Nervous System

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ATC Reimbursed

List of reimbursed drugs, is an important part of Service Packages covering the Fund of Compulsory Health Care Insurances for the population. The list of reimbursable drugs aims at improving the quality of service for all patients, particularly for people in need. In this regard, through the new list of drugs, FCHC aims at increasing the attention toward categories such as retirees and patients suffering from serious illnesses.

In compiling the list of drugs there are some scientific criteria which have been taken into consideration, by giving priority to drugs used for severe diseases; diseases of high risk for life; diseases that cause disability; diseases that risk of being spread into the society; diseases that cause much suffering as well as chronic illnesses requiring prolonged treatment.

Nervous System - Reimbursed

Tablets - 60 mg

Oral drops, solution - (0.2%) 2 mg/ml

Haloperidol belongs to a group of medicines called ‘antipsychotics’.

Haloperidol is used in adults, adolescents and children for illnesses affecting the way you think, feel or behave. These include mental health problems (such as schizophrenia and bipolar disorder) and behavioural problems.

These illnesses may make you:

  • feel confused (delirium);
  • see, hear, feel or smell things that are not there (hallucinations);
  • believe things that are not true (delusions);
  • feel unusually suspicious (paranoia);
  • feel very excited, agitated, enthusiastic, impulsive or hyperactive;
  • feel very aggressive, hostile or violent.

In adolescents and children, Haloperidol is used to treat schizophrenia in patients aged 13 to 17 years, and to treat behavioural problems in patients aged 6 to 17 years.

Haloperidol is also used:

  • in adolescents and children aged 10 to 17 years and in adults for movements or sounds you can’t control (tics), for example in severe Tourette’s syndrome
  • in adults to help control movements in Huntington’s disease.

Haloperidol is sometimes used when other medicines or treatments have not worked or caused unacceptable side effects.

Solution for injection - (0.5%) 5 mg/1 ml

 

Sugar coated tablets - 25 mg

Solution for injection - (96 mg + 104 mg)/1 ml (20%)

Caffeine is a substance that stimulates the CNS. It inhibits the enzyme phosphodiesterase and has an antagonistic effect at central adenosine receptors. In the CNS it acts primarily in the higher centers and gives a condition of wakefulness, increasing the rate and depth of respiration sometimes. Its stimulating action in vasomotor centers of medulla and the positive inotropic effect in the myocardium are compensated by the peripheral vasodilator effect in the arterioles, so it has little effect on blood pressure.

The diuretic action of caffeine is weaker than that of theophylline.

Caffeine can increase the absorption of ergotamine and sometimes is combined with the latter for the treatment of migraine. To increase the solubility of caffeine, it is combined with sodium benzoate and so is obtained caffeine sodium benzoate, which is used in the form of solution for injection.

Caffeine is well distributed in the body. It crosses the central nervous system and passes in saliva; in small concentrations it passes into breast milk.

This medicine is to be given only under the direct supervision of a doctor.

Kafeine natrium benzoat is indicated:

  • as breathing and blood circulation analeptic, mainly in diseases with high temperature and infectious diseases, as well as during poisoning.

Tablets - 200 mg

Suppositories - 250 mg

 

Suppositories - 125 mg

 

Syrup - 120 mg / 5 ml

 

Oral suspension - 160 mg / 5 ml

 

Suppositories - 100 mg

 

Sugar coated tablets - 100 mg

Solution for injection - (2.5%) 50 mg/2 ml

Sugar coated tablets - 25 mg

Levomepromazine belongs to the group of phenothiazine neuroleptics.

It acts on hypothalamus, thalamus, reticular formation and on lymbic system, inhibiting the sensory impulses.

Levomepromazine antagonizes dopamine D2 receptors, 5HT3-serotonin receptors, histamine H1 receptors, and cholinergic (muscarinic) receptors.

As a result of this antagonism appears a calming effect in small doses, an antipsychotic effect in high doses, as well as increase of the threshold of pain and stimulation of amnesia.

Levomepromazine also has analgesic, antihistaminic and anticholinergic effect.

This medicine does not cause respiratory depression, therefore it is useful especially in patients with low respiratory reserve.

Levomepromazine is used in the treatment of:

  • psychoses, to control agitation and psychomotor agitation in moderately severe depression;
  • schizophrenia;
  • psychotic disorders with hallucinations;
  • personality disorders in patients with epilepsy;
  • neurotic disorders;
  • as an analgesic to relieve moderate to severe pain prior to surgery;
  • incoercible vomiting.

Sugar coated tablets - 10 mg

Librian contains the active substance chlordiazepoxide, which like all other benzodiazepines, potentiates the effects of the gamma-aminobutiric acid (GABA) (facilitates the inhibitory neurotransmition of GABA) and of the other inhibitory neurotransmitters, by binding with the specific benzodiazepinic receptors. The potentiation of the effects of GABA causes the inhibition of the central nervous system.

Librian is almost completely absorbed after oral administration. It is highly bound (about 96%) to plasmatic proteins, while its elimination half-life is from 5 to 30 hours. Chlordiazepoxide passes in the cerebrospinal fluid and in breast milk, as also in the placenta. Metabolites pharmacologically active of chlordiazepoxide are: desmethylchlordiazepoxide, demoxepam, desmethyldiazepam and oxazepam. The unchanged drug and the metabolites are excreted through urine, mainly as coniugated metabolites.

Librian sugar-coated tablets are used in the:

  • short-term treatment of severe conditions of anxiety and tension, which occur alone or accompanied with insomnia or organic disorders;
  • treatment of muscular spasms with a psychogen and neurogen origin;
  • relief of symptoms from acute alcohol withdrawal;
  • relief of concerns and anxiety before surgical interventions.

 

Solution for injection - 40 mg/2 ml

Solution for injection - (2%) 20 mg/ml

Solution for injection - (1000 mg + 0.5 mg)/50 ml

Solution for injection - (10%) 200 mg/2 ml

Tablets - 15 mg

Luminal contains as active substance phenobarbital, which is part of the group of barbiturates. It may affect the brain activity at different levels, from excitation to mild sedation to hypnosis and coma. High therapeutic doses of barbiturates may produce anesthesia. Overdoses may cause death. Phenobarbital depresses the sensory cortex, decreases motor activity, alters cerebellar function and causes drowsiness, sedation and hypnosis. Barbiturates have poor analgesic activity in subanesthetic doses and may increase the response to painful stimuli. All barbiturates exhibit anticonvulsant action at anesthetic doses. Barbiturates are respiratory depressants. The degree of respiratory depression is dependent upon the dose. Barbiturates are absorbed in varying degrees following oral or parenteral administration. The salts are absorbed faster than the acids. The rate of absorption is increased if sodium salts are given as a dilute solution or taken on an empty stomach. The onset of action ranges from 20 to 60 minutes after oral administration. After intramuscular injection, the onset of action is more rapid, while after intravenous administration the action may start after 5 minutes. Maximal depression of central nervous system may not occur until 15 minutes after intravenous injection.

Luminal is used:

  • as long-term treatment of generalised tonic-clonic and focal-cortical seizures;
  • as part of the emergency treatment of acute convulsions, including status epilepticus;
  • as short-term treatment of insomnia;
  • as preanesthetic sedation;
  • in the treatment of febrile seizures in children.
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