Include the phenothiazines: chlorpromazine, fluphenazine, thioridazine (discontinued in Aus) and the butyrophenones: haloperidol & droperidol. These neuroleptics cause CNS depression, orthostatic hypoBP, anticholinergic effects in OD.
Thioridizine was the most cardiotoxic.
Main action is central D2 antagonism, but they have unwanted effects at other receptors (H1, GABA-A, M1, 1, 2, 5HT). They also have Na & K channel-blocking effects.
Rapidly abs but more erratically in OD. 1st pass metabolism.- Cyt P450. Many have active metabolites and long elimination half-lives.
Intoxication: within 2–4hrs.
CNS depression: LOC, coma from large OD. Seizures & EPE uncommon.