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Pharmacology > Extrapyramidal side effects > Flashcards

Extrapyramidal side effects Flashcards

1
Q

Prevalence of dystonia with typical antipsychotics

A

10%

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2
Q

Risk factors for developing dystonia on antipsychotics

A

Young males
Neuroleptic naive
High potency drugs e.g. haloperidol

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3
Q

Prevalence of pseudo-parkinsonism with typical antipsychotics

A

20%

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4
Q

Risk factors for developing pseudo-parkinsonism on antipsychotics

A

Elderly females

Pre-existing neurological damage e.g. stroke

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5
Q

Prevalence of akathisia with typical antipsychotics

A

25%

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6
Q

Prevalence of tardive dyskinesia with typical antipsychotics

A

5% per year of antipsychotic exposure

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7
Q

Risk factors for developing tardive dyskinesia with antipsychotic treatment

A

Elderly females
Affective illnesses
Those who have had EPSEs earlier on in treatment
Intellectual disability and brain damage

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8
Q

Time taken for dystonia to develop after starting antipsychotics

A

Minutes to hours

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9
Q

Time taken for pseudo-parkinsonism to develop after starting antipsychotics

A

Days to weeks - can also start days to weeks after an antipsychotic is increased

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10
Q

Time taken for akathisia to develop after starting antipsychotics

A

Hours to weeks

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11
Q

Time taken for tardive dyskinesia to develop after starting antipsychotics

A

Months to years - higher risk the longer the antipsychotics have been given for

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12
Q

Extrapyramidal side effect involving prolonged and unintentional muscular contractions

A

Dystonia

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13
Q

Extrapyramidal side effect involving tremor, rigidity, and bradykinesia

A

Pseudo-parkinsonism

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14
Q

Extrapyramidal side effect involving a subjective feeling of restlessness

A

Akathisia

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15
Q

Extrapyramidal side effect involving involuntary repetitive movements, often of the face, tongue, and lips

A

Tardive dyskinesia

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16
Q

Extrapyramidal side effect most resistant to treatment

A

Akathisia

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17
Q

Antipsychotic which carries the highest risk of extrapyramidal side effects

A

Haloperidol

18
Q

Antipsychotic which carries the lowest risk of extrapyramidal side effects

A

Clozapine

19
Q

Treatments for dystonia

A

Anticholinergic drugs
Switch to alternative antipsychotic
Botulinum toxin

20
Q

Treatments for pseudo-parkinsonism

A

Reduce dose
Switch to alternative antipsychotic
Anticholinergic drugs

21
Q

Treatments for akathisia

A 
Reduce dose
Switch to alternative antipsychotic
Propanolol
Mirtazapine
Anticholinergic drugs
Cyproheptadine
Benzodiazepines
Clonidine
22
Q

Treatments for tardive dyskinesia

A 
Reduce dose
Switch to alternative antipsychotic
Stop any anticholinergic medications already prescribed
Tetrabenazine
Ginkgo biloba
23
Q

Anticholinergics used for extrapyramidal side effects

A

Procyclidine
Trihexyphenidyl
Orphenadrine
Benztropine

24
Q

Antihistamine used for extrapyramidal side effects due to its anticholinergic properties

A

Diphenhydramine

25
Q

Most serious extrapyramidal side effect

A

Laryngeal dystonia

26
Q

Type of dystonia where there are muscle spasms resulting in a twisted posture of the neck

A

Torticollis

27
Q

Type of dystonia where the jaw muscles are contracted

A

Trismus

28
Q

Type of dystonia where there is an arched posturing of the head, trunk, and extremities

A

Opisthotonus

29
Q

Type of dystonia where there is difficulty breathing

A

Laryngeal dystonia

30
Q

Type of dystonia where there is involuntary contraction of one or more of the extraocular muscles leading to a fixed gaze +/- diplopia

A

Oculogyric crisis

31
Q

Extrapyramidal side effect which may be a feature of schizophrenia rather than just a treatment side effect

A

Tardive dyskinesia

32
Q

Benzodiazepines recommended for treating akathisia

A

Diazepam

Clonazepam

33
Q

Factors that increase symptoms of tardive dyskinesia

A

Emotional arousal

Distraction

34
Q

Factors that decrease symptoms of tardive dyskinesia

A

Relaxation

Using the muscles for voluntary tasks

35
Q

Effect of sleep on symptoms of tardive dyskinesia

A

Symptoms disappear

36
Q

Only licensed treatment for tardive dyskinesia in the UK

A

Tetrabenazine

37
Q

Percentage of cases of tardive dyskinesia which are reversible on reducing or stopping the antipsychotic

A

50-55%

38
Q

Dystonia occurring after months to years of antipsychotic treatment

A

Tardive dystonia

39
Q

Treatment options for tardive dystonia

A

Botulinum toxin
ECT
Deep brain stimulation

40
Q

Risk factors for developing akathisia

A 
Older women
Iron deficiency
Negative symptoms
Affective features
Cognitive impairment
41
Q

Vitamin used as an add on treatment for tardive dyskinesia

A

Pyridoxine (vitamin B6)

42
Q

Most well established risk factor for developing tardive dyskinesia

A

Older age

Pharmacology (34 decks)

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