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Side Effect Profiles (EPSEs (Eg (Parkinsonian
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Bradykinesia tremor,…
Side Effect Profiles
EPSEs
Causes
Typical antipsychotics
Rarely: metoclopramide, prochlorperazine
Esp. in young women
Dyskinesias and dystonias are common w/ antiparkinsonian drugs.
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Eg
Parkinsonian
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Bradykinesia tremor, rigidity
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Acute Dystonia
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Involuntary sustained muscle spasm
E.g. lock jaw, spasmodic torticollis, oculogyric crisis
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Tardive Dyskinesia
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- Rhythmic involuntary movements of head, limbs and trunk
- Chewing, grimacing
- Protruding, darting tongue
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Neuroleptic Malignant Syndrome
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- Motor: severe muscular rigidity
- Mental: fluctuating consciousness
- Autonomic: hyperthermia, ↑HR, sweating, ↑/↓BP
- Blood: ↑CK, leukocytosis
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Rx :check:
Dantrolene: inhibits muscle Ca release
Bromocriptine / apomorphine: reverse Da block
Cool pt.
Cholinoceptors
Cholinergic
- Salivation
- Bronchoconstriction
- Lacrimation
- Urination
- Diarrhoea
- GI upset
- Emesis
- Miosis
- Sweating
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Anti-muscarinic
- Constipation
- Urinary retention
- Mydriasis
- Blurred vision
- Bronchodilatation
- Drowsiness
- Dry eyes / skin
Causes
- Ipratropium
- Anti-histamines
- TCAs
- Antipsychotics
- Procyclidine
- Atropine
Dopamine
Excess
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Features
- Behaviour change
- Confusion
- Psychosis
Deficit
Causes
- Anti-psychotics
- Anti-emetics: metoclopramide, prochlorperazine
Features
- EPSEs
- ↑ PRL
- Neuroleptic malignant syndrome
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Cerebellum
- Dysdiadochokinesis, dysmetria, rebound
- Ataxia
- Nystagmus
- Intention tremor
- Slurred speech
- Hypotonia
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