NMS, Agranulocytosis

Question 1

Agranulocytosis s/s (5)

Answer 1

pallor
fatigue
headache
fever
nosebleeds

Question 2

What medications can cause agranulocytosis (2)

Answer 2

Carbamazepine/Tegretol

Question 3

Agranulocytosis

Answer 3

a life-threatening condition that involves having severely low levels of white blood cells called neutrophils. White blood cells are part of your immune system. They protect your body from infection by fighting off germs that make you sick.

Question 4

Normal range of WBC count

Answer 4

4500-11000

Question 5

Neuroleptic malignant syndrome (7)

Answer 5

life-threatening

starts with confusion, muscular rigidity*, fever, increased HR, can progress to rhabdomyolysis (Muscle breakdown increased levels of CK, K, WBC’s), mutism

Question 6

Rhabdomyolysis can progress to

Answer 6

kidney and heart failure

Question 7

Tx for NMS?

Answer 7

D/C antipsychotic
Bromocriptine (Pariodel) is a D2 agonists
give dantrolene (protects ANS)
dopamine agonists
know which type of medication they are wanting either D2 or muscle relaxer

Question 8

NMS kidney disease pneumonic (6)

Answer 8

NMS

Kidney = increase in (K) potassium
increase in CK
Increase in killer cells (WBC’s)

Disease = D/C Meds
dantrolene
dopamine agonist (3 D’s)

Question 9

What medications cause NMS?

Answer 9

antipsychotics

Question 10

What happens to CPK (creatinine phosphokinase) with NMS?

Answer 10

elevate CPK due to muscle contraction and destruction

Question 11

Myoglobinuria from NMS caused by

Answer 11

can result from the breakdown of muscle cells (rhabdomyolysis)

Question 12

What does NMS do to WBCs

Answer 12

increase (leukocytosis)

Question 13

What can NMS do to LFTs

Answer 13

Elevate LFTs

Question 14

TX for NMS (3)

Answer 14

stop offending agent
Bromocriptine (parlodel) (dopamine D2 agonist)
Dantrolene (muscle relaxant) for muscle rigidity- know the difference