QuestionSBA
QuestionChoice
Cyclizine does not commonly cause visual hallucinations
34228
d
Cyclizine 50mg PO TDS
QuestionChoice
Selegiline would not be prescribed for nausea and vomiting, and does not commonly cause visual hallucinations
34226
b
Selegiline hydrochloride 5mg PO OD
QuestionChoice
Haloperidol exert its anti-emetic effect by blocking central dopamine receptors in the chemoreceptor trigger zone in the brain. Its inhibition on D2 receptors, in particular, can worsen the symptoms of LBD as patients with LBD has increased neuroleptic sensitivity and when given typical antipsychotics like haloperidol, they can experience worsening hallucination, cognition and increased parkinsonism
34225
a
Haloperidol 5mg PO BD
QuestionChoice
Ondansetron does not commonly cause visual hallucinations
34229
e
Ondansetron 8mg PO BD
QuestionChoice
Clozapine would not be prescribed for nausea and vomiting, and does not commonly cause visual hallucinations
34227
c
Clozapine 12.5mg PO OD
QuestionComment
Under common side effects in the BNF for selegiline hydrochloride it has hallucinations - am I just being dumb, how do you know which one it should be?
6861
QuestionComment
This question requires some clinical reasoning. You are right that Selegilline causes hallucinations, but there is no indication to prescribing Selegilline as it not given for N&V. Haloperidol would go against the Levodopa and is indicated for N&V as per BNF and physiology of acting on the Dopamine receptors in the CTZ.
7387
User
subscriber
DNA Viral
User
subscriber
Suture Benign
QuestionComment
hallucinations are not listed as a side effect of haloperidol in the BNF 
6904
QuestionComment
but BNF states the lewy body dementia is a contraindication to giving  Haloperiodol
17226
User
subscriber
Serpiginous Serotonin
QuestionComment
says visual disorder until side effects
38878
User
subscriber
Headie Oneeee
User
subscriber
Dermis Cystic
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2788
Antipsychotics and Parkinsonism
Topic
74
Elderly Care
6856
Case Presentation: A 75-year-old man was admitted to the Care of the Elderly Ward following a urinary tract infection 3 days ago. A day after his admission, he felt nauseous and vomited twice in the morning. There was no blood noted in the vomitus. He was prescribed a medication for symptomatic relief of his nausea and vomiting by the on call doctor. However, on the next day, he started experiencing visual hallucinations. PMH Lewy Body Dementia. DH Rivastigmine, Levodopa.


Question: Select the prescription that is most likely to contribute to his visual hallucinations.
a