scholarly journals Systematic Review on Loxapine: A Typical Antipsychotic Drug Used to Treat Agitation in Schizophrenic Patients

Author(s):  
Abdul Halim ◽  
Ritika Puri

Loxapine is an antipsychotic drug used in neuroleptic disorders since 1980 with an entrenched drug profile. Drug possesses dibenzoxazepine tricyclic 7-membered heterocyclic ring available commercially as oral, intramuscular and inhalation dosage forms. This review comprises the various study designs of loxapine irrespective of its dose formulations. A comprehensive and systematic search was conducted on “Scopus”, “Web of science” and “Pub-med” data base and findings were critically analyzed. The data suggests that there is no significant difference in efficacy between typical and atypical antipsychotics.  Till now, oral and intramuscular route is widely in use. Oral dosage forms are available in the market for the treatment of agitation related to schizophrenia but it has limitation of delayed onset of action that results in increased risk. Intramuscular formulations reveal a significant difference compared to placebo with respect to agitation but time range could be in range of 15 to 60 minutes. Therefore, there is a need for a novel drug delivery system with rapid action, increased half life, better tolerance by the patient and sustained release to get enhanced patient compliance.

Author(s):  
Satbir Singh ◽  
Tarun Virmani ◽  
Reshu Virmani ◽  
Geeta Mahlawat ◽  
Pankaj Kumar

The Fast Dissolving Drug Delivery Systems sets a new benchmark was an expansion that came into existence in the early 1980’s and combat over the use of the different dosage form like tablets, suspension, syrups, capsules which are the other oral drug delivery systems. Fast Dissolving Drug Delivery System (FDTS)  has a major advantage over the conventional dosage forms since the drug gets rapidly disintegrated and dissolves in the saliva without the use of water .In spite of the downside lack of immediate onset of action; these oral dosage forms have valuable purposes such as self medication, increased patient compliance, ease of manufacturing and lack of pain. Hence Fast Disintegrating Tablets (FDTS) technology has been gaining importance now-a-days with wide variety of drugs serving many purposes. Fast Disintegrating Tablets (FDTS) has ever increased their demand in the last decade since they disintegrate in saliva in less than a minute that improved compliance in pediatrics and geriatric patients, who have difficulty in swallowing tablets or liquids. As fast dissolving tablet provide instantaneous disintegration after putting it on tongue, thereby rapid drug absorption and instantaneous bioavailability, whereas Fast dissolving oral films are used as practical alternative to FDTS. These films have a potential to deliver the drug systemically through intragastric, sublingual or buccal route of administration and also has been used for local action. In present review article different aspects of fast dissolving  tablets and films like method of preparations, latest technologies, evaluation parameters are discussed. This study will be useful for the researchers for their lab work.  


2016 ◽  
Vol 33 (S1) ◽  
pp. S612-S612
Author(s):  
M.D.C. García Mahía ◽  
Á. Fernández Quintana ◽  
M. Vidal Millares

IntroductionPrevious studies of prescribing in psychiatric services have identified the relatively frequent use of combined antipsychotics in schizophrenia.Aims– To analyze the proportion of patients treated with more than one antipsychotic;– to study clinical as sociodemographic variables associated with types of prescription.MethodsRetrospective descriptive study of treatment prescribed to psychiatric inpatients treated in an acute care unit of Psychiatry Service in a large teaching hospital during a period of 3 years. Consecutively admitted inpatients receiving concurrent antipsychotics were compared with those treated with a single antipsychotic. Prescription drug records at discharging were revised, n = 263.ResultsFrom the total sample, 61% received more than one antipsychotic. The most common types of combinations were atypical plus a typical antipsychotic followed by two atypical antipsychotics, being less frequent combination of three or more antipsychotics. There were 19 different drug combinations. Concurrent antipsychotics were most frequently prescribed in schizophrenia and schizoaffective disorder. Patients with more previous episodes of illness received more frequently concurrent antipsychotics than patients with low number of previous episodes of illness (P < 0.03). Patients with longer time of hospitalization, and age between 30 and 50 years were treated more frequently with several antipsychotics. Analysis with other variables is presented in the study.ConclusionsThere is a significant difference in the strategies of treatment with antipsychotics depending on diagnosis and number of previous episodes of illness. The concurrent use of multiple antipsychotics in psychiatric inpatients appears to be a response to treatment resistance and is frequent in schizophrenic patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Author(s):  
Lavanya Nagaraj ◽  
Naveen Kumar Madalageri

Background: Schizophrenia is a chronic debilitating disease with significant morbidity and mortality that often requires either typical or atypical antipsychotic pharmacotherapy. Atypical antipsychotic drugs are preferred over typical because of lower risk of extra pyramidal side effects. As there is paucity of data in Indian population, the present study was taken up to evaluate the efficacy of haloperidol and risperidone in the treatment of schizophrenia.Methods: It was a comparative study conducted on 60 patients of Schizophrenia for one year in a tertiary care hospital. The study subjects were randomly assigned into 2 groups of 30 patients each, where group 1 were treated with atypical antipsychotic drug risperidone and group 2 with typical antipsychotic drug Haloperidol and both groups received the treatment for one year. Efficacy was measured using positive and negative syndrome scale (PANSS), clinical global impression - severity of illness (CGI-S), clinical global impression - improvement (CGI-I) scales.Results: Both haloperidol and risperidone were associated with comparable baseline to endpoint reduction in symptom severity. However, risperidone treated subjects had significantly greater decrease in symptom severity as measured by PANSS score and total score, CGI-S scale. However, there is no significant difference between two groups in terms of CGI-S score.Conclusions: The reduction in positive, negative and general scores in risperidone treated patients were significant with that of haloperidol treated patients.


Author(s):  
Kiruthika Sivagourounadin ◽  
Vijayalakshmi Subbiah ◽  
Geetha Krishnasamy ◽  
Priyadharsini Rajendran

Background: The occurrence of metabolic abnormalities in schizophrenic patients has been increased with the rampant use of second-generation antipsychotics. The aim and objective of this study is to compare the metabolic derangements induced by a typical antipsychotic: haloperidol and an atypical antipsychotic, risperidone in patients with newly diagnosed schizophrenia in a tertiary care hospital.Methods: Out of 60 newly diagnosed schizophrenic patients, 30 patients received tablet haloperidol and the remaining 30 patients received tablet risperidone orally. The anthropometric measurements like height, weight, waist circumference was measured and blood investigations like fasting blood glucose level and fasting lipid profile were taken at baseline and at the end of 3 and 6 months of drug therapy. The metabolic derangements induced by the two antipsychotics were compared and analyzed at end of 3rd and 6th month using SPSS software version 16.Results: At the end of 6th month statistically significant differences (p<0.05) were observed in weight, waist circumference, fasting blood sugar, fasting triglyceride and high-density lipoprotein level between the haloperidol and risperidone group on following the International Diabetic Federation (IDF) criteria of metabolic syndrome. Risperidone caused metabolic abnormalities in 13.3%, 4 patients whereas none of the patients in haloperidol group developed metabolic syndrome.Conclusions: Hence it is concluded that the atypical antipsychotic risperidone has been associated with an increased risk of causing metabolic abnormalities than the typical antipsychotic haloperidol. Regular and periodic monitoring of the anthropometric and metabolic parameters in schizophrenic patients on antipsychotics especially the atypical antipsychotics is mandatory to prevent further complications.


2018 ◽  
Vol 6 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Pravin Kumar Sharma ◽  
Pankaj Kumar Sharma ◽  
Gajanan N Darwhekar ◽  
Birendra Shrivastava

Nowadays, novel fast dissolving oral films (FDF) have come in existence as an alternative dosage form in comparison with tablet, capsules, syrup and other oral dosage forms with respect to patient convenience and compliance. Fast dissolving oral films are helpful to paediatric and geriatric patients who experience difficulties in swallowing traditional oral solid-dosage forms. The FDF drug delivery systems are solid dosage form which disintegrate or dissolve within seconds when placed in the mouth cavity without need of water or chewing. FDF provide better drug dissolution, faster onset of action, bypassing the first pass metabolism of drugs and thus enhance their oral bioavailability with reduced dosing frequency. These formulations are suitable for cough, cold, sore throat, allergenic conditions, nausea, pain, hypertension and CNS disorders. The present review provides the details about the recent advancement in design and development of oral fast dissolving film.


2011 ◽  
Vol 139 (suppl. 1) ◽  
pp. 36-40 ◽  
Author(s):  
Goran Mihajlovic ◽  
Natalija Jovanovic-Mihajlovic ◽  
Branimir Radmanovic ◽  
Katarina Radonjic ◽  
Slavica Djukic-Dejanovic ◽  
...  

Introduction. In the last decades psychiatric patients? quality of life attracts great attention of researchers. Improving the quality of life of schizophrenic patients is increasingly becoming an imperative in pharmacological therapy. Objective. Analysis of certain aspects of quality of life in patients with schizophrenia treated with depot formulations of a typical antipsychotic (haloperidol) and injection preparation of a long-acting atypical antipsychotic (risperidone). Methods. Research was conducted as a cross-sectional study that included 60 patients of both genders. Examinees diagnosed with schizophrenia (ICD-10, F20.0-F20.9) were divided into two groups: the group of patients that received haloperidol depot (n=30) and the group of patients that received injection preparation of long-acting risperidone (n=30). In order to assess the quality of life, social functioning scale (SFS), satisfaction with life scale (SWLS), and short version of World Health Organization quality of life scale (WHO-QoL-Brief) were applied. Results. Results showed statistically significant differences when it comes to social activity and satisfaction with life in favour of patients treated with injection preparation of long-acting risperidone. Examinees from this group were much more satisfied with themselves, their health and sleep compared to those on haloperidol depot. There was no statistically significant difference found on the quality of life scale. Conclusions. Applying the scales for the assessment of the quality of life of schizophrenic patients in terms of psychosocial functioning, statistically significant difference between groups was found. Results showed higher scores in the group of patients treated with injection preparation of long-acting risperidone concerning social activities and life satisfaction.


2020 ◽  
Author(s):  
Angus N. OLI ◽  
Nwanneka ONYEASO ◽  
Stephen Chijioke Emencheta ◽  
Chijioke M. OFOMATA ◽  
James-Paul KRETCHY ◽  
...  

Abstract Background: Antibiotics are among the most common drugs used worldwide.They kill or prevent the growth of bacterial microorganisms in the body, hence, they are the major agents used in treating bacterial infections. Because they are prone to abuse and misuse, regular evaluation of their utilization is important for optimal healthcare delivery.Objective: This study determined the antibiotics type, utilization, prescriptions and cost patterns in the adult out-patient pharmacy of a public tertiary health facility in Nigeria.Methods: This is a retrospective observational study using medication utilization records (prescriptions) to investigate the study objectives. Prescriptions dispensed in 2018 in adult out-patient pharmacy of Nnamdi Azikiwe University Teaching Hospital, Nnewi were reviewed. Data were evaluated using the World Health Organization-developed prescribing indicators. Descriptive and inferential statistics were used to analyze the results. The percentage and averages of the variable were calculated.Results: The medication utilization records showed that there was a significantly higher proportion (P-value = 0.0038) of females (70%) compared to males (the ratio being 2.44:1.00) that were prescribed antibiotics. The antibiotic utilization profile showed that antibiotic selection by class was significantly different and accounted for 44.02% of the total variance seen in the prescription pattern (P-value is < 0.0001). Also, the age of participants accounted for 19.48% of the total variance seen in the selection practice and so, age significantly affected the selection practice/prescription pattern with P-value < 0.0001. Dosage forms profile showed that the oral dosage forms were significantly more prescribed (P-value < 0.0001) compared with any other dosage form encountered in the study. There was no significant difference in the prescription patterns of parenteral and other dosage forms (P-value > 0.05). A greater percentage (84.22 %) of the prescriptions was from the Essential Drug list of Nigeria. Conclusion: Though the percentage of antibiotics prescribed from essential medicines list was found to be satisfactory, a strict protocol for prescribers is required to promote rational antibiotics use. This would not only prevent antibiotic resistance but also reduce the treatment expenditure and encourage antibiotic stewardship.


2018 ◽  
Vol 6 (1) ◽  
pp. 1-7
Author(s):  
Pravin Kumar Sharma ◽  
Pankaj Kumar Sharma ◽  
Gajanan N Darwhekar ◽  
Birendra Shrivastava

Nowadays, novel fast dissolving oral films (FDF) have come in existence as an alternative dosage form in comparison with tablet, capsules, syrup and other oral dosage forms with respect to patient convenience and compliance. Fast dissolving oral films are helpful to paediatric and geriatric patients who experience difficulties in swallowing traditional oral solid-dosage forms. The FDF drug delivery systems are solid dosage form which disintegrate or dissolve within seconds when placed in the mouth cavity without need of water or chewing. FDF provide better drug dissolution, faster onset of action, bypassing the first pass metabolism of drugs and thus enhance their oral bioavailability with reduced dosing frequency. These formulations are suitable for cough, cold, sore throat, allergenic conditions, nausea, pain, hypertension and CNS disorders. The present review provides the details about the recent advancement in design and development of oral fast dissolving film.


2019 ◽  
Vol 9 (2) ◽  
pp. 461-468
Author(s):  
Rada Santosh Kumar ◽  
Annu Kumari

Mouth dissolving tablets have gained more popularity among solid oral dosage forms. They perform better than conventional tablets because of its ease of administration and patient’s compliance. It facilitates water less administration and rapid onset of action. It also helps in improving oral bioavailability. The fast disintegration followed by dissolution leads to quick therapeutic activity makes these tablets superior over available tablets and capsules. Disintegration is an important key step for any solid dosage forms to show its pharmacologic effect as any solid dosage forms should disperse into its fine particles from which it is prepared. In mouth dissolving tablets superdisintegrants are incorporated in right amount for quick disintegration with improved bioavailability. Based on the source various types of superdisintegrants are available. They are synthetic, semi-synthetic, natural, and co-processed.  In this review, main emphasis is given on different types of superdisintegrants used in mouth dissolving tablets, their mechanisms and applications. Keywords: Superdisintegrants, Mouth dissolving, Disintegration, Bioavailability


2021 ◽  
Vol 10 (4) ◽  
pp. 94-101
Author(s):  
Ranjitha M T ◽  
C N Somashekhar

A new dosage form, Oral disintegrating tablets (ODT’s) as a replacement to conventional oral dosage forms. ODT’s are dosage forms they disintegrate in mouth offering various advantages such as better mouth feel, dose accuracy, improved stability and convenient dosing as compared to oral liquids. So, there is need to designed oral disintegrating tablet to release the medicaments with an enhanced rate. Mefenamic acid is an anti- inflammatory drug while Dicyclomine HCl is anti-cholinergic drug. The combination of Mefenamic acid & Dicyclomine HCl controls pain very effectively, also relaxes bodily spasm which commonly arises during menstruation or intestinal colic spasm. This combination gives the quick onset of action and fast relief than conventional dosage form. For preparation of oral disintegrating tablet nine formulations were designed using Croscarmellose sodium and Crospovidone as superdisintegrants in varying concentration. All the formulations were prepared by direct compression method. Thus, all the formulations of Mefenamic acid and Dicyclomine HCl oral disintegrating tablets were investigated, in which F9 formulation was optimized. The % drug release of, Oral disintegrating tablet batch F9 has shown 96.98% of Mefenamic acid and 94.02 % of Dicyclomine HCl in 18 min, disintegration time in 40 sec and wetting time in 25sec.


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