Iatrogenic disorder

Risperdal, with its potent capacity to block dopamine D2 receptors, is the least atypical of all the so-called atypicals. Most of the cases of TD in children that I have evaluated have been caused by Risperdal. As you read in chapters 2-5 about the devastating toxicity of the antipsychotic drugs, keep in mind that America s drug watchdog agency has turned on its children by unleashing one of the worst iatrogenic disorders upon them. 

Hypermagnesuria is encountered in the case of metabolic and iatrogenic disorders, such as primary and secondary hyperaldosteronism (extracellular volume expansion), hypercalcemia (competition Ca/Mg at the thick ascending loop of Henle), hyperparathyroidism, and phosphate or potassium depletion. Hypermagnesuria may also result from tubulopathy, as the selective defect of the Mg tubular reabsorption (chromosome Hq23), Bartter s syndrome (thick ascending loop of Henle), or Gitelman s syndrome (distal convoluted tubule). 

Plasma cell disorders Plasma cell disorders Inflammation-associated, familial Mediterranean fever Familial amyloidotic neuropathy, systemic senile amyloidosis Dialysis-associated amyloidosis Familial amyloidotic neuropathy, aortic amyloidosis Familial systemic amyloidosis Familial systemic amyloidosis Familial systemic amyloidosis Familial cerebral hemorrhage with amyloidosis Sporadic and familial Alzheimer s disease, familial cerebral hemorrhage with amyloidosis Spongiform encephalopathies C-cell thyroid tumors Insulinoma, type II diabetes Atrial amyloidosis Prolactinomas pituitary amyloidosis Iatrogenic amyloidosis Corneal amyloidosis ... 

The observation that certain regressive forms of psychotherapy may contribute to the emergence of personalities lends some credence to this argument. Some argue that DID is an iatrogenic ally created when the shifting mood states of a borderline patient are assigned personalities. This issue obviously needs further research, and its resolution is beyond the scope of our discussion. However, it reminds us that those with severe dissociative disorders should carefully be screened for BPD. 

Organic factors may cause or contribute to affective illness in up to 50% of patients (Hall et al. 1981). In a patient with TRD, it is critical to rule out the presence of underlying medical disorders (Akiskal 1982 MacEwan and Remick 1988). Moreover, iatrogenic depression may result from the coadministration of medications for acute and chronic medical illnesses (Metzger and Friedman 1994). A partial list of organic causes of TRD with references is presented in Table 18-3. 

Somatropin extracted from cadaveric human pituitaries was used to treat growth hormone-deficient patients until several cases of the fatal degenerative neurological disorder Creutzfeldt-Jakob disease were reported in the mid-1980s. Of 267 cases of iatrogenic Creutzfeldt-Jakob disease, 139 were caused by human cadaver-derived somatropin (SEDA-25, 479). 

Q2 Constipation is a condition in which faecal material moves too slowly through the large intestine. As a result too much water is reabsorbed hard, dry faeces which are difficult to move and very abrasive are produced. Infrequent or difficult defecation is a common problem in the elderly as ageing is associated with a decline in both secretory activity and motility in the gut. Constipation could develop because of emotional problems, inactive or sedentary lifestyle, lack of fibre and fluid in the diet, intestinal muscle weakness, a neurogenic disorder or an iatrogenic effect. Iatrogenic conditions are those caused by drugs or other medical treatments. 

Recently, the extreme potency of botulinum toxin has led to multiple medical uses of this substance, including the treatment of cervical torticollis, strabismus, and other musculoskeletal disorders, as well as in cosmetic plastic surgery as Botox for the elimination of facial lines or wrinkles (Lemonick, 2002). The irreversible action of botulinum toxin on nerve transmission when used in minute amounts leads to prolonged therapeutic effects of greater than 3 months in duration. An iatrogenic form is also reported secondary to adverse effects of local injection of the toxin in cosmetic procedures or in patients with spasticity (Ihgnoli, 2002). 

Hepatic coma can be subdivided according to its aetiology as follows (7.) hepatocyte disintegration coma (= endogenous coma as a result of the loss of parenchyma), (2.) liver cell failure coma (= exogenous coma as a result of metabolic disorders, almost always in the presence of cirrhosis), (3.) electrolyte coma (= so-called false coma due to dyselectrolytaemia, almost always iatrogenic), and (4.) mixed forms of coma. (s. pp 214, 276, 381) (s. tab. 15.5)... 

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