Jimbo, a 30-year old male, has a BMI of 31 kg/m2 , hypercholesterolaemia, and glaucoma. After a series of concerning episodes of mood disturbances, his psychiatrist diagnoses him with schizophrenia. He decides to prescribe an appropriate antipsychotic. Although the treatment is ultimately effective, he initially complained of several side effects with little therapeutic improvement.

a. Suggest an appropriate antipsychotic to prescribe to him. Justify your selection by referring to pharmacodynamic and toxicodynamic responses.

b. Explain why Jimbo experienced side effects and therapeutic effects at different stages in the pharmacotherapy .

Treatment proceeds well for the next few months, though one evening Jimbo is rushed to the emergency room by his brother. The emergency room team observes severe muscle spasms, hyperpyrexia, a brown discolouration of the urine, and a blood pressure of 180/115 mmHg. His brother informs the medical team that Jimbo had taken more than the required dosage that day.

c. Discuss the underlying pathogenesis of the observed clinical manifestations, and a drug you could use to treat the condition. Explain the rationale for selecting the drug for treatment.