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Zorluk: OrtaSchizophrenia and Psychotic Disorders

For each clinical scenario describing an adverse reaction to a psychiatric medication, select the most likely causative antipsychotic agent.

  • A 31-year-old female presents with six months of amenorrhea, bilateral milky nipple discharge, and a normal thyroid-stimulating hormone level after starting a medication for auditory hallucinations.Risperidone
  • A 45-year-old male on a medication for treatment-refractory psychosis develops a fever of 39.1°C (102.4°F) and severe pharyngitis; laboratory studies show an absolute neutrophil count of 350/mm³.Clozapine
  • A 38-year-old male is started on an oral agent chosen for its low risk of metabolic syndrome; routine screening demonstrates a corrected QT interval of 520 milliseconds.Ziprasidone
  • A 50-year-old female treated for chronic paranoid delusions develops significant polydipsia, a 12-kilogram (26.4-lb) weight gain, and a fasting blood glucose of 145 mg/dL over a 10-month period.Olanzapine

Cevap

The correct matches pair Risperidone with hyperprolactinemia, Clozapine with agranulocytosis, Ziprasidone with QTc prolongation, and Olanzapine with metabolic syndrome.
Each antipsychotic medication possesses a distinct receptor binding profile that leads to characteristic adverse effects. Recognizing these specific clinical presentations is essential for safe psychopharmacological management and proper drug selection.

Adım Adım Çözüm

1
Analyze the first scenario to identify the cause of amenorrhea and galactorrhea in a patient taking an antipsychotic.
The correct agent is Risperidone.
Strong D2 blockade in the tuberoinfundibular pathway leads to elevated prolactin levels, commonly seen with risperidone and paliperidone.
2
Analyze the second scenario to identify the antipsychotic associated with profound neutropenia (agranulocytosis) in treatment-refractory psychosis.
The correct agent is Clozapine.
Clozapine is uniquely indicated for treatment-resistant schizophrenia but requires mandatory ANC monitoring due to the risk of agranulocytosis.
3
Analyze the third scenario to identify the weight-neutral agent known for causing QTc prolongation.
The correct agent is Ziprasidone.
Ziprasidone has a well-documented risk of prolonging the QTc interval, requiring baseline and follow-up electrocardiograms in at-risk patients.
4
Analyze the fourth scenario to identify the agent causing profound weight gain and diabetes.
The correct agent is Olanzapine.
Among second-generation agents, olanzapine and clozapine carry the highest risks for inducing severe metabolic syndrome.

Anahtar Kavram

Antipsychotic Adverse Effect Profiles
Tahmini Süre:1m 30s
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