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ACUTE EXPOSURE INFORMATION
- USES: Aripiprazole is an atypical antipsychotic agent used for the treatment of acute agitation in adults with schizophrenia or bipolar mania, for mood stabilization in patients with bipolar I disorder, as an adjunctive medication for depression, and for treatment of schizophrenia. In children, it as been used for treatment of aggression, conduct disorder, Tourette syndrome, bipolar I disorder, irritability associated with autistic disorder, and schizophrenia.
- PHARMACOLOGY: Aripiprazole is a quinolinone antipsychotic that has moderate to high affinity to various dopaminergic and serotonin receptors as well as H1 and alpha-1 adrenergic receptors. It also has moderate affinity for the serotonin reuptake transporter and acts as a partial agonist at the D2 and 5-HT1a receptors and as an antagonist at the 5-HT2a receptor.
- TOXICOLOGY: Aripiprazole exerts its toxicity through the above effects on the various receptors.
- EPIDEMIOLOGY: Overdose is fairly common; severe toxicity is rare and fatalities have not been reported from overdose with aripiprazole alone.
- WITH THERAPEUTIC USE
- COMMON: The most common adverse reactions include CNS symptoms (headache, agitation, insomnia, anxiety, extrapyramidal symptoms, akathisia, sedation) and gastrointestinal symptoms (weight gain, nausea, constipation, vomiting, dyspepsia).
- LESS FREQUENT: Other rarer adverse effects include other CNS symptoms (dizziness, pyrexia, restlessness, fatigue, lethargy, lightheadedness, pain, dystonia, hypersomnia, irritability, impaired coordination, suicidal ideation), cardiovascular symptoms (orthostatic hypotension, tachycardia, chest pain, hypertension, peripheral edema), dermatologic symptoms (rash, hyperhidrosis), gastrointestinal symptoms (increased salivation, decreased appetite, increased appetite, xerostomia, toothache, abdominal pain, diarrhea, weight gain), neuromuscular and skeletal symptoms (tremor, extremity pain, stiffness, myalgias, spasm, arthralgias, dyskinesia, increased creatine phosphokinase, weakness), and respiratory symptoms (nasopharyngitis, pharyngolaryngeal pain, cough, rhinorrhea).
- WITH POISONING/EXPOSURE
- MILD TO MODERATE TOXICITY: In overdose, the most prominent effect seen is CNS sedation. After a mild to moderate exposure, other symptoms reported have included tachycardia, tremors, irritability, and nausea/vomiting.
- SEVERE TOXICITY: More severe effects reported from aripiprazole overdoses/exposures include hypotension, coma, and neuroleptic malignant syndrome.
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