Psychiatric Emergencies Flashcards
What can occur as a reaction to antipsychotics or from withdrawal?
Neuroleptic malignant syndrome
Give some symptoms of neuroleptic malignant syndrome?
Lead pipe rigidity, fever, confusion, tachycardia, HTN
What is a key lab finding of neuroleptic malignant syndrome?
Raised CK
Why are IV fluids given in neuroleptic malignant syndrome?
To prevent renal failure
How can you tell the difference between serotonin syndrome and neuroleptic malignant syndrome?
Raised WCC is high in neuroleptic malignant syndrome
What is serotonin syndrome?
High synaptic concentration of serotonin
What are the 3 A’s of serotonin syndrome?
Activity - clonus, hypertonia, tremors
Autonomic instability
Altered mental state - confusion
What can typical antipsychotics cause?
Acute dystonic syndrome
What are some symptoms of acute dystonic syndrome?
Eyes - oculogyric crisis
Neck - torticollis
Dystonic posture
What is the management of acute dystonic syndrome?
IM Procyclidine 5-10mg
What is the therapeutic range of lithium?
0.5-1
When are lithium levels checked?
7 days after a dose increase
12 hours after a dose
What is the most common cause of lithium toxicity?
Dehydration
Most commonly secondary to gastroenteritis
What does TOXICC stand for in lithium toxicity?
Tremor
Oliguric renal failure
Ataxia
Including reflexes
Convulsions
Consciousness decreased
Coma
When does delirium tremens occur?
72 hours after alcohol cessation
