EPS Flashcards
Acute dystonia s/s (8)
muscle spasms of face neck tongue
back or neck muscles
stiff neck
painful facial grimacing
oculogyric crises (3)
Rare presentation of acute dystonia
can be permanent
prolonged involuntary upwards deviation of bilateral eyes
Akathisia (5)
restless
pacing
difficulty standing still
constant motion rocking
often mistaken for increased anxiety
Akathasia Tx (3)
betablockers
bronchodilators
cogentin (Benzotropine)
Beta blockers are contraindicated with
bronchodilators like albuterol
Akinesia (2)
absence of movement difficult in initiating motion, mistake for laziness/ lack of interest
Akinesia treatment
Cogentin
What can be used to determine early TD
AIMS scale
What med to avoid for TD?
Cogentin
TX for TD?
decrease the current dose or change to atypical antipsychotic
austedo and ingrezza FDA approved
EPS symptoms (4)
dystonia
akathisia
Parkinsonism
tardive dyskinesia
Parkinsonism (5)
identical to parkinsons
cogwheel rigidity
mask face
shuffling gait
tremor
Tardive dykinesia
repetitive uncontrolled movement of lip and tongue
Dystonia and Parkinsonism tx (3)
anticholinergics
benztropine or benadryl
Akathisia tx
beta blockers
TD tx?
decrease antipsychotic and can maybe give clozapine
Reglan (metoclopramide) can cause ?
EPS effects like TD and Parkinsonism
EPS has an increase in ____ levels and decrease in ____ levels
ACH increase
dopamine decrease
Psudo parkinson shows a decrease in what levels
dopamine
Treatment for EPS (acute dystonia, akathisia, akinesia, pseudo parkinsonism) except for tardive dyskinesia
Cogentin (benzotropine)
if the patient is taking reglan with antipsychotic you want to monitor them for
Tardive dyskinesia or EPS symptoms
you can give cogentin to treat EPS except for
TD
due to possibility of exacerbation of symptoms
why can congentin exacerbate tardive dyskinesia?
further disrupting the balance between dopamine and ACH in the basal ganglia, leading to increased involuntary movements of TD
Cogentin’s suppression of other EPS symptoms can mask early signs of TD which can
allow delay of diagnosis and worsening of condition
