramine may delay or abolish ejaculation by blockade of alpha-adrenergic receptors. The MONOAMINE OXIDASE INHIBITORS (MAOIS) often inhibit ejaculation. The PHENOTHIAZINES reduce sexual desire and arousal and may cause di?culty in maintaining an erection. The antihypertensive drug, methyldopa, causes impotence in over 20 per cent of patients on large doses. The beta-adrenoceptorblockers and the DIURETICS can also cause impotence. The main psychiatric causes of sexual dysfunction include stress, depression and guilt.... sexual dysfunction

A condition in which the affected person loses the power of balancing him or herself, and has a false sensation as to his or her own movements or those of surrounding objects. The power of balancing depends upon sensations derived partly through the sense of touch, partly from the eyes, but mainly from the semicircular canals of the internal EAR – the vestibular mechanism. In general, vertigo is due to some interference with this vestibular ocular re?ex mechanism or with the centres in the cerebellum and cerebrum (see BRAIN) with which it is connected. Giddiness is often associated with headache, nausea and vomiting.

Causes The simplest cause of vertigo is some mechanical disturbance of the body affecting the ?uid in the internal ear; such as that produced by moving in a swing with the eyes shut, the motion of a boat causing sea-sickness, or a sudden fall. (See also MOTION (TRAVEL) SICKNESS.)

Another common positional variety is benign paroxysmal positional vertigo (BPPV) caused by sudden change in the position of the head; this causes small granular masses in the cupola of the posterior semicircular canal in the inner ear to be displaced. It may subside spontaneously within a few weeks but can recur. Sometimes altering the position of the head so as to facilitate return of the crystals to the cupola will stop the vertigo.

The cause which produces a severe and sudden giddiness is MENIÈRE’S DISEASE, a condition in which there is loss of function of the vestibular mechanism of the inner ear. An acute labyrinthitis – in?ammation of the labyrinth of the ear – may result from viral infection and produce a severe vertigo lasting 2–5 days. Because it often occurs in epidemics it is often called epidemic vertigo. Vertigo is sometimes produced by the removal of wax from the ear, or even by syringing out the ear. (See EAR, DISEASES OF.)

A severe upset in the gastrointestinal tract may cause vertigo. Refractive errors in the eyes, an attack of MIGRAINE, a mild attack of EPILEPSY, and gross diseases of the brain, such as tumours, are other causes acting more directly upon the central nervous system. Finally, giddiness may be due to some disorder of the circulation, for example, reduced blood supply to the brain produced by fainting, or by disease of the heart.

Treatment While the attack lasts, this requires the sufferer to lie down in a darkened, quiet room. SEDATIVES have most in?uence in diminishing giddiness when it is distressing. After the attack is over, the individual should be examined to establish the cause and, if necessary, to be given appropriate treatment.

Vertigo and nausea linked to Menière’s disease – or following surgery on the middle ear – can be hard to treat. HYOSCINE, ANTI HISTAMINE DRUGS and PHENOTHIAZINES – for example, prochlorperazine – are often e?ective in preventing and treating these disorders. Cinnarizine and betahistine have been marketed as e?ective drugs for Menière’s disease; for acute attacks, cyclizine or prochlorperazine given by intramuscular injection or rectally can be of value. Research in America is exploring the use of virtual-reality technology to change subjects’ visual perception of the outside world gradually during several 30-minute sessions, helping them to adjust to the abnormal sensations that occur during an attack. Early results are promising.... vertigo

A condition in which there is a marked decrease or absence of polynuclear or granular white cells in the blood following prolonged septic conditions or from taking such drugs as phenothiazines, thiouracil and chloramphenicol. Other causes: radiation therapy, leukaemia, aplastic anaemia.

Symptoms: sore mouth, throat and lungs with bacterial infection.

Treatment: Should be supportive to specific medical treatment. Stop drugs that may be causative. Select from:–

Angelica, Burdock leaves, Calamus, Chamomile, Chickweed, Comfrey, Dandelion, Ginseng, Ground Ivy, Gotu Kola, Iceland Moss, Irish Moss, Liquorice root. Lime flowers, Linseed, Marshmallow leaves, Mullein leaves, Plantain, Red Clover flowers, Thuja, Violet leaves.

Tea. Combine equal parts: Red Clover, Gotu Kola, Mullein. 1 heaped teaspoon to each cup boiling water; infuse 10-15 minutes; dose, half-1 cup freely, as tolerated.

Tablets/capsules: Goldenseal, Echinacea, Iceland Moss, Ginseng. Dosage as on bottle.

Powders: Formula. Red Clover 2; Ginseng 1; Echinacea 1. Dose: 750mg (or three 00 capsules or half a teaspoon) thrice daily.

Tinctures. Combine Echinacea 2; Goldenseal 1; Fringe Tree 1. Dose: 1-2 teaspoons in water thrice daily. Topical: Epsom’s salts baths.

Diet: High protein, high fibre, low fat, low salt, regular raw food days. Vitamins C, B-complex (especially B12), folic acid, bioflavonoids. Minerals – copper, iron, zinc. ... agranulocytosis

n. any one of a group of drugs used to treat severe mental disorders (psychoses), including schizophrenia and mania; some are administered in small doses to relieve anxiety and tic disorders or to treat impulsivity in *emotionally unstable personality disorder. Formerly called major tranquillizers, and later typical and atypical antipsychotics, they are now known as first- and second-generation antipsychotics. The first-generation (or typical) antipsychotics include the *phenothiazines (e.g. *chlorpromazine), *butyrophenones (e.g. *haloperidol), and thioxanthenes (e.g. *flupentixol). Side-effects of antipsychotic drugs can include *extrapyramidal effects, sedation, *antimuscarinic effects, weight gain, and *long QT syndrome. The second-generation (or atypical) antipsychotics are a group of more recently developed drugs that are in theory associated with fewer extrapyramidal effects than first-generation antipsychotics: they include *clozapine, *risperidone, amisulpride, aripiprazole, olanzapine, and quetiapine. Antipsychotics act on various neurotransmitter receptors in the brain, including dopamine, histamine, serotonin, and cholinergic receptors. Most of them block neurotransmitter activity, but some have partially agonistic effects. Recent evidence suggests that there are significant differences among the second-generation antipsychotics regarding their efficacy and side-effect profiles. Clozapine, amisulpride, and olanzapine were found to be the most effective antipsychotics. Clozapine, zotepine, and olanzapine caused the most weight gain; haloperidol, zotepine, and chlorpromazine caused the most extrapyramidal side-effects; sertindole, amisulpride, and ziprasidone caused the most QT-prolongation; and clozapine, zotepine, and chlorpromazine caused the most sedation.... antipsychotic

n. a *catecholamine derived from dopa that functions as a *neurotransmitter, acting on specific dopamine receptors and also on adrenoceptors throughout the body, especially in the *limbic system and *extrapyramidal system of the brain as well as the arteries and the heart. It also stimulates the release of noradrenaline from nerve endings. The effects vary with location and concentration. Dopamine is used in carefully controlled dosage to increase the strength of contraction of the heart in heart failure, shock, severe trauma, and septicaemia. Possible side-effects include unduly rapid or irregular heartbeat, nausea, vomiting, breathlessness, angina pectoris, and kidney damage.

Certain drugs (dopamine receptor agonists) have an effect on the body similar to that of dopamine. They include *apomorphine, *pergolide, *ropinirole, *cabergoline, and pramipexole and are used to treat *parkinsonism. Drugs that compete with dopamine to occupy and block the dopamine receptor sites in the body are known as dopamine receptor antagonists. They include some *antipsychotic drugs (e.g. the phenothiazines and *butyrophenones) and certain drugs (e.g. *domperidone and *metoclopramide) used to treat nausea and vomiting.... dopamine