Typical Antipsychotics- Quiz Series.

Q.1: Typical Antipsychotics can be be safely used in which of the following patient population?

Patient presented to ED with shakes, body ache, hallucination and history of drinking unknown amount of alcohol.

Patient presented to ED with Phencyclidine (PCP) intoxication.

Patients with rigid form of Huntington's disease.

All of the above.

None of the above.

Q.2: Patient was started on typical antipsychotics and pt presented with severe orthostatic hypotension. Which of the following medication is contraindicated in the management of typical antipsychotics induced orthostatic hypotension?

Norepinephrine

Epinephrine

Metaraminol

All of the above can be used.

None of the above should be used.

Q.3: Which of the following typical antipsychotic is considered safe in overdose (compared to other atypical antipsychotics)?

Chlorpromazine

Haloperidol

Fluphenazine

Thioridazine

Q.4: Patient presented to ED with complaints of drowsiness, mydriasis, rigidity, restlessness, decreased DTR (deep tendon reflexes), tachycardia, & hypotension. Pt reports overdosing on unknown amount of typical antipsychotic medication pills.
Which of the following management is not effective in patient with overdose on typical antipsychotics?

Activated charcoal

Gastric lavage

Anti-emetics

IV Diazepam

Phenytoin

Q.5: Which of the following are NOT a contraindication for typical antipsychotics use?

Severe cardiac abnormality

High risk for seizures

History of tardive dyskinesia

Narrow angle of glaucoma

All of the above are contraindications

None of the above are contraindications

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Answer 1: (e) None of the above.

Typical Antipsychotics should be avoided in above mentioned conditions.

Patient presented to ED with shakes, body ache, hallucination and history of drinking unknown amount of alcohol: This patient is in alcohol withdrawal, and use of typical antipsychotics will increase the risk of seizure.

Patient presented to ED with Phencyclidine (PCP) intoxication: additive anticholinergic effects of PCP and typicalantipsychotics. Benzodiazepines should be used.

Patients with rigid form of Huntington’s disease: Pt may experience acute EPS.

Answer 2: (b) Epinephrine

Hypotension is produced by alpha adrenergic blockage property of typical antipsychotics, & these drugs also block the alpha adrenergic stimulating property of epinephrine, leaving beta adrenergic stimulating property untouched. As a result epinephrine will cause paradoxical worsening of hypotension and hence epinephrine is contraindicated in antipsychotic induced hypotension.

Answer 3: (b) Haloperidol

Answer 4: (c) Anti-emetics
Antiemetic action of typical antipsychotics limits the efficacy.

Answer 5: (e) All of the above are contraindications.

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Dr. Harvinder Singh, M.D. (Admin)

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