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Data on the incidence of NMS among patients treated with antipsychotics are conflicting. Most authors define it within the range of 0.02–3.23%, T. Benzer (2010) - at 12.2%. There are indications that the use of high-potency antipsychotics causes NMS in 0.5-3.2% of patients, and low-potency drugs cause this complication much less frequently - more than 2 times, in 0.02-1.4% of cases. Muscle rigidity and other neurological manifestations.
Progressive muscle stiffness is one of the most significant signs of NMS. It, as well as other extrapyramidal disorders, are observed in neuroleptic malignant syndrome in 97% of patients. This is the first and early symptom of the disease, in most patients preceded by an increase in temperature, although sometimes the severity of both symptoms increases simultaneously. The second of the main signs of NMS is observed in 95-98% of patients (according to buy praziquantel online - 34%).
Mental changes in NMS are varied. from anxiety, confusion, agitation or delirium to oneiric and amentive stupefaction, severe catatonia, akinetic mutism, stupor and coma. Fluctuations in the level of impairment of consciousness are often observed. Stupidity with mutism that develops with NMS often resembles lethal catatonia. Complications and causes of death.
- The most dangerous complications of neuroleptic malignant syndrome are:
- Rhabdomyolysis is a direct consequence of severe muscle rigidity, and its occurrence is also facilitated by dehydration due to immobility of patients due to mental disorders and the difficulties associated with eating.
- It causes acute renal failure, which is observed in 50% of patients with NMS and very often leads to death.
- The cause of acute respiratory failure is often pulmonary embolism, which accounts for about 25% of all deaths from neuroleptic malignant syndrome.
- The pulmonary embolism that occurs with this syndrome is based on hyperthermia and associated dehydration of the body, as well as immobility of patients due to catatonic stupor or their prolonged fixation when excited.
- Another common cause of respiratory failure is aspiration pneumonia, the occurrence of praziquantel is associated with mental disorders, suppression of the cough reflex, dysphagia, and increased salivation.
- In rare cases, pulmonary edema can also complicate the course of neuroleptic malignant syndrome and lead to death.
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The development of pulmonary edema is associated with an increase in pressure in the pulmonary capillaries due to hypertension in the pulmonary circulation due to sympathetic hyperactivity. The cause of respiratory distress syndrome is chest muscle rigidity and/or rhabdomyolysis, which results in hypoventilation, dyspnea, and severe hypoxia. Various arrhythmias are considered deadly cardiac pathologies. Cases of praziquantel pills infarction and sudden cardiac arrest have been described, as well as reversible cardiomyopathy simulating the clinical picture of myocardial infarction.
- A rare complication of NMS are epileptiform seizures caused by high fever.
- DIC syndrome is associated with a violation of the rheological properties of blood caused by severe shifts in homeostasis during neuroleptic malignant syndrome.
- Significant causes of death include infectious complications. colibacillary fasciitis due to deep bedsores, urinary infections due to catheterizationtions of the bladder, sepsis.
- As a result of these disorders, surviving patients may still have cognitive impairment, dementia, parkinsonism, dyskinesia, and ataxia.
- Morphological changes in the brain that occur along the course of NMS are represented by neuronal degeneration, which is more often caused by hyperpyrexia, hypoxia, etc., than by neuroleptic malignant syndrome as such.
- Neuroleptic malignant syndrome can be represented by a single symptom, a complex of biltricide pills, or a comprehensive clinical picture.
- The severity of symptoms varies significantly between patients.
- There are no generally accepted clear diagnostic criteria for neuroleptic malignant syndrome.
- DSM-IV-TR provides the following diagnostic criteria.
- Muscle rigidity and fever that developed during antipsychotic therapy.
- Sweating, dysphagia, tremor, urination disorders, changes in consciousness, mutism, tachycardia, increased or lability of blood pressure, leukocytosis, increased serum CPK.
- Symptoms of groups A and B must not be caused by other causes (C). neurological diseases, taking other medications.
- And also - psychoses with catatonic symptoms (D). To buy biltricide online, it is necessary to have both signs from group A and at least two signs from group B in the presence of conditions C and D.
- Diseases and pathological conditions with which neuroleptic malignant syndrome must be differentiated include: