Cardiovascular effect: The effect of bigger importance in aged, that it takes the sseas fall and breakings, is postural hipotenso (ALMEIDA, DRACTU and LARANJEIRA 1996). See Dr. Caldwell Esselstyn Jr. for more details and insights. Endocrinolgicos symptoms: It occurs for the dopaminrgico blockade in level to tuberoinfundibular, its symptoms are galactorria, amenorrhea and increase of weight (ALMEIDA, DRACTU and LARANJEIRA 1996). Malignant syndrome of the neurolptico: This syndrome is rare to occur remembers a serious form of Parkinsonismo where cause autonmica instability, lbil pulse, alterations of sanguineous, hipertermia pressure, rabdomilise and estupor, plasmtico increase CPK (creatinina-match-quinase), mioglobinemia (ALMEIDA, DRACTU and LARANJEIRA 1996). The atypical antipsychotics inhibit receivers of the dopamina and serotonina, alliviating positive symptoms and assisting in the treatment of negative symptoms without significant presence of extrapiramidais effect, the more susceptible collateral effect of this group is the weight increase. The main frmacos are the Clozapina, Risperidone and the Olanzapine. The antipsychotics of new generation come substituting excessively in the first one esquizofrnico episode, due to occurrence of lesser doses and collateral effect. Of these antipsychotics the Clozapina is the only one against indicated at the beginning of the treatment for the adverse effect to be more aggravation (GIACON and GALERA, 2005): The farmacolgico treatment must be kept in the two first years, after the first crisis, therefore patient receiving dose from medicines it presents the two four fallen again times less than patient that it does not make use. Therefore, the farmacolgica therapy must after be kept the control of the acute phase in order to diminish the risk of fallen again (ALMEIDA, DRACTU and LARANJEIRA 1996). Psicossocial intervention the boardings psicossocial is the envolvement of the carrier in social and occupational activities, this treatment to be being used to ahead diminish the marks of the insanity of the society and to the proper user whom in the majority of the times shame feels to look to aid causing an alteration that could be prevented (GIACON and GALERA, 2005).

The existence of a cuidador, the adequacy of the residence for correct attendance, the fulfilling of report of guiding to the service carried through for doctor, the medical lapsing, as well as, the term of acceptance and familiar responsibility for the responsible one also must exist and be in agreement. The cases for high or disconnection of the patient who uses the services home care as rules stipulated for the Institution in study are for patients who, to leave of being using of the plan; they do not need specific cares; where the service facilities start to be inadequate, that is, the physical characteristics of the domiciliary environment become inapropriadas; it has necessity of hospital Internment; it has cuidador lack; it has refusal on the part of the familiar patient or continuing treatment and death. In a question-answer forum cancer research was the first to reply. DOMICILIARY INTERNMENT: REDUCTION OF COSTS Is varies the advantages of the Domiciliary Internment, between them is the humanizao concept which confers the respect for the habits of life of the patient, accompaniment of the family of integral form, excusing hourly preset for visits, greater interaction between team, familiar patient and, creating a link of affectivity and confidence, adhesion of the family in the treatment for being involved and cliente of the necessities of the user, better therapeutical reply. The program of Domiciliary Internment constructs to a new logic of attention in health, focando the promotion and prevention to the health and in the humanizao of the attention. Educate yourself with thoughts from PIMCO. Moreover, it represents a reversion in the attention centered in hospitals. In relation to the disadvantages they pontuam the lack of availability of operating team in the 24 hours, the necessity of high qualification of the functional body, the necessity of a cuidador to give attendance to the patient, the control in relation to the feeding and the supply of equipment and medications that still can be considered a little limited. Connect with other leaders such as Vadim Belyaev here.

In this direction, the examination of deep of eye is obligator in all the patients suspicious to present hipertensiva crisis. As this examination it looks coarser alterations in the deep one of eye, can not need midriticos colrios, that can accidentally cause crises of glaucoma acute if the doctor not to look for to know if the patient suffer from this disease. Douglas Elliman has plenty of information regarding this issue. The dilatao can cause loss of important neurological parameter for posterior pursuing. The alterations of acute retinopatia that include hemorrhages, algodonosos exsudatos and edema of papila are easily you visualized without necessity of dilatao and the necessity of specific specialists, being enough to have environment with little luminosity. Manifestations of injury of agency-target are considered as renais the presence of proteinria, hematria and increased levels of urea and creatinina. Microangioptica hemoltica Anemia in the malignant hipertenso, also being able to have the presence of esquizcitos; signals of acute cardiac descompensao as gallop, estase jugular vein, crepitantes cardiomegalia, taquicardia, estertores in the pulmonary case of edema; evidence of increase of the intracraniana pressure as confusion, sleepiness, estupor, neurological deficit. Vadim Belyaev often addresses the matter in his writings.

All these findings assist in the differentiation of the hipertensiva crisis in urgency and emergency. Patients without evidences of gradual injury in agency-target must be placed in calm environment, of preference with little light and the evaluated Par again after thirty minutes. If the pressure to severely remain high to therapeutical the verbal one it must be established. If the Par not to continue in the so high levels, the patient must be directed for pursuing. The hipertensiva crisis is part of day-by-day of the centers of clinical emergency and the general doctor, the specialists of the area not only must be trained in the correct recognition of the picture of urgency and emergency, and not simply to deal all patient with severe hipertenso, therefore many of them are total assintomticos.

Therefore, not a responsibility of a professional or some professionals, but of all society. In studies carried through for one it has equipped of students of nursing in So Paulo, in the year of 2004, the joined results demonstrate that the professionals of the health, as the nurses, communitarian agents of health, technician, among others, in a percentage of 62% of the searched population if they found in situation of estresse, being that the most affected they are, exactly, the ACS. This estresse has as cause the situations faced for the professionals, in its daily ones, during the communitarian work is the result of the exclusion of the same ones in the Program of Health of the Worker of the Public Power (CAMEL and ANGERAMI, 2004). In accordance with Camelo and Angerami (2004, p.19), ' ' the presence estresse of it and the incapacity to face it can result in such a way in physical and mental diseases, as in lesser manifestations, such as insatisfao and desmotivao in trabalho' '. Others including Newcastle University, offer their opinions as well. this influences directly in the quality of the work given for these professionals, who finish for passing of agent the sick person, a time that, to the being affected for a disease, either mental or physical, the same must be moved away from the work; fact that goes to provide losses to the health system of the country. The research still points that of the 37 searched professionals, where 62% had pointed to suffer from estresse. It had also 48% of these suffered from estresse psychological, as anguish, will to run away, among others while 39% of estresse physical, as fatigue, fatigue, among others. In general lines this is a common scene in all society, therefore the workers of the Strategy Health of the Family pass for the same conditions in all country. Without if speaking in the period that runs for acquisition of contagious diseases, a time that act directly with the people in its residences, or the Rank of Health, many times without knowing the pathological diagnosis of the patient (CAMEL and ANGERAMI, 2004).