Pharm

Trihexyphenidyl

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Trihexyphenidyl, Artane

  • Indications
  1. Parkinsonism (Idiopathic, Drug-Induced)
    1. Adjunctive, symptomatic management of Tremor or Drooling
  • Contraindications
  1. Narrow Angle Glaucoma
  2. Acute Bowel Obstruction
  3. Megacolon
  4. Elderly (relative)
    1. On Beer's List, due to risk of Delirium, pscyhosis, Fall Risk
  • Mechanism
  1. Centrally acting Muscarinic Antagonist
  2. Decreases imbalance of Acetylcholine to Dopamine ratio within corpus striatum (Basal Ganglia)
  1. Start 1 mg orally daily
  2. May titrate dose by 2 mg/day weekly
  3. Target 6 to 10 mg/day orally divided three to four times daily
  4. Maximum: 15 mg/day divided 3-4 times daily
  • Adverse Effects
  1. Anticholinergic Symptoms (Dry Mouth, Constipation, Urinary Retention, altered mentation)
  2. Pregnancy Category C
  3. Unknown safety in Lactation
  4. Withdrawal symptoms with severe increase in Parkinsonism symptoms
    1. Titrate medication off without abruptly stopping
  • References
  1. (2021) Med Lett Drugs Ther 63(1618): 25-32
  2. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 46-7
  3. Hamilton (2020) Tarascon Pocket Pharmacopoeia