Neuroleptic malignant syndrome Flashcards
1
Q
NMS Clinical
A
CNS: -Confusino -delirium -stupor -coma Autonomic Instability -hyperthermia -tachycardia -HTN -Resp Irregularities -Cardiac dysrhthmia Neuromuscular -Lead pipe rigidity -general bradykinesia -mutisum & staring -dysarthria -dystonia & abn posture -abnormal involuntary movment -incontinenc
2
Q
NMS RF
A
high dose neuroleptic increased dose parenteral 2 or more simultaneously yong age male pscyhiatric comorbidity genetic pre-existing organic brain disorder dehydration
3
Q
NMS DDx
A
acute lethal catatonia malignant hyperthermia serotonin syndrome anticholinergic syndrome sympathomimetic syndrome encephalitis metabolic encephalopathies
4
Q
NMS Complications
A
respiratory failure dehydration renal failure multi organ failure thrombo embolism Residual catatonia parkinsonism recurrence after rechallenge
5
Q
NMS Mx
A
Resus Ix: -cxr -ECG -FBC -UEC -CK -CMP -LFT -ABG -blood & urine culture -CTB -LP MRI
6
Q
NMS Supportive
A
cease causatie agent reassure IV fluid/ fluid balance Benzo- sedation Thrombo prophylaxis
7
Q
NMS anti dote
A
Bromocriptine -NGT or P -2.5 mg q 8 hr (increase to 5 mg q4hr) Dantrolene (if muscle rigidity & fever) -2-3mg/kg/day IV ECT
