RU2063753C1 - Method for treating extrapyramidal syndrome in the cases of acute poisoning with haloperidol - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves administering riboxin at an intravenous jet dose of 1200-1500 mg (saturation dose) and then at an intravenous dropwise dose of 1600 mg with 5% glucose solution during 2-2.5 h. EFFECT: accelerated treatment course.

Description

 The invention relates to medicine, in particular to toxicology and can be used to treat extrapyramidal disorders in acute poisoning caused by haloperidol.

 Closest to the proposed method is a method of treating extrapyramidal disorders in acute poisoning with haloperidol using a central anticholinergic cyclodol (Mashkovsky M.D., 1988).

 The disadvantages of this method are relapses of extrapyramidal disorders, the treatment effect is not rapidly developing, possible disorders of the central nervous system with an increase in a single dose of cyclodol (agitation, hallucinations), the absence of a water-soluble form of this drug. In addition, cyclodol is contraindicated in glaucoma, in diseases of the heart, liver, and kidneys.

 The aim of the proposed method is to reduce the timing of stopping and preventing the recurrence of extrapyramidal disorders that occur during acute poisoning or overdose of haloperidol.

 This goal is achieved by the fact that riboxin (inosine), known as a pharmacopoeial drug approved for use, is one of the metabolites of purine metabolism (9-β-D-ribofuranosyl-hypoxanthine or hypoxanthine ribosin), a precursor of ATP and used to treat coronary disease from heart, heart rhythm disturbances, liver diseases, are administered intravenously, depending on the severity of the disorders, from 1200 to 1600 mg jet slowly once (saturation dose), and then drip into a 5% glucose solution at a dose of 1600 mg per ton 2 chenii 2.5 hours (maintenance dose).

 Example 1. Patient A., 19 years old, medical history N 1261, the diagnosis of acute haloperidol poisoning, extrapyramidal syndrome, established on the basis of anamnesis, clinical presentation and forensic chemistry of urine. At admission, motor disorders occurred that reflected on the muscles of the head and neck: peribular spasms, protrusions of the tongue, trismus, difficulty swallowing, spasms with hyperextension of the neck and trunk. The time from the moment of taking haloperidol was 36 hours (1.5 days). In order to stop the above clinical symptoms, the patient received orally 2 mg of cyclodol. Extrapyramidal disorders disappeared after 40 minutes. Discharged home in satisfactory condition, followed by relapse after 24 hours. Re-hospitalization was required.

 Example 2. Patient M., 25 years old, medical history N 1903. The diagnosis of acute haloperidol poisoning, extrapyramidal syndrome, established on the basis of the clinical picture and forensic chemical examination of urine. On admission, there were hyperkinetic and motor disorders: spasms with hyperextension of the neck and trunk, eye-glomerular crises, difficulty swallowing, peribuccal cramps, tongue protrusion. In this case, the patient was given riboxin at a dose of 1200 mg once intravenously and 1600 mg dropwise in a 5% glucose solution for 2 hours. After 12 minutes, the clinical manifestations characteristic of extrapyramidal syndrome were stopped and neither in the first hours nor subsequently resumed.

 The use of riboxin based on the fact that it is an endogenous ligand exhibits sedative properties. As an endogenous purine, it can bind to benzodiazepine receptors (for which high concentrations are necessary) and at the same time exhibits an anticonvulsant and muscle relaxant effect. Inosine receptor blockade takes place in its action.

 Riboxin has a similar effect in doses of 1200 to 1600 mg. Doses of less than 1200 mg may not cause the desired effect, while administration in doses exceeding 3000 4000 mg can also lead to a side effect in the form of skin itching, flushing of the skin.

 Clinical observations showed that this method stops the developed extrapyramidal syndrome within 12 to 20 minutes. After the treatment, patients noted an improvement in their general condition, the disappearance of violent movements, and restoration of their working capacity.

 When using cyclodol as a corrector of extrapyramidal disorders, a positive effect developed only after 30-40 minutes, and in many cases relapses of extrapyramidal symptoms occurred, which required re-hospitalization. An increase in the dose of cyclodol led to overdose symptoms.

 In parallel with the assessment of clinical symptoms, an electromyographic study was performed before and after treatment (after 12 minutes, 1, 12 and 24 hours).

 In all patients (28 people), no relapse of extrapyramidal disorders was observed either in the early or in the long term (2 weeks).

 The proposed method of treatment reduced the treatment time for patients with acute haloperidol poisoning by 1 2 days. The method allows you to quickly restore the ability to work of patients, simple to perform, available for use in outpatient practice and in ambulance.

Claims (1)

 A method of treating extrapyramidal syndrome in acute haloperidol poisoning by administering a drug, characterized in that riboxin is administered in a dose of 1200-1600 mg once and then dripped in a 5% glucose solution in a dose of 1600 mg for 2-2.5 hours.