Ver el código de «Antipsychotic toxicity»

==Background==
*Isolated overdose of antipsychotics is rarely fatal
*Toxicity results in blockade of some or all of the following receptors:
**Dopamine - extrapyramidal symptoms
**α-1 - orthostatic hypotension, reflex tachycardia
**Muscarinic - anticholinergic symptoms
**Histamine - sedation

==Clinical Features==
[[File:Atypical Antipsychotic Toxicity.png|thumb|Evaluation of SGA (Second Generation Antipsychotic) Toxicity]]
*[[Extrapyramidal reaction|Extrapyramidal]]
**Acute [[dystonic reaction]]
***Tongue protrusion, facial grimacing, trismus, oculogyric crisis
**Akathisia
*CNS
**Lethargy, ataxia, dyarthria, confusion, coma
**[[Seizure]] (1%)
*Anticholinergic Effects
**Tachycardia, dry mucous membranes, dry skin, decreased bowel sounds, delirium
*[[ECG]] changes
**Sinus tachycardia
**[[QT prolongation]]

==Differential Diagnosis==
{{Anticholinergic types}}

==Evaluation==
===Workup===
*POC Glucose
*[[ECG]] (QT interval)
*Co-ingestions: serum acetaminophen, salicylate, EtOH level, other known drug levels
*Urine toxicology screen
*Chemistry (metabolic acidosis, electrolytes, renal function)
*LFT (hepatotoxicity)
*CK (rhabdomyolysis)
*Serum osmolarity (osmolar gap)
*ABG (carboxyhemoglobin, methemoglobin)

==Management==
===Supportive===
*[[Hypotension]]
**[[IVF]]
**[[Norepinephrine]]
*[[QT prolongation]]
**Treat all with QTc >500ms with [[magnesium]] 2-4gm IV over 10min

===Extrapyramidal===
*[[Diphenhydramine]] 25-50mg IV/IM '''OR''' [[benztropine]] 1-2mg IV/IM
*Oral therapy with either of above meds should be continued for 2 weeks

==Disposition==
*Consider discharge after 6hr as long as there are all of the following:
**No mental status changes
**Normal HR/BP
**No orthostatic hypotension
**Normal QT interval

==See Also==
*[[Antipsychotics]]
*[[Toxicology (main)]]
*[[Neuroleptic Malignant Syndrome (NMS)]]
*[[Tardive_dyskinesia|Tardive dyskinesia]]
*[[Beta-Blocker Toxicity]]
*[[Calcium Channel Blocker Toxicity]]
*[[Extrapyramidal reaction]]

==External Links==
*[http://ddxof.com/atypical-antipsychotic-overdose/ DDxOf: Atypical Antipsychotic Overdose]

==References==
<references/>

[[Category:Toxicology]]