Rivastigmine tachycardia likely due to the antiparkinson therapy. Which of the following actions most likely mediate the adverse effect reported by the patient?

Correct Answer: B

Rationale: The adverse effect of tachycardia in this case is likely mediated by the decreased acetylcholine release from cholinergic terminals. Rivastigmine is a cholinesterase inhibitor used to treat Alzheimer's disease, and blocking the breakdown of acetylcholine can lead to cholinergic overstimulation, resulting in tachycardia.

Correct Answer: D

Rationale: Clozapine is the most appropriate choice for this patient as he has not responded well to previous medications such as haloperidol, chlorpromazine, and risperidone. Clozapine is often used as a last resort for treatment-resistant schizophrenia and has shown to be effective in cases where other antipsychotics have failed. Additionally, the patient had a partial response to uphenazine, which indicates the need for a different medication approach, making clozapine the best option in this scenario.

Correct Answer: F

Rationale: Haloperidol is the most appropriate choice for this patient with Huntington chorea as it is a typical antipsychotic that can help suppress choreic movements and agitated behavior. Haloperidol is commonly used to manage the motor symptoms associated with Huntington's disease, making it the best option in this case. Additionally, the patient's symptoms of persecutory delusions and auditory hallucinations may also be alleviated by haloperidol, further supporting its use in this scenario.

Correct Answer: C

Rationale: The patient most likely exhibited akathisia, which is a common adverse effect of antipsychotic medications like haloperidol. Akathisia is characterized by restlessness, an inability to sit still, and a feeling of wanting to jump out of one's skin. This aligns with the patient's symptoms of increased agitation and confusion, as well as the fact that she had recently started therapy with uphenazine, an antipsychotic medication. The other choices are less likely to cause the specific symptoms described.

Correct Answer: C

Rationale: The patient complained of abnormal growth of his breast after receiving a psychotropic drug for 6 months. The most likely cause of this adverse effect is Amitriptyline, as it is known to cause gynecomastia (abnormal breast growth) as a side effect. Amitriptyline is a tricyclic antidepressant that can lead to hormonal imbalances and breast enlargement in males. The other options, such as Haloperidol and Risperidone, are less likely to cause this specific symptom.