Extra Pyramidal Side Effects (EPS) and Treatment – Flashcards

- Sudden severe onset of abnormal spasm/sustained muscle contractions. - Twisting, repetitive movements, or abnormal posture. - Can look like a tremor or seizure - Typically involves the tongue, jaw, eyes, neck, limbs, trunk, or toes. - Usually occurs 24-96 hours after initial dose. - Painful and scary; patient is conscious and aware of situation. - Crisis situation that requires rapid treatment.

- Bradykinesia, akinesia, slowed speech - Cogwheel Rigidity - Shuffling gait; difficulty starting and stopping - Drooling - Resting tremor - Pill rolling tremor - Usually reversible within weeks of discontinuation

- Motor restlessness or inability to sit or stand still (ants in the pants) - Continual pacing, shuffling, shifting, foot tapping - Agitation or inner restlessness - Harder to manage; must decrease dosage or switch to different class of med

- Late EPSs, which can require months to years of medication therapy for TD to develop - Involuntary movement of the tongue and face, such as lip smacking and tongue fasciculations - Involuntary movement of the arms, legs, and trunk - Early signs may be reversible - AIMS assessment every 3-6 months - If not detected early, may be irreversible, even with drug discontinuation. - Symptoms may interfere with ability to speak, chew, or swallow

Diphenhydramine (Benadryl)- anti-histamine Benztropine (Cogentin)- anti-tremor Lorazepam (Ativan)- benzodiazepine

Propranolol (Inderal)- beta blocker

Benztropine (Cogentin)- benzodiazepine Trihexphenidyl (Artane)- anti-spasmadic