mental health

Question 1

Neuroleptic Malignant Syndrome (s/s)

Answer 1

F: F ever
E: Encephalopathy
V: Vital sign instability
E: Elevated WBC & CPK
R: Rigidity - cogwheeling (robotic)
- Overt hallucinations

Question 2

what are risks of antipsychotics (5)

Answer 2

NMS, Anticholinergic Crisis, Agranulocytosis, Tardive Dyskinesia, EPS

Question 3

onset of NMS

Answer 3

3-9 days

Question 4

tx of NMS (6)

Answer 4

• Stop neuroleptic med
• monitor V/S
  -↓temp (cooling blankets)
  -protect muscles (Dantrolene)
  -bromocriptine
  (dopamine agonist drug)
  -hydration

Question 5

anticholinergic crisis (4)

Answer 5

Hot as a hare, blind as a bat, mad as a hatter, dry as a bone

Question 6

tx anticholinergic crisis (4)

Answer 6

-stop med
-gastric lavage,
-charcoal,
-physostigmine 1-2mg IV

Question 7

Agranulocytosis (5)

Answer 7

-sore throat
-fever
-malaise,
-mouth sores (first 12 weeks-Clozaril)
-liver

Question 8

Agranulocytosis tx (4)

Answer 8

-blood work-leukopenia
-stop med
-reverse isolation
-monitor for infection

Question 9

difference btwn tardive dyskinesia and EPS

Answer 9

TD- after 6 months-irreversible
EPS-within hours-reversible

Question 10

EPS (4)

Answer 10

Acute dystonia: within hours, tx with Artane

Akathesia: within days

Parkinsonism: within weeks, tx with Artane

Akinesia- tx with beta blocker

Question 11

what are risks of antidepressants (2)

Answer 11

hypertensive crisis
serotonin syndrome

Question 12

Hypertensive Crisis (4)

Answer 12

-Severe headache
-Tachycardia, palpitations
-Hypertension
-Nausea and vomiting

Question 13

serotonin syndrome (SHITS & SHIVERS)

Answer 13

Shits: Diarrhea
S: Shivering
H: Hyper reflexia
I: ↑temperature
V: Vital sign instability
E: Encephalopathy
R: Restlessness
S: Sweating

Question 14

serotonin tx (3)

Answer 14

stop medication,
resolve within 24 hrs
2-12% mortality rate

Question 15

acetylcholine effects (SLUDGEM)

Answer 15

Salivation
Lacrimation
Urination
Diaphoresis
GI effect
Emesis
Miosis (pupil constriction)