Ciamemazina

Estrutura química de Ciamemazina
Ciamemazina
Aviso médico
Nome IUPAC (sistemática)
10-[3-(dimethylamino)-2-methylpropyl]phenothiazine-2-carbonitrile
Identificadores
CAS 3546-03-0
ATC N05AA06
PubChem 62865
DrugBank DB09000
Informação química
Fórmula molecular C19H21N3S 
Massa molar 323.458 g/mol
Farmacocinética
Biodisponibilidade De 10% a 70%.
Metabolismo Hepático.
Meia-vida 10 Horas.
Excreção Renal
Considerações terapêuticas
Administração Oral
DL50 ?

A ciamemazina é um antipsicótico típico pertencente ao grupo das fenotiazinas que, assim como outras drogas desse grupo, é dotada de atividade antiadrenérgica, antidopaminérgica, anti-histamínica, anticolinérgica e é um antagonista do receptor de serotonina. Dentre essas propriedades, a que mais se destaca é a de anti-histamínica, fazendo com que esse psicofármaco tenha uma ação sedativa com potência de 2 a 3 vezes, em média, superior à da clorpromazina.[1][2]

Indicações

  • Estados ansiosos e psicóticos (tanto em adultos como em crianças);
  • Neuroses obsessivas de evolução grave, como as que ocorrem durante o período de abstinência em pacientes dependentes de álcool ou outras drogas;
  • Estado elevado de agressividade;
  • Tratamento das depressões graves (geralmente associado a um antidepressivo).[2]

Mecanismo de ação

Exerce seu efeito sedativo bloqueando os receptores de dopamina (do tipo D2, D3 e D4), receptores serotoninérgicos (do tipo 5-HT1A; 5-HT2A; 5-HT2C e 5-HT7), receptores histamínicos H1, receptores muscarínicos (M2; M4, M5 e os receptores adrenérgicos alfa 1.

O principal mecanismo que contribui para a ação antipsicótica é o bloqueio (antagonismo) dos receptores dopaminérgicos.[3]

Efeitos colaterais

As reações descritas como mais relevantes foram: sonolência; astenia; apatia; hipotensão ortostática; taquicardia; boca seca; obstipação e diminuição da líbido.

Já as mais raras ou menos comuns foram: convulsões, colapso respiratório; enterocolite necrosante e priapismo.[4]

Interações medicamentosas

A associação da Ciamemazina com alguns antiarrítmicos (como quinidina, amiodarona, ibutilida, sotalol) pode provocar uma complicação conhecida como torsades de pointes.[carece de fontes?]

Pode potencializar o efeito de medicamentos anti-hipertensivos, como o captopril, aumentando o risco da ocorrência de uma hipotensão ortostática. Já o uso concomitante com a guanetidina pode inibir o efeito anti-hipertensivo da mesma.[carece de fontes?]

O uso com substâncias de ação depressora sobre o sistema nervoso central (álcool, barbitúricos, opiáceos, benzodiazepinas, anti-histamínicos H1 de primeira geração, tranquilizantes e outros) pode intensificar os efeitos de sonolência, hipotensão e astenia, por exemplo.[4]

Ver também

Referências

  1. ↑ GORENSTEIN, CLARICE. «ANTIPSICÓTICOS.» (PDF). Instituto de Ciências Biomédicas. Universidade de São Paulo (USP). Consultado em 4 de Julho de 2017 
  2. ↑ a b www.mymedfarma.com, MyMedFarma -. «TERCIAN gotas orais, sol. | Princípios Ativos». mymedfarma.com. Consultado em 4 de julho de 2017 
  3. ↑ Hameg, Ahcène; Bayle, Franck; Nuss, Philippe; Dupuis, Philippe; Garay, Ricardo P.; Dib, Michel (1 de fevereiro de 2003). «Affinity of cyamemazine, an anxiolytic antipsychotic drug, for human recombinant dopamine vs. serotonin receptor subtypes». Biochemical Pharmacology. 65 (3): 435–440. doi:10.1016/S0006-2952(02)01515-0 
  4. ↑ a b «Tercian 40 mg/ml gotas orais». 29 de Junho de 2015. Consultado em 4 de Julho de 2017 

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