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Tourette's syndrome is a common childhood-onset hereditary neurological and behavioral disorder. It is characterized by the presence of both motor and vocal tics. Tics are sudden, rapid, repetitive, non-rhythmic, intermittent movements or movement fragments that are almost always briefly suppressible and are usually associated with awareness of an urge to perform the movement. The tics in Tourette's syndrome can be simple or complex. Tourette's syndrome is also associated with several psychiatric disorders. The most common of these are attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). In some instances, these psychiatric disorders may impact quality of life more than the tics themselves. The severity of this disease varies from patient to patient. While some patients have a very mild form of Tourette's syndrome, many of them may have it severe enough to interfere with their ability to participate in school and other important activities of childhood and adulthood. The cause of Tourette's syndrome is unknown, and the genetic basis of this disease also remains a mystery. In addition to Tourette’s syndrome, there are other related tic disorders. These include transient tic disorders that last less than a year, and chronic tic disorders that may consist of simple or complex motor tics, or vocal tics. These tic disorders commonly have onset in childhood but may also have onset in adulthood. Other tics may be a consequence of medications. DiagnosisThe diagnoses of Tourette's syndrome and tic disorders are made by an expert clinician, typically a psychiatrist or neurologist, and is based on the patient's clinical history and physical exam. There are no diagnostic laboratory tests, brain imaging, or genetic screening tests for this disease. TreatmentThere are several medical treatments for Tourette's syndrome, including clonidine, guanfacine, dopamine antagonist agents, and other medications which may be helpful in controlling tics and their related behavioral disorders. However, these medication treatments may have unwanted side effects and may only provide partial relief. Newer treatments are currently under investigation, including the use of deep brain stimulation. Why Choose Emory?Emory provides a full spectrum of treatment for Tourette's syndrome and tic disorders. This includes medication management, neurosurgical management including deep brain stimulations, therapeutic procedures including botulinum toxin therapy, rehabilitation services such as physical and occupational therapy, and psychologic/psychiatric care. Psychotherapy such as Comprehensive Behavioral Intervention for Tics (CBIT) and Habit Reversal Therapy (HRT) are provided through close relationships with community providers. Emory participates in the latest research in Tourette's syndrome including clinical trials. Emory is honored to be a Tourette Association Center of Excellence for care of Tourette's syndrome and tic disorders, and continues to work with the Tourette Association of America to provide patient support and advocate for patients with Tourette's syndrome and tics in the local community. Related Care at Emory
pronounced as (ha loe per' i dole) Studies have shown that older adults with dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and that may cause changes in mood and personality) who take antipsychotics (medications for mental illness) such as haloperidol have an increased chance of death during treatment. Haloperidol is not approved by the Food and Drug Administration (FDA) for the treatment of behavior problems in older adults with dementia. Talk to the doctor who prescribed this medication if you, a family member, or someone you care for has dementia and is taking haloperidol. For more information, visit the FDA website: http://www.fda.gov/Drugs Haloperidol is used to treat psychotic disorders (conditions that cause difficulty telling the difference between things or ideas that are real and things or ideas that are not real). Haloperidol is also used to control motor tics (uncontrollable need to repeat certain body movements) and verbal tics (uncontrollable need to repeat sounds or words) in adults and children who have Tourette's disorder (condition characterized by motor or verbal tics). Haloperidol is also used to treat severe behavioral problems such as explosive, aggressive behavior or hyperactivity in children who cannot be treated with psychotherapy or with other medications. Haloperidol is in a group of medications called conventional antipsychotics. It works by decreasing abnormal excitement in the brain. Haloperidol comes as a tablet and concentrated liquid to take by mouth. It is usually taken two or three times a day. Take haloperidol at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take haloperidol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor will probably start you on a low dose of haloperidol and gradually increase your dose. Your doctor may decrease your dose once your condition is controlled. Be sure to tell your doctor how you are feeling during your treatment with haloperidol. Haloperidol may help control your condition, but will not cure it. Continue to take haloperidol even if you feel well. Do not stop taking haloperidol without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking haloperidol, you may experience difficulty controlling your movements. Haloperidol is also used to treat confusion and difficulty thinking and understanding that is caused by severe physical or mental illness. Talk to your doctor about the possible risks of using this medication for your condition. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. Before taking haloperidol,
Unless your doctor tells you otherwise, continue your normal diet. Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. Haloperidol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
If you experience any of the following symptoms, call your doctor immediately:
Haloperidol may cause other side effects. Tell your doctor if you have any unusual problems while you are taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Protect the liquid from light and do not allow it to freeze. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. Symptoms of overdose may include:
Keep all appointments with your doctor. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
¶ This branded product is no longer on the market. Generic alternatives may be available. Last Revised - 07/15/2017Which class of medications is frequently prescribed for a client with bipolar disorder to induce sedation?Benzodiazepines prescribed for bipolar disorder include (among others): Alprazolam (Xanax) Clonazepam (Klonopin) Diazepam (Valium)
Which medications would the nurse identify as used to treat generalized anxiety disorder?Selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) classes are the first-line agents with a response rate of 30% to 50%. This class of drugs includes escitalopram (Lexapro), duloxetine (Cymbalta), venlafaxine (Effexor XR) and paroxetine (Paxil, Pexeva).
Which tricyclic antidepressant medication causes fewer complications in older clients?Nortriptyline is the tricyclic that has been the most studied. The results of those studies show that it should be recommended as an antidepressant for older patients. It is effective in both the acute and continuation treatment of depression in the elderly.
Which medications may cause an increase in the serum clozapine level select all that apply one some or all responses may be correct?Psychotropic medications most likely to increase clozapine levels include: fluvoxamine, lamotrigine, aripiprazole and the discontinuation of levomepromazine and carbamazepine.
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The nurse understands that which medication would be used to treat a client with severe motor tics
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