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Paramedical Emergency 3 > Psychotropics and Anticonvulsants > Flashcards

Psychotropics and Anticonvulsants Flashcards

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1
Q

Lithium
Mechanism of Action
(3)

A
  • decrease noradrenaline release
  • increase serotonin synthesis
  • decrease postsynaptic receptor sensitivity
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2
Q

Lithium
What raises levels?
(6)

A
  • low sodium levels
  • excessive sweating
  • diarrhoea
  • diuretics
  • fever
  • strenuous exercise
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3
Q

Lithium
What lowers levels?
(3)

A
  • high sodium levels
  • high potassium levels
  • theophylline
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4
Q

Lithium Toxicity
Neural Symptoms
(8)

A
  • nystagmus
  • ALOC
  • delirium
  • lethargy
  • tremors
  • ataxia
  • seizures
  • coma
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5
Q

Lithium Toxicity
Cardiac Symptoms
(2)

A
  • tachycardia
  • hypotension (severe levels)
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6
Q

Lithium Toxicity
ECG Findings
(4)

A
  • PR widening
  • QRS widening
  • QT widening
  • flat/inverted T waves
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7
Q

Lithium Toxicity
Peripheral Symptoms
(9)

A
  • weakness
  • hyperreflexia
  • increased tone
  • myoclonic jerks
  • hyperthermia
  • gastric irritation
  • nausea
  • vomiting
  • renal toxicity
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8
Q

Antipyschotics
Primary Action
(2)

A
  • dopamine receptor antagonist
  • effective when >60% dopamine receptors blocked
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9
Q

Antipsychotic Toxicity
Neural Symptoms
(11)

A
  • agitated delirium
  • dysphasia
  • mutism
  • oculogyric crisis
  • trismus
  • ALOC
  • lethargy
  • stupor
  • seizures
  • respiratory depression
  • coma
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10
Q

Antipsychotic Toxicity
Extrapyramidal Syndromes
(4)

A
  • acute dystonia
  • akasthesia
  • parkinsonism
  • tardive dyskinesia
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11
Q

Antipsychotic Toxicity
Cardiac Symptoms

A
  • tachycardia
  • QT prolongation
  • labile blood pressure
  • orthostasis
  • hypotension
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12
Q

Antipsychotic Toxicity
Peripheral Symptoms

A
  • abnormal neuromuscular activity
  • hyporeflexia
  • lead pipe muscle rigidity
  • hyperthermia
  • diaphoresis
  • flushing
  • urinary retention
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13
Q

Neuroleptic Malignant Syndrome
Symptoms

A
  • mydriasis
  • diaphoresis
  • agitation
  • tachycardia
  • hypertensive
  • increased bowel sounds/diarrhea
  • clonos (lower extremities)
  • tremor (lower extremities)
  • hyperreflexia (lower extremities)
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14
Q

Anticonvulsant Toxicity
Neural Symptoms

A
  • nystagmus
  • dizziness
  • ataxia
  • ALOC
  • lethargy
  • stupor
  • seizures
  • respiratory depression
  • coma
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15
Q

Anticonvulsant Toxicity
Cardiac Symptoms
(2)

A
  • VT (refractory)
  • VF (refractory)
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16
Q

Anticonvulsant Toxicity
ECG Findings
(3)

A
  • QRS widening
  • R axis deviation
  • QT prolongation
17
Q

Anticonvulsant Toxicity
Peripheral Symptoms
(3)

A
  • tremor
  • myoclonus
  • hyperthermia
18
Q

Anticonvulsant Toxicity
Treatment Plan
(6)

A
  • safety, QPS back up and/or sedation
  • early airway management, vomit/secretion likely
  • consider oxygen
  • consider IV access for fluids
  • cool down pts with hyperthermia
  • seizures, may be unresponsive to midazolam
19
Q

Anticonvulsant Toxicity
Specific Considerations
Risk Assessment

A

clarify drug class for back up and clinical progression

20
Q

Anticonvulsant Toxicity
Specific Considerations
Lithium

A

prehospital treatment is mostly supportive

21
Q

Anticonvulsant Toxicity
Specific Considerations
Sodium Blockade

A

sodium bicarbonate 8.4% if QRS >160ms

22
Q

Anticonvulsant Toxicity
Specific Considerations
Hyperthermia

A

aggressive cooling regardless of aetiology

23
Q

Anticonvulsant Toxicity
Specific Considerations
Hypotension

A

fluids, reassessing every 250-500mLs

24
Q

Anticonvulsant Toxicity
Specific Considerations
Seizures

A

midazolam to be given even for anticonvulsants

Paramedical Emergency 3 (12 decks)

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