Psych
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| Side effects include muscular rigidity and cramping, a stiff or thick tongue with difficulty swallowing. usually occurs in the 1st week of treatment, in pt under 40yo, males, drugs involved Haloperidol & Thiothixene | Dystonia
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| twisted head and neck | torticollis
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| tightness in the entire body with the head back and an arched neck | opisthotonus
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| eyes rolled back in a locked position | oculogyric crisis
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| loss of coordination of muscles especially those of the extremities | ataxia
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| what medications are used to treat Acute Dystonia | IM benztropine mesylate or IM/IV diphenhydramine
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| intense need to move about | akathisia
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| a potentially fatal idiosyncratic reaction to an antipsychotic drug. often occurs in the first 2 weeks of treatment or after a increase in dosage. | Neuroleptic malignant syndrome
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| S/S rigidity, high fever, autonomic instability such as unstable BP, diaphoresis, pallor, delirium, and elevated levels of enzymes | NMS neuroleptic malignant syndrome
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| TX immediate discontinuance of all antipsychotic medication and the institution of supportive medical care to treat dehydration and hyperthermia | NMS neuroleptic malignant syndrome
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| S/S involuntary movement of the tongue, facial and neck muscles, upper/lower extremities. tongue thrusting & protruding, lip smacking, blinking, grimacing after it develops it is irreversible. Tx includes Atypical antipsychotic drugs | Tardive dyskinesia
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| S/S stiff stooped posture, mask-like-facies, decreased arm swing, a shuffling, festinating gait (small steps), cogwheel rigidity (ratchet like movements of joints), drooling, tremor, bradycardia, pill rolling | pseudoparkinsonism
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| ziprasidone is contraindicated in pt with a known HX of QT prolongation, recent MI, or uncompensated heart failure. it should not be used with other QT-prolonging drugs | FYI
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| acute dystonia, pseudoparkinism, akathisia | extrapyramidal symptoms
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| clients taking anticholinergic agents for EPS may have problems with anticholinergic side effects. Side effects usually decrease within 3-4 weeks but don't entirely remit | FYI
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| this drug may cause agranulocytosis, which may not show up for 24 weeks after TX is started. It also causes pt to have a baseline WBC count & differential before initiation of TX and Q weekly for 6 months and 4 weeks after discontinuation | Clozapine (Atypical antipsychotic)
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