Antipsychotic

Antipsychotics, also known as strong tranquilizers or nerve blockers, are a group of drugs used to treat schizophrenia and other severe psychosis. A wide variety of commonly used phenothiazines and butyrylbenzenes are commonly used. Such as chlorpromazine, thioridazine, perphenazine, trifluoperazine, haloperidol and the like. Antipsychotic poisoning (Antipsy-chotics poisoning) causes various neuropsychiatric disorders due to long-term use, misuse or attempted suicide to swallow a large dose of antipsychotic drugs. [Pathogenesis] Antipsychotic drugs (especially phenothiazines) mainly act on the network structure. The ascending activation system of the reticular structure is involved in maintaining excitability and wakefulness in the cerebral cortex, while the descending system is involved in exercise and behavior. Therefore, antipsychotic drugs are excessive, causing inhibition of the cerebral cortex and subcortical center, and there is a disturbance of consciousness, sometimes causing seizures. Antipsychotics can inhibit striatal dopamine, acetylcholine excitement, and large doses can cause extrapyramidal system symptoms. This group of drugs can inhibit the vasomotor center and block the adrenergic α-receptor to dilate blood vessels, and the peripheral resistance is reduced, so it can cause hypotension when taking large doses. [Clinical manifestations] A large number of antipsychotic drugs (after 750 ~ 1000mg) caused acute poisoning, in addition to the symptoms of lower blood pressure, heart function changes, etc., the main neuropsychiatric symptoms are: First, mental symptoms: the main manifestations of acute poisoning Disorder of consciousness. In the early stage of mildness or poisoning, drowsiness, apathy, weakness, irritability, excitement, and restlessness may occur. Severe poisoning is characterized by progressive disturbance of consciousness, lethargy, and coma. Second, the nervous system symptoms and signs: mild poisoning may have ataxia, tremor, increased muscle tone. Often accompanied by acute extrapyramidal symptoms, such as sedation can not, eye movement crisis, spastic torticollis, angular arch reversal, torsion paralysis, myoclonus and so on. Severe poisoning can present seizures, dilated pupils, decreased muscle tone, and disappeared tendon reflexes. [Diagnosis] 1. A history of taking antipsychotic drugs should be asked in detail about the time, dose and variety of the drug. Whether it is a single drug poisoning or a mixed drug poisoning is crucial for establishing a diagnosis, identifying the condition, and estimating the prognosis. Second, laboratory tests: Qualitative or quantitative examination of urine or blood toxicants in patients, which is helpful for diagnosis and prognosis. Attention should be paid to the difference between other drug poisoning and disturbance of consciousness caused by brain organic diseases. It is mainly based on the history of medication, the severity of extrapyramidal symptoms, and the analysis of urine and blood poisons.