SUGGESTED PHARMACOTHERAPY
FOR THE SYMPTOMS
AND COMPLICATIONS OF THE ACUTE ATTACK
This list should
be read in conjunction with the
page Management
of the acute attack.
SPECIFIC SUPPRESSIVE THERAPY FOR THE ACUTE
ATTACK
- Haem arginate (Normosang)
- Lyophilised haematin (Panhematin)
(in the USA).
PAIN
- Oral codeine or
dihydrocodeine
- Parenteral pethidine
or morphine (Note that frequent dosing
is usually required).
VOMITING
- Oral prochlorperazine, metaclopramide
or chlorpromazine
- Rectal prochlorperazine suppositories
- Parenteral prochlorperazine or metaclopramide
RESTLESSNESS, CONFUSION
OR PSYCHOSIS
- Oral: promazine, chlorpromazine or
trifluoroperazine
- Parenteral chlorpromazine
CONVULSIONS
- Parenteral clonazepam or diazepam.
- Intravenous magnesium sulphate in
difficult cases.
HYPERTENSION
- Beta-blockers may have some anti-porphyrinogenic
effect in themselves and are thus particularly
useful for the control of these autonomic
manifestations.
- Intravenous labetalol and magnesium
sulphate for the adrenergic crisis.
SEVERE HYPONATRAEMIA
- Avoidance of hypotonic
intravenous fluids
- Intravenous hypertonic
saline for severe, symptomatic
hyponatraemia (with standard
protocols to avoid central
pontine myelinolysis).
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