Assuntos
Doenças dos Gânglios da Base/diagnóstico , Calcinose/diagnóstico , Serviços de Emergência Psiquiátrica/métodos , Transtornos Mentais , Doenças Neurodegenerativas/diagnóstico , Adulto , Doenças dos Gânglios da Base/enfermagem , Encéfalo/diagnóstico por imagem , Calcinose/enfermagem , Diagnóstico Diferencial , Enfermagem em Emergência , Humanos , Imageamento por Ressonância Magnética , Masculino , Doenças Neurodegenerativas/enfermagemRESUMO
Antipsychotic or neuroleptic medications are known to produce various extrapyramidal symptoms as common side effects. Extrapyramidal symptoms may present clinically as acute dystonic reactions, tardive dyskinesia, akinesia, Parkinsonism, akathisia, and neuroleptic malignant syndrome. Dopamine blockade or depletion in the basal ganglia produces these symptoms. Not as widely known or understood is that extrapyramidal symptoms can also occur as side effects from a variety of nonantipsychotic agents, namely certain antidepressants, antiemetics, lithium, and, rarely, some anticonvulsants and oral contraceptive agents. These symptoms mimic the naturally occurring, idiopathic pathologies of the extrapyramidal system and basal ganglia disease. Clinicians must be able to recognize these symptoms as side effects, distinguish extrapyramidal symptoms from psychiatric symptoms and, assess the possible nonantipsychotic causes of extrapyramidal symptoms, particularly in nonpsychiatric settings.
Assuntos
Antipsicóticos/efeitos adversos , Doenças dos Gânglios da Base/induzido quimicamente , Doenças dos Gânglios da Base/enfermagem , Antidepressivos/efeitos adversos , Antipsicóticos/farmacologia , Consultores , Quimioterapia Combinada , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiros ClínicosRESUMO
1. Akathisia is a state of restlessness and motor agitation, which includes subjective feelings of inner tension, emotional unease, anxiety, a constant need to move, restless motor activity, and an inability to tolerate inactivity or rest. 2. Akathisia is often unrecognized or misdiagnosed as agitation or anxiety of psychiatric origin; this often leads to inappropriate increases in the antipsychotic dosage, which then potentiates its severity, or to the misuse of antianxiety agents, which masks symptoms. 3. Akathisia can be easy to recognize by simple clinical observation of the patient's behaviors, especially if the symptoms worsen after increases in antipsychotic dosages or the frequent use of as needed medications. Assessment must also include the patient's own report.
Assuntos
Acatisia Induzida por Medicamentos , Antipsicóticos/efeitos adversos , Doenças dos Gânglios da Base/induzido quimicamente , Adulto , Antipsicóticos/uso terapêutico , Doenças dos Gânglios da Base/enfermagem , Doenças dos Gânglios da Base/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação em Enfermagem , Esquizofrenia/tratamento farmacológicoRESUMO
Extrapyramidal symptoms (EPS), the side effects of antipsychotic medications, have become the focus of much attention from clinical researchers, the courts, consumer groups, and even the U.S. Congress. The major clinical manifestations of EPS, the etiology, symptoms, and treatments are reviewed. The literature identified risk factors for EPS--those specific to the patient, to the particular antipsychotic agent used, and to the nature of the ongoing treatment for EPS. By quantifying these factors, weighting them according to the known risks, a risk management tool is developed for use in predicting which patients are at higher risks for EPS, in evaluating treatment, and in assessing the responses of patients to changes in their condition and to the subsequent adjustments in treatment. The risk management tool provides guidelines for the continual evaluation of these changes, with the goal of minimizing the risks for EPS.
