Schizophrenia MCQs

Etomidate: It is another induction anaesthetic (0.2-0.5 mg/kg) which has a briefer duration of action (4-8 min) than thiopentone; produces little cardiovascular and respiratory depression, but motor restlessness and rigidity is more prominent as are pain on injection or nausea and vomiting on recovery. It is a poor analgesic and has not found much favour except for patients with compromised cardiovascular status. Options B,C,D: Propofol, Methohexitone and Thiopentone have cardiac side effects and hence not used in cardiac patients.

Acute dystonic reactions are usually very painful and should be treated immediately with parenteral administration of a drug that blocks muscarinic receptors such as benztropine. Option A- Adding risperidone is not protective, and fluphenazine is as likely as haloperidol to cause acute dystonia. Option B- There is no role of observing the patient in acute dystonia. Option C- Oral administration of diphenhydramine is a possibility, but the patient may find it difficult to swallow and it would take a longer time to act. Reference: Basic & Clinical Pharmacology, Fourteenth Edition by Bertram G. Katzung Pg no. 542-543

Epidural opioids can cause nausea, pruritus, and respiratory depression Biggest advantage of these agents over epidural administration of local anesthetics is the hemodynamic stability , as there is no inhibition of sympathetic system Hypotension is highly unlikely with epidural fentanyl administration Reference : https://pubmed.ncbi.nlm.nih.gov/8706199/

The opioid Fentanyl is available in a transdermal therapeutic system (TTS) Advantages of transdermal fentanyl include: Increased patient compliance and comfort Avoidance of hepatic first pass metabolism Consistent analgesia Fentanyl is as effective as oral morphine for relieving cancer pain Disadvantages: Respiratory depression was significant and other side effects of opioids like nausea, vomiting, constipation is still seen but less in comparison to oral morphine Sufentanil and buprenorphine could be suitable for transdermal delivery, but their safety and efficacy are yet to be tested (Option B) Morphine can be delivered trans-dermally only after application to the deepithelialized skin Reference: Stoelting's pharmacology and physiology in anaesthetic practice 5th edition