Non sedating anti emetic
Fulminant Hepatitis in children is a major drawback. Has primarily serotonin effects, with little anti-cholinergic effects. Often works when the other neuroleptics fail; similar in structure to tri-cyclics. Similar to the barbiturates but there is more rapid recovery. Centrally acting anti-cholinergic used as adjunct therapy in Parkinson's, to inhibit cholinergic interneurons.
The active metabolite of imipramine; more potent than imipramine. Preferred TCA for geriatric population, because of minimal sedation and anti-cholinergic effects. Has prominent anti-cholinergic effects: urinary retention, blurred vision, dry mouth. Desipramine is an active metabolite, which is more potent than imipramine itself. Still only used as second-line drug, because it has a high incidence (3%) of agranulocytosis. Used as (1) Anxiolytic (low dose), (2) Anti-convulsant (Status Epilepticus), (3) Pre-anesthetic medication, (4) Anti-Spasmodic Half-life prolonged by cimetidine. Can be used as adjunct therapy with anti-psychotics, to attenuate extra-pyramidal effects.
Sometimes used for its centrally-acting anti-cholinergic properties, as in an adjunct to anti-psychotic therapy.
Partial seizure treatment, or as adjunct to grand-mal treatment.
Up to 85% of women experience nausea in early pregnancy with approximately half of women vomiting as well.
Diuretic: Used to increase urinary excretion of weak acids: counteract salicylate and phenobarbitol poisoning.Anti-Convulsive: In CNS, indicated for treatment of petit-mal seizures, as it increases CO is thought to be the superior product.Administered at bedtime, and it takes 1-2 days for the softened feces to pass through.Normal saline (0.9%; 150 mmol/L) or Hartmann’s solution (sodium lactate) are appropriate choices for IV rehydration of pregnant women who are severely dehydrated.Dextrose containing fluids and hypertonic saline are inappropriate because they can precipitate severe neurological complications such as Wernicke’s encephalopathy and central pontine myelinolysis.