Pharmacotherapy
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Patients with chronic obstructive pulmonary disease are at high risk for acute exacerbations. Strategies that may prevent exacerbations are smoking cessation, pulmonary rehabilitation, and influenza vaccination. Therapy includes bronchodilators, corticosteroids, and antibiotics. ⋯ Antibiotics should be included in the regimen if two of the three following are present: increased dyspnea, increased sputum volume, and increased sputum purulence. Many exacerbations may be caused by viruses or noninfective sources, in which case antibiotics are not indicated. Oxygen administration with or without assisted ventilation may be required for short-term management.
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Case Reports
Failed challenge with quetiapine after neuroleptic malignant syndrome with conventional antipsychotics.
Neuroleptic malignant syndrome (NMS) is an uncommon but potentially life-threatening adverse effect associated with conventional antipsychotic agents. The syndrome is characterized by muscular rigidity, hyperpyrexia, altered consciousness, and autonomic dysfunction. Few cases of quetiapine-induced NMS have been reported. A 54-year-old man was unsuccessfully challenged with quetiapine after conventional antipsychotic-induced NMS.