UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS
Types of EPS and cause - CORRECT ANSWER 1) Acute dystonia
2) Akathisia
3) Pseudoparkinsonism
4) Tardive dyskinesia
- Caused by antipsychotic medications which block dopamine and serotonin in the limbic system
Pseudoparkinsonism - CORRECT ANSWER Repetitive "pill rolling" movement, persistent
tremors, shuffling gait, drooling, rigidity
acute dystonia - CORRECT ANSWER - Severe muscle spasms
- difficulty swallowing
- Stiff neck
- rotation of eyes upward
- Extreme facial grimacing
- Protrusion of tongue
Akathisia - CORRECT ANSWER Muscle restlessness, pacing, jittery
Tardive dyskinesia - CORRECT ANSWER involuntary movements of the facial muscles,
tongue, lips, and trunk
Antidote for acute dystonia - CORRECT ANSWER Benztropine (anticholinergic) and
diphenhydramine (antihistamine) and lorazepam (benzodiazepine)
Antidote for akathisia - CORRECT ANSWER Propranolol (beta-blocker) and lorazepam
(benzo)
, Antidote for Parkinsonism - CORRECT ANSWER Benztropine (anticholinergic) and
diphenhydramine (antihistamine)
Treatment for NMS - CORRECT ANSWER Stop offending agents (support with dantrolene
and lorazepam)
Is there treatment for tardive dyskinesia? - CORRECT ANSWER No, stop offending agents
(may be irreversible)
Atypical vs typical antipsychotics - CORRECT ANSWER Atypical:
- 2nd generation
- Treats positive and negative symptoms
- Have life threatening side effects
- Examples: respiridone, paliperidone, clozapine, olanzapine
Typical:
- Deals with positive symptoms (e.g., hallucinations)
- Block only dopamine
- higher risk of EPS
- Examples: Loxapine, haloperidone
Serious side effect of clozapine - CORRECT ANSWER - Agranulocytosis (neutropenia) =
dangerously low WBCs
- Last resort medication b/c of this side effect
General side effects of antispychotics - CORRECT ANSWER Metabolic syndrome,
neuromalignant syndrome, constipation, hypothyroidism, decreased BP, increased prolactin, increased
lipids and blood glucose
Metabolic syndrome - CORRECT ANSWER - Side effect of atypical antipsychotics
- Increased BP, increased blood sugar, increased lipids, and weight gain