Description of the medicine: Thiethylperazin (Thiethylperazinum)
THIETHYLPERAZIN (Thiethylperazinum) *. 2-Ethylthio-10- [3- (1-methylpiperazinyl-4) propyl] phenothiazine dimaleate.
Synonyms: Torecan, Thiethylperazini maleas, Thiethylperazine maleate, Torecan, Toresten, Tresten.
Thietilperazine belongs to phenothiazine derivatives and in chemical structure is very close to the antipsychotic drug merazine (see). Thiethyl perazine differs from the latter in that in position 2 of the phenothiazine nucleus, hydrogen is replaced instead of the Cl atom by the SC 2 H 5 group.
Thiethyl perazine differs from typical phenothiazine antipsychotics in that it does not have pronounced sedative activity, only weakly potentiates the effect of sleeping pills and analgesic substances, does not have a pronounced cataleptogenic effect and usually does not cause severe extrapyramidal disorders in clinical use. However, thiethylperazine has a strong antiemetic effect; in this indicator, it is significantly more active than chlorpromazine, and is superior to meterazine.
The drug is effective for vomiting of various origins. Under experimental conditions, it suppresses vomiting caused by excitation of the vomiting center (apomorphine) and irritation of the gastrointestinal receptors (copper sulfate). The mechanism of antiemetic action of thiethylperazine consists of a calming effect on the vomiting center and simultaneous action on the chemoreceptor trigger (trigger) area of the medulla oblongata, while the effect on the chemoreceptor trigger zone predominates in the mechanism of antiemetic action of aminazine and other phenothiazine preparations. Thiethylperazine is therefore a more versatile antiemetic.
Thiethylperazine is used to prevent and stop nausea and vomiting of various origins, including during radiation therapy and chemotherapy of malignant neoplasms, during surgical interventions, diseases of the gastrointestinal tract, sea and air sickness, during migraine, and vomiting of pregnant women. Positive results (cessation of nausea and vomiting, reduction or termination of dizziness, nystagmus, gait disorders) were noted in vestibular and coordination disorders associated with cerebrovascular disorders, vegetovascular dystonia, and Meniere's disease.
Thiethyl perazine is prescribed orally in 1 tablet (6, 5 mg) 1–3 times a day or 1 suppository (6, 5 mg) is administered 2 times a day (morning and evening), in acute cases, 1–2 ml is administered intramuscularly ( 6, 5 - 13 mg) per day. The course of treatment continues if necessary for 2 to 4 weeks. To prevent postoperative vomiting, 1 ml (6, 5 mg) is administered intramuscularly about half an hour before the end of the operation.
The drug is usually well tolerated. Dry mouth, drowsiness, postural hypotension (at high doses) are sometimes observed. In rare cases (more often in children), extrapyramidal disorders may develop; in this regard, it is not recommended to prescribe the drug to children under the age of 15 years.