Disorders of D2R Blockade

Question 1

acute dystonia onset

Answer 1

hours to days

Question 2

neuroleptic malignant syndrome onset

Answer 2

variable, but most often after initiation or dose increase

Question 3

akathisia onset

Answer 3

days to weeks

Question 4

Parkinsonism onset

Answer 4

weeks to months

Question 5

tardive dyskinesia onset

Answer 5

> 6 months

Question 6

acute dystonia characteristics

Answer 6

intermittent muscle spasms (e.g. torticollis, laryngospasm, oculogyric crisis)

Question 7

neuroleptic malignant syndrome characteristics

Answer 7

‘lead pipe’ rigidity, tremor, AMS, unstable vital signs

Question 8

akathisia characteristics

Answer 8

extreme restlessness

Question 9

Parkinsonism characteristics

Answer 9

bradykinesia, tremor, cogwheel rigidity

Question 10

tardive dyskinesia characteristics

Answer 10

abnormal involuntary movements (e.g. lip smacking, grimacing, blinking)

Question 11

tardive dyskinesia tx

Answer 11

lower the dose or remove offending agent

lower risk with atypicals

Question 12

Parkinsonism tx

Answer 12

diphenhydramine or benztropine

and/or lower the dose or remove offending agent

Question 13

akathisia tx

Answer 13

propranolol

Question 14

neuroleptic malignant syndrome tx

Answer 14

remove offending agent, supportive care, bromocriptine or dantroline

Question 15

acute dystonia tx

Answer 15

diphenhydramine or benztropine