Psychiatric Emergencies

Question 1

First Generation Antipsychotics (Haldol) when to avoid:

Answer 1

Cases of alcohol withdrawal
Benzodiazepine withdrawal
Other withdrawal symptoms
Anticholinergic toxicity
Patients w/ seizures
Pregnant and lactating females

Question 2

Delirium Tremens (DTs)‏ treatment

Answer 2

Benzodiazepines
IV fluids
Nutritional supplementation—K+, Magnesium
Thiamine* BEFORE glucose

Question 3

Catatonia Treatment

Answer 3

Treat underlying cause
Supportive
Lorazepam** if respond to do:
ECT: mortality may increase if not begun within 5 days of symptom onset

Question 4

Serotonin Syndrome—Diagnosis Hunter Criteria

Answer 4

Must be taking a serotonergic agent
And meet ONE of the following criteria:
Spontaneous clonus
Inducible clonus PLUS agitation or diaphoresis
Ocular clonus PLUS agitation or diaphoresis
Tremor PLUS hyperreflexia
Hypertonia PLUS temperature above 38ºC PLUS ocular clonus or inducible clonus

Question 5

Benzodiazepines—SE

Answer 5

Sedation
Lethargy
**Respiratory depression
Impaired psychomotor skills and judgment
Cognitive dysfunction
Delirium (especially in elderly)‏
Ataxia
Exacerbation of COPD, sleep apnea
Cardiovascular instability
Death