Neuroleptic Malignant Syndrome
Clinical Preparation Journal
Each week you will be given a prompt to write a reflective journal assignment that will allow you to investigate areas for clinical preparation in psychiatric mental health. For this week’s journal entry complete the Psychiatric Emergencies s/sx and treatment template.
Complete the chart below with the following information:
o Onset and Causes
o Additional Notes
o S/Sx
o Treatment
Emergency
Neuroleptic Malignant Syndrome (NMS)
Onset/Causes
within hours or days after exposure to a causative drug, with most exhibiting symptoms within 2 weeks and nearly all within 30 days
Primary trigger of NMS is dopamine receptor blockade and the standard causative agent is an antipsychotic. Potent typical neuroleptics such as haloperidol, fluphenazine, chlorpromazine, trifluoperazine, and prochlorperazine have been most frequently associated with NMS and thought to confer the greatest risk.
Idiosyncratic-time limited reaction
Additional Notes
More common in men than women
S/Sx
Fever
Muscle rigidity
Autonomic instability
Clouding of consciousness, LOC
Elevated WBC/CPK
Tx
Withhold neuroleptics
Hydrate (IV)
Consider Dantrolene
Emergency
Delirium Tremens (DTs)
Onset/Causes
Additional Notes
S/Sx
Tx
Emergency
Serotonin Syndrome (SS)
Onset/Causes
Additional Notes
S/Sx
Tx
Emergency
Tyramine Reaction/Hypertensive Crisis
Onset/Causes
Additional Notes
S/Sx
Tx
Emergency
Acute Dystonia
Onset/Causes
Additional Notes
S/Sx
Tx
Emergency
Tardive Dyskinesia* (adverse reaction not always emergency state)
Onset/Causes
Additional Notes
S/Sx
Tx
Emergency
Lithium Toxicity
Onset/Causes
Additional Notes
Lab values?
S/Sx
Tx
Emergency
Tricyclic Antidepressant (TCA) Toxicity
Onset/Causes
Additional Notes
S/Sx
Tx
Emergency
Neonatal Abstinence Syndrome
Onset/Causes
Additional Notes
S/Sx
Tx
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