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MRCPSYCH_Paper B_MENTOR & More_Dr. ART > EPSE > Flashcards

EPSE Flashcards

1
Q

what are 4 EPSE?

A

Dystonia
Pseudoparkinsonism
Akathisia
Tardive dyskinesia

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2
Q

prevalence of dystonia

A

10%

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3
Q

Risk for dystonia?

A

young male
neuroleptic naive
high potency drugs (haloperidol)

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4
Q

onset of dystonia?

A

minutes to hours

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5
Q

Prevalence of pseudoparkinsonism?

A

20%

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6
Q

risk for pseudoparkinsonism?

A

Female elderly
Brain injury (stroke and brain injury)

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7
Q

onset of pseudoparkinsonism

A

days to weeks

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8
Q

prevalence of akathisia

A

25%

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9
Q

onset of akathisia?

A

hours to weeks

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10
Q

risk of akathisia

A

iron deficiency,
cognitive dysfunction,
affective disorder diagnoses,
female sex
elderly

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11
Q

prevalence of Tardive dyskinesia

A

5%

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12
Q

onset of TD

A

Months to years

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13
Q

Rx of dystonia

A

anticholinergic drugs
reduce or change antipsychotics
botulinum toxins

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14
Q

Rx of pseudoparkinsonism

A

anticholinergics
reduce or change antipsychotic

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15
Q

Rx of akathisia

A

Anticholinergic
Reduce or change antipsychotic (que and olan is better)
Propranolol
Mirtazapine (or mianserin low dose)
Cyproheptadine
Benzodiazepine (diazepam or clonazepam)
Clonidine

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16
Q

Rx of TD

A

Stop anticholinergic
Reduce or switch ( clozapine & quetiapine)
Tetrabenzine
Ginkgo biloba

17
Q

list anticholinergics

A

Orphanedrine
benzotropine
trihexyphenidyl
procyclidine

18
Q

which antihistamine is used as it has anticholinergic

A

diphenhydromine

19
Q

what is pacing or rocking?

A

akathisia

20
Q

what is the reason behind EPSE?

A

hypersensitivity of D2

21
Q

why is it called EPSE?

A

cause it by passes pyramidal tract from cortex to spinal cord

22
Q

what is save occupancy of D2 receptors according to PET scan studies?

A

65-80%?

23
Q

types of dystonia

A

torticollis
trismas
opisthotonus
oculogyric crises

24
Q

most Rx resistant EPSE?

A

akathisia

25
Q

most causative agent of EPSE?

A

haloperidol

26
Q

least causative agent of EPSE

A

Clozapine

27
Q

other neuroleptic drugs that cause EPSE

A

SSRI & TCIs

28
Q

other drugs that cause EPSE

A

anti emetic
lithium
CCB
drug withdrawal

29
Q

what anti emetic cause EPSE?

A

metoclopromide
prochlorperazine

30
Q

what CCB cause EPSE?

A

fluna —-rizine
cinna—-rizine

MRCPSYCH_Paper B_MENTOR & More_Dr. ART (69 decks)

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