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Zorluk: OrtaPsychopharmacology and Psychological Therapies

Match each patient's clinical presentation of an adverse drug reaction to the psychotropic medication most likely responsible for their symptoms.

  • A patient develops a severe inner sense of restlessness and an uncontrollable urge to pace two weeks after initiating treatment for schizophrenia.Haloperidol
  • A patient treated for bipolar disorder presents with increased thirst, frequent urination, and a fine bilateral hand tremor.Lithium
  • A patient treated for major depressive disorder and insomnia presents to the emergency department with a painful, prolonged erection lasting over four hours.Trazodone
  • A patient receiving treatment for refractory psychotic symptoms presents with a fever, severe pharyngitis, and an absolute neutrophil count of 300/mm³.Clozapine
  • A patient recently started on a mood stabilizer for bipolar depression develops a rapidly spreading, painful blistering rash with oral mucosal ulcerations.Lamotrigine

Cevap

The correct matches are: Restlessness (akathisia) with Haloperidol; Polyuria and tremor with Lithium; Priapism with Trazodone; Agranulocytosis with Clozapine; and Blistering rash with Lamotrigine.
Each psychotropic medication has a distinct and highly tested adverse effect profile. Recognizing these specific toxicities is crucial for appropriate monitoring and safe psychopharmacologic management.

Adım Adım Çözüm

1
Analyze the first presentation (severe restlessness and pacing).
Identify this as akathisia, a common extrapyramidal symptom.
Haloperidol, a high-potency first-generation antipsychotic, has the highest risk of extrapyramidal symptoms among the choices provided.
2
Analyze the second presentation (polyuria, polydipsia, fine tremor).
Identify these as classic signs of lithium use.
Lithium commonly causes nephrogenic diabetes insipidus and neurologic side effects like fine tremors.
3
Analyze the third presentation (prolonged, painful erection).
Identify this as priapism.
Trazodone is well-known for causing priapism due to its alpha-1 adrenergic blockade.
4
Analyze the fourth presentation (fever, sore throat, severe neutropenia).
Identify this as agranulocytosis.
Clozapine carries a black box warning for agranulocytosis and requires continuous absolute neutrophil count monitoring.
5
Analyze the fifth presentation (blistering rash with mucosal involvement).
Identify this as Stevens-Johnson syndrome.
Lamotrigine is associated with a severe, potentially life-threatening rash, especially during rapid dose escalation.

Anahtar Kavram

Adverse effect profiles of psychotropic medications
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