ER Psych - Reynolds Flashcards
what are some medical diagnoses that can cause an acute psychosis, hallucinations V/A, delusions, or dementia?
CVA Lytes OD Sepsis Hypovolemia EPS Serotonin Syndrome Neuroleptic Malignant Syndrome
what are the extrapyramidal sx? (disco in this inn)
tardive dyskinesia akinesia (not moving at all) akathesia (uncontrollable movements) pseudoparkinsonism torticollis oculogyric crisis
what kind of meds may cause extrapyramidal sx?
typical antipsychotics
some atypicals
dopamine agonists
what is an oculogyric crisis? (an EPS)
eyes staring at the ceiling……..
reglan!
what are some characteristics of neuroleptic malignant syndrome
MS change, HYPERTHERMIA, autonomic inability (Tachy and HTN), muscle rigidity (pipe-like), dyskinesias, dystonia, trismus, chorea, sialorrhea, dysphagia, clonis
what drugs can cause neuroleptic malignant syndrome?
antipsychotics (classically in typicals)
what is the treatment for neuroleptic malignant syndrome?
catch it quick! – stop defending agents, give fluids (bc they go into rhabdo), muscle relaxants, benzos
what are the characteristics of serotonin syndrome?
Change MS, Autonomic hyperactivity (moving all the time, irritable) neuromuscular abnormalities
N/V/D, tremor, myoclonus fatigues
what are the hunter criteria?
- spontaneous clonus
- inducible clonus PLUS agitation or diaphoresis
- ocular clonus PLUS agitation or diaphoresis
- tremor PLUS hyperreflexia
- hypertonia PLUS >38C PLUS ocular or inducible clonus
what are the hunter criteria for?
serotonin toxicity
what are some SNRI’s?
duloxetine (Cymbalta)
venlaxafine (Effexor)
what is an example of an NDRI (norepi-dopamine reuptake inhibitor)?
buproprion (Wellbutrin)
what are some TCA’s?
Doxepin (Sinequan) Prothiaden (dothiepin) Norpramin (desipramine) Anafranil (clomipramine) Elavil (Amitriptyline) Asendin (amoxapine) Ludiomil (maprotiline)
