emergencies Flashcards
1
Q
when do withdrawal symptoms start?
seizures?
DT?
A
- 4-12 hours after last drink
- seizures at 36 hours
- delirium tremens at 72 hours
2
Q
what features are there of alcohol withdrawal?
A
- coarse tremor,
- sweating
- insomnia,
- tachycardia
- N+V
- psychomotor agitation
- generalised anxiety
- occasionally you get transitory visual, tactile or auditory hallucinations/ illusions
3
Q
what symptoms are there apart from the uncomplicated withdrawal features?
what would indicate a severe withdrawal?
A
- clouding of consciousness
- disorientation
- amnesia for recent events
- marked psychomotor agitation
- visual, auditory and tactile hallucinations
- heavy sweating, fear, paranoid delusions, agitation, raised temp, sudden cardiovascular collapse
4
Q
what is the 4 core symptoms of neuroleptic malignant syndrome?
A
- fever
- muscular rigidity
- altered mental state
- autonomic dysfunction
5
Q
how do you treat NMS?
A
- stop medication
- Treat symptoms:
>IV fluids, 500ml stat
> rigidity: muscle relaxant - dantrolene sodium
> fever: antipyretic- paracetamol and cool down
> mental state: lorazepam
6
Q
what is the muscle rigidity and activity like in NMS compared to SS?
A
- severe (lead pipe)
- bradykinesia both in NMS
- SS is less rigid but more hyperkinesia
7
Q
what are the symptoms of serotonin syndrome?
A
neuromuscular:
- myoclonus
- rigidity
- tremors
- hyperreflexia
- ataxia
- hyperthermia
- GI upset (D+ N)
- tachycardia
fluctuating BP
8
Q
what happens to the mental state in Serotonin syndrome?
A
- agitation
- confusion
- coma
