Management Of Disturbed Behaviour

Question 1

Management of akathesia 2ary to antipsychotic

Answer 1

Reduce/change antipsychotic; propranolol;
clonazepam; 5-HT2 antagonists eg mirtazapine.

Question 2

A behaviour modification technique which denies a
patient, for a period of no more than 15 minutes,
opportunities to participate in an activity or to obtain
positive reinforcers immediately following an incident
of unacceptable behaviour.
What is the term that represents this?

Answer 2

Time out

Question 3

True or false
Time out should always be in a locked room

Answer 3

False, time out should never be in a locked room

Question 4

What are the two options of last resort for management of acute disturbing behavior?

Answer 4

Seclusion or Rapid tranquilisation

Question 5

A violent psychiatric patient was put in seclusion because of his risky behavior, how often should the dr review him?

Answer 5

Observe at all times and review every 2 hours

Question 6

A violent patient in the psychiatric ward is doing a risky behavior, physical restraint is the option available, should the Dr attempt to undertake the patient himself or wait for help?

Answer 6

Do not attempt to undertake yourself; this should
only be carried out by staff trained in control and
restraint

Question 7

What are the rapid tranquilizers that can be used with violent behaviors?

Answer 7

Benzodiazepines: Lorazepam

+/- Haloperidol

Offer oral before parenteral

Question 8

A violent patient in psychiatric ward is given benzodiazepines to control his outburst, after the injection, he lost consciousness. Which of the following is the antidote?
. Anticholinergic
. Naloxone
. Flumazenil

Answer 8

Flumazenil

Question 9

QTC prolongation is a complication of which antipsychotic?

Answer 9

Haloperidol

Question 10

Rapid tranquilization is required in a patient with acute disturbing behavior, he is not showing psychotic symptoms,
What is the preferred first regimen of the following?
. Lorazepam only oral
. Lorazepam only IV
. Lorazepam oral + haloperidol

Answer 10

Lorazepam oral only

Question 11

Rapid tranquilization is required in a patient with acute disturbing behavior, he is showing psychotic symptoms,
What is the preferred first regimen of the following?
. Lorazepam only oral
. Lorazepam only IV
. Lorazepam oral + haloperidol

Answer 11

Lorazepam +haloperidol

Question 12

Parenteral Rapid tranquilization has been performed in a psychotic violent patient,
What is the next step?

Answer 12

Review vitals every 5-10 mins for 1 hour, then half-
hourly until patient ambulatory

Monitor ECG and hematology test because you gave lorazepam by IV

Question 13

True or false
In Patients who receive haloperidol, ECG SHOULD BE monitored.

Answer 13

True