EPS

Question 1

Acute dystonia s/s (8)

Answer 1

muscle spasms of face neck tongue
back or neck muscles
stiff neck
painful facial grimacing

Question 2

oculogyric crises (3)

Answer 2

Rare presentation of acute dystonia
can be permanent
prolonged involuntary upwards deviation of bilateral eyes

Question 3

Akathisia (5)

Answer 3

restless
pacing
difficulty standing still
constant motion rocking
often mistaken for increased anxiety

Question 4

Akathasia Tx (3)

Answer 4

betablockers
bronchodilators
cogentin (Benzotropine)

Question 5

Beta blockers are contraindicated with

Answer 5

bronchodilators like albuterol

Question 6

Akinesia (2)

Answer 6

absence of movement difficult in initiating motion, mistake for laziness/ lack of interest

Question 7

Akinesia treatment

Answer 7

Cogentin

Question 8

What can be used to determine early TD

Answer 8

AIMS scale

Question 9

What med to avoid for TD?

Answer 9

Cogentin

Question 10

TX for TD?

Answer 10

decrease the current dose or change to atypical antipsychotic

austedo and ingrezza FDA approved

Question 11

EPS symptoms (4)

Answer 11

dystonia
akathisia
Parkinsonism
tardive dyskinesia

Question 12

Parkinsonism (5)

Answer 12

identical to parkinsons
cogwheel rigidity
mask face
shuffling gait
tremor

Question 13

Tardive dykinesia

Answer 13

repetitive uncontrolled movement of lip and tongue

Question 14

Dystonia and Parkinsonism tx (3)

Answer 14

anticholinergics
benztropine or benadryl

Question 15

Akathisia tx

Answer 15

beta blockers

Question 16

TD tx?

Answer 16

decrease antipsychotic and can maybe give clozapine

Question 17

Reglan (metoclopramide) can cause ?

Answer 17

EPS effects like TD and Parkinsonism

Question 18

EPS has an increase in ____ levels and decrease in ____ levels

Answer 18

ACH increase
dopamine decrease

Question 19

Psudo parkinson shows a decrease in what levels

Answer 19

dopamine

Question 20

Treatment for EPS (acute dystonia, akathisia, akinesia, pseudo parkinsonism) except for tardive dyskinesia

Answer 20

Cogentin (benzotropine)

Question 21

if the patient is taking reglan with antipsychotic you want to monitor them for

Answer 21

Tardive dyskinesia or EPS symptoms

Question 22

you can give cogentin to treat EPS except for

Answer 22

TD
due to possibility of exacerbation of symptoms

Question 23

why can congentin exacerbate tardive dyskinesia?

Answer 23

further disrupting the balance between dopamine and ACH in the basal ganglia, leading to increased involuntary movements of TD

Question 24

Cogentin’s suppression of other EPS symptoms can mask early signs of TD which can

Answer 24

allow delay of diagnosis and worsening of condition

Question 25

Treatment of TD is to (2)

Answer 25

reduce current dose or change client to an atypical agent

Question 26

VMAT2 inhibitors (vesicular monoaxmine transporter type 2) such as ____ and _____ are medications FDA approved to treat? (3)

Answer 26

Austedo (Deutetrabenzene)
Valbenazine (Ingrezza)
TD