Sunday, July 19, 2020

Facebook: Schizophrenia treatment

Q2) A schizophrenic patient was on chlorpromazine and olanzapine for the past 6 months, with each drug being prescribed for atleast 6 weeks. The patient is still symptomatic. What is next line of management?
A) Haloperidol depot
B) Aripiprazole
C) Risperidone depot
D) Clozapine


Answer to the above question is D) Clozapine.
Explanation: If two drugs are used for schizophrenia and yet no improvement is seen, then Clozapine is used. Clozapine is DOC for resistant schizophrenia.

Some key points of Clozapine:-
1) It is most effective Antipsychotic
2) Clozapine is most toxic Antipsychotic.
3) It causes following special side effects:-
    a) Agranulocytosis :
-Therapeutic Drug monitoring (TDM) cannot be done because plasma concentration is not proportional with agranulocytosis
- Hence it is C/I with Carbamazepine.
   b) De novo seizure.
   c) Myocarditis.
   d) Sedation - Most common side effect.
   e) Sialorrhea- Wet pillow syndrome.
4) It shows Antisuicidal effect.

That's all!

- Demotional bloke!

Saturday, July 18, 2020

Facebook: Acid and Alkali ingestion question.

Q1) In a child with accidental alkali ingestion, which of the following is recommended as acute treatment:-
A) Administer mild acid
B) Administer milk
C) Administer rice
D) Gag the child to induce emesis

So answer to the above question is Milk, Option B.

For acute administration of caustic ingestion, dilution with milk or water is recommended.
Contraindications in case of caustic ingestion:-
1) Neutralization
2) Induce emesis
3) Gastric lavage

Some key points:-

Acid ingestion produces coagulative necrosis and a somewhat protective thick eschar.
Alkali ingestion produces:-
1) Liquefactive necrosis
2) Saponification of fat
3) Exothermic reaction

PS: Do follow our Facebook Medicowesome page for more such questions.


Thursday, July 2, 2020

Simplifying Carotid Sheath For AIIMS Aspirants

Carotid Sheath

C - Cervical Fascia Modification
A - Ant'r relation = Ansa Cervicalis
R - ❌
O - ❌
T - Tenth nerve/ vagus is a content
I - Internal Jugular Vein  & Internal Carotid are contents
D - DOES NOT contain External Carotid

Happy Preparing :)