Red Flags
New rash
Lamotrigine
A rash, particularly in/around the mouth, can be a sign of Stevens-Johnson Syndrome. Stop the medication and seek urgent review.
I am a mood stabilizer with a narrow therapeutic index. Dehydration can make me dangerous, and I require regular serum levels.
Lithium
A patient recently started on an antipsychotic develops a sore neck, jaw stiffness, and a fixed upward gaze. What is the most appropriate medication to administer?
Benztropine
Fever + sore throat
Agranulocytosis/neutropenia
Although infections may be common, clozapine-associated neutropenia must always be urgently ruled out.
I am an antipsychotic commonly associated with hyperprolactinemia, galactorrhoea, and sexual dysfunction.
Risperidone
A 28-year-old with acute mania has not slept for four days, is grandiose, pressured, and increasingly agitated. She has no significant medical history. What would you expect her to be prescribed.
Atypical antipsychotics are commonly used to treat acute mania as they are effective at reducing agitation, psychosis, and manic symptoms. Their sedating properties can be particularly useful in the acute phase of illness.
No bowel movements x3 days
Clozapine-induced gastrointestinal hypomobility
Clozapine can cause severe bowel obstructions that may even result in death. Close monitoring and prompt escalation are essential.
I am often chosen when weight gain is a major concern, but I may cause significant akathisia.
Aripiprazole
A 23-year-old with first-episode psychosis is distressed by voices but is worried about weight gain because obesity runs in the family. What would you expect to be charted?
Aripiprazole
Vomiting, tremor, confusion
Lithium toxicity
Lithium has a very narrow window of tolerance and efficacy, so levels must be monitored carefully.
I am great for acute psychosis and agitation, but I also carry the highest risk of acute dystonia and EPS.
Haloperidol
A patient is threatening another patient and has attempted to punch staff. What would you pull from Pyxis?
Lorazepam
Quetiapine
Zopiclone
Lorazepam
Rapid weight gain
Olanzapine
This category of medication should never be given IMI within an hour of IMI olanzapine due to the increased risk of CNS depression and respiratory failure.
Benzodiazepines
A patient is responding to NAS, becoming increasingly paranoid, and believes staff are trying to poison him. What would you choose?
Lorazepam
Olanzapine
Zopiclone
Olanzapine