A 73-Year-Old Man with Bipolar Disorder Is Brought to the Emergency

question 78

Multiple Choice

A 73-year-old man with bipolar disorder is brought to the emergency department by his daughter, who has been visiting him for several days.  She reports that "he's not himself."  The patient has become increasingly confused, which is not typical for him.  He has bilateral hand tremors, has difficulty walking straight, and has vomited over the past few days.  Two weeks ago, he saw his new primary care physician, who added hydrochlorothiazide to the patient's medication regimen.  The patient has been psychiatrically stable for many years and has been seeing a psychiatrist, who has prescribed mood stabilizers and antipsychotics.  He has no history of alcohol or substance use disorders.  His daughter does not know which psychiatric medications he takes.  Temperature is 37.2 C (99 F) , blood pressure is 130/80 mm Hg, pulse is 65/min, and respirations are 16/min.  The patient's pulse oximetry shows 93% on room air.  He is disoriented and ataxic.  As he is being assessed, he has a generalized seizure that lasts 2-3 minutes.  Which of the following medications is the most likely cause of this patient's symptoms?

• A)Bupropion
• B)Haloperidol
• C)Lamotrigine
• D)Lithium
• E)Risperidone
• F)Valproic acid

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Definitions:

Product Lines

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Product Cluster

A group of related products marketed together to appeal to a specific market segment or to maximize their selling power.

Product Life Cycle

The sequence of stages from introduction to growth, maturity, and decline through which a product goes over its lifetime.

Wheel of Retailing

A theory that describes how retail outlets begin at the low end of the market and gradually upgrade their facilities and offerings to move upmarket.