scholarly journals Metoclopramide-Induced Neuroleptic Malignant Syndrome: A Review Study

2020 ◽  
Vol 14 (3) ◽  
Author(s):  
Ideh Ghafour ◽  
Forouzan Elyasi
Keyword(s):  
Side Effects ◽  
Neuroleptic Malignant Syndrome ◽  
Psychiatric Symptoms ◽  
Previous History ◽  
Muscle Rigidity ◽  
Drug Induced ◽  
Idiosyncratic Reaction ◽  
History Of ◽  
And Gender ◽  
Age Range

Context: Neuroleptic malignant syndrome (NMS) has been introduced as a rare but lethal and idiosyncratic reaction to neuroleptics/antipsychotics. The most obvious risk of this syndrome is the use of neuroleptics, especially high-potency ones. Metoclopramide is also known as an anti-nausea medication administered before surgery to manage digestive problems. Evidence Acquisition: Formerly, it had been assumed that metoclopramide was a type of chlorobenzamide that was not in the phenothiazine group but free of extrapyramidal side effects (EPSs). The sequential reports of complications indicate that metoclopramide can cause EPSs and drug-induced motor side effects. A total number of 5044 articles were obtained after the initial search. Then, two researchers independently screened out their titles, and abstracts and 20 articles were finally selected based on the inclusion criteria. Results: Of the 20 articles reporting metoclopramide-induced NMS, treatments had been successful in 16 (80%) cases, but it had led to death in four (20%) patients. There were 11 and 8 male and female patients, respectively, and gender was not mentioned for a patient in one article. The age range of the patients was from six months to 84 years, and the mean age was 50.92 years. Conclusions: Although NMS following metoclopramide intake is reported very rarely, it should be considered for any psychiatric symptoms with unexpected mental changes, muscle rigidity, and fever after being treated with metoclopramide. The neuroleptic malignant syndrome can occur following multiple doses or just one dose of metoclopramide. Also, metoclopramide use in patients affected with kidney failure is accompanied by a higher risk of NMS. A previous history of NMS, a recent episode of catatonia, and severe agitation are all taken into account as risk factors in this domain.

scholarly journals Pharmacogenetics and Gender Association with Psychotic Episodes on Nortriptyline Lower Doses: Patient Cases

2011 ◽  
Vol 2011 ◽  
pp. 1-6
Author(s):  
Irina Piatkov ◽  
Trudi Jones
Keyword(s):  
Side Effects ◽  
Adverse Reactions ◽  
Psychotic Disorders ◽  
Psychiatric Symptoms ◽  
Antidepressant Treatment ◽  
Medical Community ◽  
Drug Induced ◽  
Life Threatening ◽  
History Of ◽  
And Gender

The variation in individual responses to psychotropic drug treatment remains a critical problem in the management of psychotic disorders. Although most patients will experience remission, some patients may develop drug-induced adverse effects that may range from troublesome to life threatening. Antidepressants are freely prescribed by general practitioners, and there should be constant awareness in the medical community about possible serious side effects. We describe two cases of adverse drug reactions on low dosage treatment that led to extreme psychotic episodes as examples of the potential for dangerous side effects. The patients developed adverse reactions on the normal recommended dosage of nortriptyline, a tricyclics antidepressant (TCA). Both were females, with no history of antidepressant treatment, unsocial behaviour, nor any family history of psychosis, but both experienced severe psychiatric symptoms. Pharmacogenetic tests can easily be performed and interpreted according to the likelihood of adverse reactions and should be included in toxicity interpretation.

Syphilis among men who have sex with men attending a large HIV clinic in Trinidad

2021 ◽  
pp. 095646242199719
Author(s):  
Robert Jeffrey Edwards ◽  
Isshad John ◽  
Selena Todd ◽  
Leon-Omari Lavia ◽  
David Musa ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Chart Review ◽  
Laboratory Data ◽  
Previous History ◽  
History Of ◽  
Review Study ◽  
Sex With Men ◽  
Associated Risk Factors ◽  
Living With Hiv ◽  
Age Range

A chart review study was conducted to determine the prevalence of syphilis and explore the associated risk factors among men who have sex with men (MSM) who attended a large HIV clinic in Trinidad during the period January–December 2019. Patients were routinely screened for syphilis annually, and demographic, clinical, and laboratory data were extracted from the medical records. Descriptive and bivariate analyses were performed, and factors significantly associated with a syphilis diagnosis were assessed using multivariate logistic regression. During the period, 218 MSM were seen, age range 19–67 years, and median age 34.0 years. The prevalence of syphilis was 41.3% (90/218), and 71.1% (64//90) of these infections were asymptomatic. Multivariate analysis using logistic regression showed that MSM living with HIV in the 30–34 years old-age group (OR, 4.32; 95% CI, 1.04–18.02), and those with a previous history of treated syphilis (OR, 10.18; 95% CI, 4.60–22.53) were more likely to be diagnosed with syphilis. The prevalence of syphilis is high among MSM attending the HIV clinic in Trinidad, and most of these infections were asymptomatic; hence, targeted and sustained interventions to reduce syphilis transmission are urgently required. Repeat episodes of syphilis may play a role in the transmission dynamics of syphilis in MSM.

Drug Prediction in Healthcare Using Big Data and Machine Learning

2019 ◽  
pp. 79-92 ◽  
Author(s):  
Mamoon Rashid ◽  
Vishal Goyal ◽  
Shabir Ahmad Parah ◽  
Harjeet Singh
Keyword(s):  
Machine Learning ◽  
Big Data ◽  
Data Analysis ◽  
Side Effects ◽  
Previous History ◽  
Distributed File System ◽  
Optimal Drug ◽  
Hadoop Distributed File System ◽  
History Of ◽  
Medicinal Drugs

The healthcare system is literally losing patients due to improper diagnosis, accidents, and infections in hospitals alone. To address these challenges, the authors are proposing the drug prediction model that will act as informative guide for patients and help them for taking right medicines for the cure of particular disease. In this chapter, the authors are proposing use of Hadoop distributed file system for the storage of medical datasets related to medicinal drugs. MLLib Library of Apache Spark is to be used for initial data analysis for drug suggestions related to symptoms gathered from particular user. The model will analyze the previous history of patients for any side effects of the drug to be recommended. This proposal will consider weather and maps API from Google as well so that the patients can easily locate the nearby stores where the medicines will be available. It is believed that this proposal of research will surely eradicate the issues by prescribing the optimal drug and its availability by giving the location of the retailer of that drug near the customer.

Neuroleptic Malignant Syndrome – A medical emergency in a psychiatric patient

2018 ◽  
Vol 6 (2) ◽  
pp. 108-110
Author(s):  
Rajib Ahsan Sumon ◽  
Eshita Majumder
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Complete Resolution ◽  
Antipsychotic Drugs ◽  
Medical Emergency ◽  
Muscle Rigidity ◽  
Atypical Antipsychotic Drug ◽  
Presumptive Diagnosis ◽  
Idiosyncratic Reaction ◽  
High Fatality Rate ◽  
Work Up

With an estimated incidence of 0.02 to 3.23%1, neuroleptic malignant syndrome (NMS) is a rare idiosyncratic reaction to antipsychotic drugs; having a relatively high fatality rate of about 10%2. Here, we are reporting, a 38 years old female schizoaffective patient, presented with fever, muscle rigidity and altered sensorium who had started tablet risperidone(an atypical antipsychotic drug) 11 days prior to hospital admission. After initial sepsis work up and neuroimaging, infective causes and acute cerebrovascular incidents were ruled out and a presumptive diagnosis of NMS was made. Immediate discontinuation of suspected causative agent, along with the provision of supportive care leads to complete resolution of all the symptoms in our patient.Bangladesh Crit Care J September 2018; 6(2): 108-110

A Preliminary Report on the Use of Clomipramine in General Practice

1975 ◽  
Vol 20 (1_suppl) ◽  
pp. 67-71 ◽  
Author(s):  
L. W. Wootton ◽  
R. I. Bailey
Keyword(s):  
General Practice ◽  
Side Effects ◽  
Combined Treatment ◽  
Clinical Situation ◽  
Illustrative Case ◽  
Case Histories ◽  
Drug Induced ◽  
Practice Population ◽  
History Of ◽  
Continue Therapy

The use of clomipramine in a large suburban general practice is reviewed. Three hundred and fifty patients have been treated to date out of a total practice population of twenty-one thousand. It is argued that phobic anxiety states are much commoner than is normally supposed and that they are usually associated with a history of separation or rejection in childhood. A combined treatment regime is employed for one month thereafter clomipramine alone is used. Side-effects may initially present a problem although they may not all be truly drug induced. Some patients use side-effects to manipulate the clinical situation. However proper interpretative management of side effects can assist the clinicians in persuading patients to continue therapy. Some impressive results have been obtained with clomipramine therapy. Illustrative case histories are provided.

Risperidone-Induced Neuroleptic Malignant Syndrome: A Case Report and Review

1996 ◽  
Vol 41 (1) ◽  
pp. 52-54 ◽  
Author(s):  
Gb Meterissian
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Neuroleptic Malignant Syndrome ◽  
Clinical Features ◽  
Prior History ◽  
Extrapyramidal Side Effects ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication ◽  
The One

Objectives: 1. To report the case of a 53-year-old patient who developed neuroleptic malignant syndrome (NMS) — a rare but potentially life-threatening complication of neuroleptic therapy — 4 days after treatment with risperidone was initiated. 2. To review previously reported cases of NMS associated with risperidone. Methods: A computerized search of several databases, including MEDLINE, was conducted to find all previously reported cases of NMS with risperidone. Results: Five reported cases of risperidone-induced NMS were found in the literature. All cases including the one reported here displayed typical clinical features of NMS and all 6 patients had a prior history of extrapyramidal side effects and/or NMS. Age and duration of exposure to risperidone did not seem to be of significance. Conclusions: These cases illustrate that clinicians should be on the lookout for risperidone-induced NMS.

Fluphenazine-Induced Neuroleptic Malignant Syndrome in a Schizophrenic Patient

2005 ◽  
Vol 39 (6) ◽  
pp. 1131-1135 ◽  
Author(s):  
Augustine S Aruna ◽  
James H Murungi
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Schizophrenic Patient ◽  
Hospital Admissions ◽  
Group Home ◽  
Muscle Rigidity ◽  
Drug Induced ◽  
Fluphenazine Decanoate ◽  
Fatal Reaction ◽  
Concurrent Use ◽  
Increased Risk

OBJECTIVE: To report a case of neuroleptic malignant syndrome (NMS) associated with fluphenazine in a schizophrenic patient and review the literature related to this condition. CASE SUMMARY: A 21-year-old African American male with schizophrenia came to our medical intensive care unit from the crisis intervention unit (CIU). He was hyperthermic (oral temperature 40.6 °C), diaphoretic, tachycardic (heart rate 140 beats/min), and tachypneic (respiratory rate 22 breaths/min), with severe muscle rigidity and shaking tremors. He had an extensive psychiatric history significant for schizophrenia and multiple past hospital admissions, starting at age 14 years. Two days prior to admission to the CIU, he had been given 25 mg of fluphenazine decanoate injection intramuscularly in addition to his regular psychotropic regimen of thioridazine and haloperidol after reportedly making several verbal threats and displaying aggressive behavior toward the personnel at the group home where he resided. Laboratory studies showed elevated creatine kinase, aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase levels, as well as azotemia, hyperphosphatemia, hypocalcemia, and leukocytosis. DISCUSSION: NMS is a rare but potentially fatal reaction associated with neuroleptic drugs. It occurs in approximately 0.07–2.2% of patients treated with neuroleptics. Risk factors include previous episodes, dehydration, agitation, polypharmacy, and the rate and route of neuroleptic administration. CONCLUSIONS: An objective causality assessment revealed that fluphenazine was the probable cause of NMS in this patient. There was no reaction associated with thioridazine and/or haloperidol. Clinicians need to be aware of this drug-induced condition and the potential increased risk associated with concurrent use of multiple psychotropics.

scholarly journals Clinico-Epidemiological Study of Self-Poisoning by Different Pharmaceutical Agents

2017 ◽  
Vol 8 (1) ◽  
pp. 17-22
Author(s):  
Habib Ahmed ◽  
Ferdousi Rahman ◽  
Mahbubur Rahman ◽  
Mohammad Enamul Karim ◽  
Sayeda Rahim ◽  
...  
Keyword(s):  
Urban Area ◽  
Urban Areas ◽  
Previous History ◽  
Socioeconomic Background ◽  
Tertiary Level ◽  
Organophosphorous Compound ◽  
History Of ◽  
Pharmaceutical Agents ◽  
Age Range ◽  
Level Hospital

Background: In Bangladesh self-poisoning cases are mostly of organophosphorous compound (OPC). It is documented that 14% of all deaths amongst 10 to 50 year old women in Bangladesh were due to poisoning, the majority following suicidal ingestion of pesticides. In tertiary level hospital, a large number of self-poisoning cases are of different pharmaceutical agents, mostly from urban areas and mostly of teenager group. So the trend of self-poisoning is different in urban area than that of rural area. These pharmaceutical agent self-poisoning cases admitted into the hospitals have different modalities of clinical features with variable outcomes and socioeconomic background. But there is no actual data of these self-poisoning by the different pharmaceutical agents. Therefore, this study was aimed to describe the pattern of self-poisoning by different pharmaceutical agents.Methods: A descriptive longitudinal study was conducted in five adult medicine units of a tertiary level hospital from January 2008 to June 2008. All self-poisoned patients with different pharmaceutical agents were included with their prior informed written consent. A pre-tested questionnaire was used for data collection.Results: A total of 281 patients were interviewed. Most of the patients were female (70.8%) with highest age range from 13 to 30 years (91.81%). Most of the patients were students (53%) and 40.9% were secondary school certificate pass. 60.1% patients were unmarried. Most of the patients were from urban area (84%). The commonest background for self-poisoning was family disharmony (74.46%). Most common offending pharmaceutical agents were benzodiazepines (44.10%), collected mostly from local dispensary without prescription (89.33%). Most of the patients consulted within 1 to 2 hours of poisoning (44.5%). Commonest consultation before admission was in a Government hospital (48.40%). Only 3 patients (1.10%) were known to have psychiatric illness. Five patients (1.80%) had previous history of self-poisoning. Most of the patients (89.3%) stayed in the hospital for 1 day with no mortality.Conclusion: Self poisoning by pharmaceutical agents is common especially in urban areas. Common offending pharmaceutical agents were benzodiazepines. The commonest background for self-poisoning was family disharmony.J Shaheed Suhrawardy Med Coll, June 2016, Vol.8(1); 17-22

scholarly journals A Study of Posterior Segment Pathology in Cataractous Eyes Using B-scan Ultrasonography

2021 ◽  
Vol 11 (1) ◽  
pp. 78-81
Author(s):  
Mohammed Shakour ◽  
Caroline Ayad ◽  
Samih Kajoak ◽  
Hamid Osman ◽  
E. Rahim
Keyword(s):  
Imaging Modality ◽  
Previous History ◽  
Cross Sectional Study ◽  
Posterior Segment ◽  
Ocular Surgery ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
History Of ◽  
And Gender ◽  
Cataract Patients

Background: Ultrasonography (US) is a valuable diagnostic modality for detecting posterior segment eye diseases (PSEDs) in patients with cataractous eyes. This imaging modality can better facilitate planning surgery and predicting prognosis. The purpose of this study was to determine the role of B-scan US in evaluating posterior segment abnormalities of eyes in cataract patients pre-operatively to limit complications and visual impairment. Methods and Results: A prospective, cross‑sectional study to assess cataracts by US, as well as to detect posterior segment abnormalities of eyes in cataract patients, was conducted in Sudan at Albasar International Foundation (Makah Eye Complex in Omdurman) between December 2018 and December 2019. All patients (n=380; 48% males and 52% females; a mean age of 63±12.57 years) with non-visualization of the fundus, regardless of age and gender, were involved and were assumed to have orbital pathologies. Patients with high-risk extrusion of intraocular contents and a previous history of ocular surgery were excluded from the present study. All patients with dense cataracts were evaluated using standard US machines (Echoscan US-4000; NIDEK CO., LTD.) equipped with a real-time high-frequency probe. The typical age of the patients complaining of cataracts was between 61 and 70 years, which constituted 35% of cases, followed by age >70 years, which constituted 24.2% of cases. About 47.63% patients had ocular pathology in the posterior segment of the eye (Table 3). The most common PSEDs were vitreous abnormalities (46.2%). Among vitreous abnormalities, most abnormal eyes had vitreous changes (36.1%), followed by VD (3.7%); 1.3% of patients had retinal detachment. Conclusion: Ocular US should be the first screening modality in the evaluation of posterior segment pathologies in cataractous eyes and should be performed in cataract patients pre-operatively for better surgical planning and predicting post-operative visual prognosis.

Malignant catatonia and neuroleptic malignant syndrome: How different/similar are they?

2016 ◽  
Vol 33 (S1) ◽  
pp. S640-S640 ◽  
Author(s):  
P. Sales ◽  
M. Bernardo ◽  
A. Lopes ◽  
E. Trigo
Keyword(s):  
Supportive Care ◽  
Neuroleptic Malignant Syndrome ◽  
Specific Treatment ◽  
Hemodynamic Instability ◽  
Psychotic Symptoms ◽  
Muscle Rigidity ◽  
Life Threatening ◽  
History Of ◽  
Competing Interest ◽  
Malignant Catatonia

IntroductionCatatonia is a neuropsychiatric syndrome that appears in medical, neurological or psychiatric conditions. There are presentation variants: “malignant catatonia” (MC) subtype shares many characteristics with the neuroleptic malignant syndrome (NMS), possibly reflecting common pathophysiology.Objectives/methodsWe present a clinical vignette and review the literature available on online databases about MC/NMS.ResultsWe present a man, 41-years-old, black ethnicity, with no relevant medical history. He had two previous episodes compatible with brief psychosis, the last one in 2013, and a history of adverse reactions to low doses of antipsychotics. Since the last episode he was asymptomatic on olanzapine 2.5 mg id. He acutely presented to the Emergency Room with mutism, negativism, immobility and delusional speech, similar to the previous episodes mentioned and was admitted to a psychiatric infirmary, where his clinical condition worsened, showing muscle rigidity, hemodynamic instability, leukocytosis, rhabdomyolysis and fever. Supportive care was provided, olanzapine was suspended and electroconvulsive therapy (ECT) was initiated. After two months, he was discharged with no psychotic symptoms. He is still under ECT and no antipsychotic medication was reintroduced.Discussion/conclusionMany studies suggest that clinical or laboratory tests do not distinguish MC from NMS and that they are the same entity. These two conditions are life-threatening and key to treatment is a high suspicion level. There is no specific treatment; supportive care and stopping involved medications are the most widely used measures. ECT is a useful alternative to medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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