Chlorpromazine, interactions with

A and solid state NMR study was undertaken to study chlorpromazine interaction with phosphatidylserines. Chlorpromazine is widely used as an antipsychotic drug. and solid state NMR techniques were employed to study phospholipid bilayers with and without chlorpromazine. 

Compounds 40—43 interacted with bovine brain-calmodulin as detected in a SDS-PAGE electrophoresis. Calmodulin treated with the lactones had lower electrophoretic mobility than untreated calmodulin. The effect was comparable to that of chlorpromazine, a well known calmodulin inhibitor. In addition, different concentrations of compounds 40 and 41 inhibited calmodulin-depen dent PDEl. The inhibitory activity of herbaru-mins 1 (IC50 = 14.2 xM) and II (IC50 = 6.6 xM) was higher than that of chlorpromazine (IC50 = 9.8... 

Clinicians should be aware of a few drug interactions with Zolpidem. Flumazenil acts as an antagonist to the hypnotic effects of zolpidem. There is decreased alertness when zolpidem is combined with cimetidine. There is an increase in anterograde amnesia in volunteers treated with a combination of imipramine and zolpidem. Haloperidol, ranitidine, chlorpromazine, warfarin, and digoxin, along with cimetidine and flumazenil, do not alter the pharmacokinetics of zolpidem (Salva and Costa, 1995). 

Several other examples of drug-membrane interactions have been reported. Using X-ray diffraction techniques, interactions with tetracyclines [75], pindolol [76], and chlorpromazine [77, 78] have been described. In these studies, it was shown that in the presence of chlorpromazine the bilayer thickness or lipid head group separation in DPPC liposomes is only 30 A, which is about 20 A smaller than two fully extended DPPC molecules. Chlorpromazine produced an interdigitated phase, which is in agreement with the observed effect of chlorpromazine on the shape of erythrocytes. 

Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, interact with drugs including clarithromycin, warfarin, phenelzine, benzotropine, chlorpromazine, diazepam, and cyproheptadine. Cigarette smokers metabolize SSRIs faster. 

Sulfonylureas In acute poisoning with sulfonylureas, the stomach should be washed and treated with activated charcoal, and hypoglycemia must be treated. Sulfonylureas interact with oral contraceptives, thiazide diuretics, corticosteroids, adrenaline, chlorpromazine, ACE inhibitors, some NSAIDs, antihistamines, anticoagulants, MAOIs, antidepressants, and many other drugs. Care must be exercised when treating with sulfonylureas. 

Seppala, T., Saario, I., Manila, M. (1976). Two weeks treatment with chlorpromazine, thioridazine, sulpiride, or bromazepam Actions and interactions with alcohol on psychomotor skills related to driving. Modern Problems in Pharmacopsychiatry, 11, 85-90. 

Lack of selectivity (C). Despite appropriate dosing and normal sensitivity, undesired effects can occur because the drug does not specifically act on the targeted (diseased) tissue or organ. For instance, the anticholinergic atropine is bound only to acetylcholine receptors of the muscarinic type however, these are present in many different organs. Moreover, the neuroleptic chlorpromazine is able to interact with several different receptor types. Thus, its action is neither organ-specific nor receptor-specific. 

Some pressor agents (e.g., epinephrine) may interact with chlorpromazine to lower blood pressure... 

As is shown in Table II, the EDA complexes of chlorpromazine with quinones are much more active than those with trinitrobenzene or pyromellitic acid anhydride, which are stronger electron acceptors. It might be suggested that the )>C=0 groups of quinones interact with the two nitrogen atoms in the chlorpromazine molecule to give active EDA complexes. From the biochemical point of view it is of interest that chlorpromazine forms a stable EDA complex with 2-methyl-a-naphthoquinone... 

Clinically important, potentially hazardous interactions with abacavir, amiodarone, bretylium, chlorpromazine, ciprofloxacin, disopyramide, enoxacin, fluphenazine, gatifloxacin, lomefloxacin, mesoridazine, moxifloxacin, norfloxacin, ofloxacin, phenothiazines, procainamide, prochlorperazine, promethazine, quinidine, quinolones, sotalol, sparfloxacin, thioridazine, trifluoperazine... 

Clinically important, potentially hazardous interactions with alcohol, anticholinergics, barbiturates, benzodiazepines, butabarbital, chloral hydrate, chlordiazepoxide, chlorpromazine, clonazepam, clorazepate, diazepam, ethchlorvynol, fluphenazine, flurazepam, hypnotics, lorazepam, MAO inhibitors, mephobarbital, mesoridazine, midazolam, narcotics, oxazepam, pentobarbital, phenobarbital, phenothiazines, phenylbutazone, primidone, prochlorperazine, promethazine, quazepam, secobarbital, sedatives, temazepam, thioridazine, tranquilizers, trifluoperazine, zolpidem... 

Clinically important, potentially hazardous interactions with atazanavir, chlorpromazine, cimetidine, co-trimoxazole, degarelix, fluphenazine, ketoconazole, medroxyprogesterone, megestrol, mesoridazine, phenothiazines, prochlorperazine, progestins, promethazine, ranolazine, thioridazine, trifluoperazine, trimethoprim, verapamil, zuclopenthixol... 

Clinically important, potentially hazardous interactions with albuterol, alpha-blockers, amitriptyline, amoxapine, atenolol, beta-blockers, carteolol, chlorpromazine, clomipramine, cocaine, desipramine, doxepin, ephedra, ergotamine, furazolidone, halothane, imipramine, insulin detemir, MAO inhibitors, metoprolol, nadolol, nortriptyline, oxprenolol, penbutolol, phenelzine, phenoxybenzamine, phenylephrine, pindolol, prazosin, propranolol, protriptyline, sympathomimetics, terbutaline, thioridazine, timolol, tranylcypromine, tricyclic antidepressants, trimipramine, vasopressors... 

Clinically important, potentially hazardous interactions with acetazolamide, aminoglycosides, anticholinesterases, bambuterol, calcium channel blockers, chloroquine, chlorpromazine, clindamycin, d-pencillamine, ecothiophate iodine, enflurane, furosemide, halothane, hexomethonium, isoflurane, ketamine, lidocaine, lincomycin, lithium salts, magnesium salts, mannitol, MAO inhibitors, organophosphates, pancuronium, phenytoin, polymyxins, procainamide, quinidine, sevoflurane, spectinomycin, tetracyclines... 

Clinically important, potentially hazardous interactions with amiodarone, amisulpride, amitriptyline, amoxapine, arsenic, bepridil, bretylium, calcium, chlorpromazine, clomipramine, desipramine, disopyramide, doxepin, erythromycin, fluphenazine, imipramine, iron salts, magnesium, mesoridazine, nortriptyline, pentamidine, perphenazine, phenothiazines, pimozide, procainamide, prochlorperazine, promazine, promethazine, protriptyline, quinidine, sotalol, sucralfate, thioridazine, tricyclic antidepressants, trifluoperazine, trimipramine, zinc salts... 

Thalidomide s interactions with other dmgs have not been systematically addressed, except for lack of significant interaction with oral contraceptives and thalidomide s effect in enhancing the sedative effects of barbitnrates and alcohol and the catatoiuc effects of chlorpromazine and reserpine. Conversely, CNS stimnlants (snch as metham-phetamine and methylphenidate) connteract the depressant effects of thalidomide. 

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