Drug-Induced Neurologic Conditions Overview
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Questions and Answers

High doses and concomitant use of certain drugs can be risk factors for cerebrovascular disorders.

True

Cognitive impairment and delirium can only occur in elderly patients.

False

Neuroleptic Malignant Syndrome typically develops within a few hours after the onset of symptoms.

False

The majority of drug-induced seizures present as Generalised Tonic Clonic (GTC) seizures.

<p>True</p> Signup and view all the answers

Dopamine blockade is a mechanism that can contribute to movement disorders.

<p>True</p> Signup and view all the answers

CNS stimulants are responsible for inducing insomnia.

<p>True</p> Signup and view all the answers

Estrogen and progestin therapy can increase the risk of stroke by raising cholesterol and platelet aggregation.

<p>True</p> Signup and view all the answers

Benzodiazepines do not have anticholinergic side effects.

<p>True</p> Signup and view all the answers

Cerebrovascular disorders can lead to ataxia and nystagmus.

<p>True</p> Signup and view all the answers

Delirium is characterized by impairment in cognitive function without any disturbance in consciousness.

<p>False</p> Signup and view all the answers

Serotonin syndrome is associated with cognitive behavior changes and autonomic instability.

<p>True</p> Signup and view all the answers

Peripheral neuropathy can result in muscular weakness and loss of coordination.

<p>True</p> Signup and view all the answers

Optic neuritis can lead to colour blindness and loss of visual acuity.

<p>True</p> Signup and view all the answers

Headaches can occur due to intracranial hypertension.

<p>True</p> Signup and view all the answers

Excessive daytime sleepiness is a side effect of insomnia.

<p>True</p> Signup and view all the answers

Withdrawal seizure can occur as a side effect of severely reducing seizure thresholds.

<p>True</p> Signup and view all the answers

Muscular rigidity is a common symptom of neuroleptic malignant syndrome.

<p>True</p> Signup and view all the answers

Parkinsonism is not associated with movement disorders.

<p>False</p> Signup and view all the answers

Study Notes

Drug-Induced Neurologic Conditions (DINCS)

  • DINCS are neurological conditions caused by drugs.
  • Pathologic factors, medical illnesses, drug side effects, and psychological factors contribute to clinical conditions.
  • Illnesses/Clinical Conditions can lead to DINCS.
  • Psychological disorders/Pseudo-disease factors contribute to DINCS.

Neurological Complications of Prescribed Drugs

  • Cerebrovascular disorders:

    • Risk factors include high-dose and concomitant drug use.
    • Mechanism involves ion channel blockade, electrolyte imbalance, and vestibular toxicity.
    • Example drugs causing these disorders are lithium, carbamazepine, phenytoin, aminoglycosides.
    • Stroke mechanism involves increased cholesterol and platelet aggregation, exemplified by estrogen/progestin therapy.

  • Cognitive impairment and Delirium:

    • Risk factors are high doses and concomitant illnesses, especially in elderly patients.
    • Mechanism is related to CNS penetration blocking cholinergic receptors and anticholinergic side effects (sedation).
    • Examples of drugs that cause these disorders include 1st-generation antihistamines, antiparkinsonian agents, skeletal muscle relaxants, tertiary TCAs, and first and second-generation antipsychotics and benzodiazepines.

  • Neuroleptic Malignant Syndrome (NMS):

    • NMS onset ranges from hours (with serotonin syndrome) to days.
    • NMS may be fatal.
    • Mechanism involves dopamine blockade in the corpus striatum, spinal cord, and hypothalamus.
    • Example drugs include first-generation antipsychotics like chlorpromazine, haloperidol; D₂-antagonists like metoclopramide; dopamine agonists (levodopa).
    • This can also be developed after abrupt discontinuation of dopamine agonist use.

  • Movement Disorders:

    • Prevalence: up to 50% of Parkinsonism may be drug-induced.
    • Mechanism is dopamine blockade or serotonin receptor agonist/antagonists.
    • Example drugs include 1st-generation antipsychotics (chlorpromazine, haloperidol), D₂ antagonists (metoclopramide), and abrupt discontinuation of dopamine agonists (levodopa).

  • Seizure Disorders:

    • Drug-induced seizures are commonly generalised tonic-clonic seizures.
    • Mechanism is related to lowering the seizure threshold and excitating excitatory neurotransmitters.
    • Example drugs include antiarrhythmics (lidocaine, verapamil, diltiazem), antibiotics (cephalosporins, carbapenems), antidepressants (TCAs), antineoplastics (chlorambucil, methotrexate), antipsychotics, mood stabilisers (lithium), analgesics (fentanyl, pethidine, tramadol), and benzodiazepine withdrawal

  • Sleeping Disorders (Insomnia):

    • Prevalence: 40% drug-induced, common among women and elderly.
    • Mechanism involves CNS stimulants.
    • Example drugs include antiasthma agents (theophylline, beta agonists).

Managing DINCS

  • Identify the causal drug.
  • Remove the offending drug.
  • Manage DINCS with appropriate symptom management.
  • Closely monitor the patient's condition.

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Drug-Induced Neurological Conditions (DINCS) PDF

Description

This quiz explores Drug-Induced Neurologic Conditions (DINCS), including their pathologic factors and the impact of prescribed drugs on neurological health. Learn about the specific disorders, risk factors, and mechanisms involved, particularly in the context of cerebrovascular issues and cognitive impairment. Test your understanding of how various medications can lead to these challenging neurological conditions.

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