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Cerebral perfusion pressure, or CPP, is the net pressure gradient causing cerebral blood flow to the brain (brain perfusion). It must be maintained within narrow limits because too little pressure could cause brain tissue to become ischemic (having inadequate blood flow), and too much could raise intracranial pressure (ICP).
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Medications are used to reverse the symptoms of extrapyramidal side effects caused by antipsychotics or other drugs, by either directly or indirectly increasing dopaminergic neurotransmission. The treatment varies by the type of the EPS, but may involve anticholinergic agents such as procyclidine, benztropine, diphenhydramine, and trihexyphenidyl.
Intracranial hypertension (IH), also called increased ICP (IICP) or raised intracranial pressure (RICP), refers to elevated pressure in the cranium. 20–25 mmHg is the upper limit of normal at which treatment is necessary, though it is common to use 15 mmHg as the threshold for beginning treatment.
The effects on the intracranial pressure itself are more modest. Moreover, the procedure may lead to significant complications, including blindness in 1–2%. [ 5 ] The procedure is therefore recommended mainly in those who have limited headache symptoms but significant papilledema or threatened vision, and those who have undergone unsuccessful ...
Severe symptoms are usually due to acute elevation of the plasma sodium concentration to above 157 mmol/L [10] (normal blood levels are generally about 135–145 mmol/L for adults and elderly). [10] Values above 180 mmol/L are associated with a high mortality rate, particularly in adults. [ 11 ]
More recently, the selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine and citalopram, have become the pharmacologic therapy of choice due to the lower incidence of side effects. Also, psychologic treatment such as cognitive behavioral therapy, group therapy, and family therapy are reported to be useful adjuncts to treatment.
These side effects arise in approximately 10–20% of users, are mild to moderate in severity, and can be managed by slowly adjusting medication doses. [192] Less common secondary effects include muscle cramps , decreased heart rate ( bradycardia ), decreased appetite and weight, and increased gastric acid production.