EPSE Flashcards
what are 4 EPSE?
Dystonia
Pseudoparkinsonism
Akathisia
Tardive dyskinesia
prevalence of dystonia
10%
Risk for dystonia?
young male
neuroleptic naive
high potency drugs (haloperidol)
onset of dystonia?
minutes to hours
Prevalence of pseudoparkinsonism?
20%
risk for pseudoparkinsonism?
Female elderly
Brain injury (stroke and brain injury)
onset of pseudoparkinsonism
days to weeks
prevalence of akathisia
25%
onset of akathisia?
hours to weeks
risk of akathisia
iron deficiency,
cognitive dysfunction,
affective disorder diagnoses,
female sex
elderly
prevalence of Tardive dyskinesia
5%
onset of TD
Months to years
Rx of dystonia
anticholinergic drugs
reduce or change antipsychotics
botulinum toxins
Rx of pseudoparkinsonism
anticholinergics
reduce or change antipsychotic
Rx of akathisia
Anticholinergic
Reduce or change antipsychotic (que and olan is better)
Propranolol
Mirtazapine (or mianserin low dose)
Cyproheptadine
Benzodiazepine (diazepam or clonazepam)
Clonidine
Rx of TD
Stop anticholinergic
Reduce or switch ( clozapine & quetiapine)
Tetrabenzine
Ginkgo biloba
list anticholinergics
Orphanedrine
benzotropine
trihexyphenidyl
procyclidine
which antihistamine is used as it has anticholinergic
diphenhydromine
what is pacing or rocking?
akathisia
what is the reason behind EPSE?
hypersensitivity of D2
why is it called EPSE?
cause it by passes pyramidal tract from cortex to spinal cord
what is save occupancy of D2 receptors according to PET scan studies?
65-80%?
types of dystonia
torticollis
trismas
opisthotonus
oculogyric crises
most Rx resistant EPSE?
akathisia
most causative agent of EPSE?
haloperidol
least causative agent of EPSE
Clozapine
other neuroleptic drugs that cause EPSE
SSRI & TCIs
other drugs that cause EPSE
anti emetic
lithium
CCB
drug withdrawal
what anti emetic cause EPSE?
metoclopromide
prochlorperazine
what CCB cause EPSE?
fluna —-rizine
cinna—-rizine
