Saturday, June 9, 2012

Learn a Drug a Day - Tetrabenazine




Today's drug is tetrabenazine.
What is tetrabenazine indicated for?
INDICATIONS : 
  • It is used for the treatment of diseases, which cause jerky, irregular, uncontrollable movements such as Huntington’s chorea, senile chorea and hemiballismus.
  • It helps to control the condition, but does not cure it. 




How does tetrabenazine work?
MECHANISMS OF ACTION : 
  • Tetrabenazine act by depleting nerve endings of dopamine in the brain and is used to control movement disorders.



How is tetrabenazine being used?
ROUTE OF ADMINISTRATION : 
  • It is taken orally as tablets.
  • It may be taken with or without food.



Is there any contraindication?
CONTRAINDICATIONS : 
  • Tetrabenazine tablets contain lactose. It may cause problem in a small number of people who are sensitive to it.



Are there any possible side effects?
SIDE EFFECTS : 
  • Sleepiness and drowsiness 
  • Depression 
  • Uncontrollable movements of the hands, arms, legs and head (similar to those in Parkinson’s disease) 
  • Digestive problems 
  • Lowering of blood pressure 
  • Feeling nervous or anxious 
  • Trouble sleeping 
  • Difficulty in swallowing 
  • Chocking attacks 
  • Stiffness or tightness in the arms or legs 
  • Confusion or having thoughts of irrational ideas not shared by others 
  • Suicidal thoughts or behaviour




What precautions are necessary?
PRECAUTIONS :  
  • May exacerbate symptoms of parkinsonism. 
  • Caution to be exercised when driving or performing skilled tasks. 


DRUG INTERACTIONS : 
  • Reserpine and levodopa 
  • Medicines used to treat depression, such as monoamine oxidase inhibitors (MAOIs) and CYP2D6 inhibitors, such as fluoxetine, paroxetine, quinidine, duloxetine, terbinafine, amiodarone, or sertraline. It should not be given with or within 14 days of discontinuation of MAOI therapy. 
  • Medicines that affect the brain and nervous system including medication used to treat psychiatric conditions, strong painkillers and medication used to help sleep.  
  • Medicines used to treat psychosis, such as haloperidol, chlorpromazine and metoclopramide 
  • Medicines used to treat high blood pressure 
  • Medicines used to treat low blood pressure, such as beta blockers


Pregnancy and breastfeeding:  
  • There are no adequate and well-controlled studies in pregnant women. Tetrabenazine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
  • It is not known whether tetrabenazine or its metabolites are excreted in human milk.
  • Since many drugs are excreted into human milk and because of the potential for serious adverse reactions in nursing infants from tetrabenazine, a decision should be made whether to discontinue nursing or to discontinue tetrabenazine, taking into account the importance of the drug to the mother.









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