Block 5
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Gabatino-Labra Block 5 CASE 5
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Block 5. CASE 5. Gabatino-Labra. CASE 5. Patient is a known schizophrenic maintained on Chlorpromazine 100 mg per orem 2x/day for 6 months . Two weeks prior to consult, he was prescribed Propranolol 40 mg/tablet 2 tablets 3x/day. QUESTION. What caused the symptoms of the patient?. - PowerPoint PPT Presentation
Transcript of Block 5
Gabatino-Labra
Block 5
CASE 5
45 year old
50 kg
male
referred for INCREASED SLEEPING HOURS and when awake would complain of DIZZY SPELLS.
CASE 5
• Patient is a known schizophrenic • maintained on CHLORPROMAZINE
– 100 MG PER OREM 2X/DAY FOR 6 MONTHS. • Two weeks prior to consult, he was
prescribed PROPRANOLOL – 40 MG/TABLET 2 TABLETS 3X/DAY.
QUESTION
• What caused the symptoms of the patient?
Psychotic Disorders
Increase dosage gradually until symptoms are controlled.
Daily dosage of 200 mg is not unusual
Side Effect: Drowsiness
Chlorpromazine
Metabolism
CYP 2D6
Chlorpromazine
7-hydroxylation
typically degraded by the liver by the action of cytochrome-P450 family
enzymes, usually CYP2D6
Hypertension
40 mg Inderal twice daily as usual dose
Side effects on the Central Nervous System: depression & lassitude
Propranolol
Metabolism
CYP 2D6
Propranolol
aromatic hydroxylation
4-hydroxy propranolol is a weak inhibitor of CYP2D6
DRUG INTERACTION
Chlorpromazine + propranolol
Sleepiness and dizziness
Chlorpromazine
70%Propranolol
DRUG INTERACTION
