Psychiatric Emergencies Flashcards
1
Q
What is neuroleptic Malignant syndrome
A
life threatening medical emergency - 10% mortality leading to hyperthermia, muscle rigidity and autonomic instability
2
Q
What drugs cause Neuroleptic malignant syndrome
A
- Anti-psychotics
- Dopaminergic drugs
When drug suddenly stopped or dramatically reduced
3
Q
Signs of Neuroleptic malignant syndrome
A
- Hyperthermia >38
- muscle rigidity - lead pipe
- confusion/agitation/alteration in consciousness
- hyporeflexia
- pallor, tachycardia, fluctuating blood pressure, excessive sweating/salivation, tremor and incontinence.
4
Q
Investigations of Neuroleptic malignant syndrome
A
- Very raised CK - rhabdomyolysis
- FBC: often shows leucocytosis
- U&Es: AKI
- ABG
- Ca: often shows hypocalcaemia
- Urine myoglobin
- Urinary drug screen
5
Q
Management of Neuroleptic Malignant Syndrome
A
- Stop offending drug
- Push IV fluids - AKI
- Cooling aids to reduce hyperthermia
- IV benzodiazepines if very agitated
- Dopaminergic drugs, such as bromocriptine and amantadine and muscle relaxants
