You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is Haloperidol toxicity can cause? and explain in detail?
ANSWER: (C) AkathasiaREF: Kaplan 9rh ed p. 1050, Goodman & Gillman 2008 edition page 304HALOPERIDOL TOXICITY:i. Cardiac depressant:QT prolongationTorsades de pointesWeight gain: (little)Sedation: (very little)Anticholinergic side effects: (dry mouth, constipation .paralytic ileus, difficulties in urinating, massive sweating)Adverse neurological syndromes: (Extra pyramidal effects common to most antipsychotic)- ref table belowNEUROLEPTIC INDUCED DISORDERS Acute dystoniaAkathisiaParkinsonismTardive DyskinesiaNeurolepticMalignantSyndrome EarlyIntermediateIntermediateLate (tardive)AnyOWithin 7 days of therapy or| doseWithin 3 monthsof therapy or | doseWithin 3 monthsof therapy or | dose>3-6 months (|dose may unmask dyskinesia)Anytime during therapy(| dose or high potency drugs)I15-20%with typical neuroleptics, 5% with atypical20%30%5% per year of therapy Le. 50% in 10 years0.5%(20-30% mortality)MUnclear, dopamine hypofunction at basal gangliaD2 receptor blockage in mesocortical pathwayD2 receptor blockage at striatumD2 receptor blockage at striatumIdiosyncratic, Relative depletion of dopamine in CNSRFMale , young, mental retardation, h/o ECT, dose elevationElderly,female, mental retardation, Iron deficiency, Affective disorders, dose elevationElderly, Females , dementia, underlying parkinsonism, AIDS, dose elevationElderly, female, h/o ECT, substance abuse, iron deficiency, Mental retardation, Mood disorder, Organic brain damage, Anticholinergic Dose decreaseMale, young, dose elevationSSlow, irregular,continuouscontractions,oculogyricmovements oftongue, torticollis,trismus,abnormal posture, blephero spasmUncontrolledrestlessness,pacing,compulsive foot taping, rocking movement, adversity to stand still, rapid alternation of standing & sittingR = rigidityA = akinesia(mc)T = tremor (atypical-coarse, not pill rolling, late) RABBIT SYNDROME= Lip & perioral tremorsRapid, irregular, continuous or intermittent contractions, orofasciolingual orlimb/trunkal, | by stress activity,Life threateningF = feverE = EncephalopathyV = Vitals unstableE = Elevated CPK,WBCR = RigidityTAnticholinergics: Benzatropine Antihistaminics: DiphenhydramineReduce dose&/or changeantipsychotic.Propranolol=doc, poortreatmentoutcomeAnticholinergics:BenzatropineAntihistaminics:Amantadine,DiphenhydramineReplace by atypical antipsychotic (clozapine is best), lithium & carbamazepine for psychosis, BZD: buspirone for dyskinesiaBromocriptine, lisuride, carbidopa- levodopa,dantrolene sodium, ECTO= Onset, 1= incidence, M= Mechanism, RF= Risk factors, S= Symptoms, T=Treatment