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Block 5. CASE 5. Gabatino-Labra. CASE 5. Patient is a known schizophrenic maintained on Chlorpromazine 100 mg per orem 2x/day for 6 months . Two weeks prior to consult, he was prescribed Propranolol 40 mg/tablet 2 tablets 3x/day. QUESTION. What caused the symptoms of the patient?.

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Block 5

CASE 5

Gabatino-Labra


CASE 5


  • Patient is a knownschizophrenic

  • maintained on Chlorpromazine

    • 100 mg per orem 2x/day for 6 months.

  • Two weeks prior to consult, he was prescribed Propranolol

    • 40 mg/tablet 2 tablets 3x/day.


QUESTION

  • What caused the symptoms of the patient?


Chlorpromazine


Metabolism

Chlorpromazine

CYP 2D6

typically degraded by the liver by the action of cytochrome-P450 family enzymes, usually CYP2D6

  • 7-hydroxylation


Propranolol


Metabolism

Propranolol

CYP 2D6

  • aromatic hydroxylation

4-hydroxy propranolol is a weak inhibitor of CYP2D6


Drug Interaction

70%

Propranolol

Chlorpromazine


Drug Interaction


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