How do you manage extrapyramidal syndrome?

Lipophilic beta-blockers, especially propranolol and metoprolol, appear to be the most effective treatments. Anticholinergic agents are commonly given to prevent acute dystonias, especially in high-risk patients, but long-term prophylaxis is controversial. Atypical antipsychotics may have less potential to induce EPEs.

How do you treat Mepclopramide extrapyramidal side effects?

Intravenous anticholinergic benztropine is effective for most dystonic reactions within 5 minutes. Antihistamine, benzodiazepines, beta-adrenergic antagonists (propranolol), beta-adrenergic agonists (clonidine), or dopamine agonists (amantadine) may also be used [8].

Why do anticholinergics help with EPS?

When anticholinergic agents, such as benztropine, are given to relieve EPS, the intention is to block the excessive nigrostriatal acetylcholine transmission that ultimately causes the motor side effects.

Does Benadryl help with EPS?

IM diphenhydramine (Benadryl) can be used to treat acute dystonia. Oral diphenhydramine 25-100 mg can be helpful for neuroleptic-induced parkinsonism….Extra-Pyramidal Symptoms (EPS)

Type Dystonia
Description Tongue swelling, jaw locking, oculogyric crisis, emergency situation
Time Minutes to hours
Treatment IM benztropine or IM diphenhydramine

What is the nursing intervention for EPS?

Nursing Actions: Assess and monitor for EPS – AIMS (Assessment of Involuntary Movement Scale). Monitor for EKG changes. Administer anticholinergic for treatment of EPS prn. Encourage sugarless candy for dry mouth.

Which antiemetics are known to cause extrapyramidal symptoms?

Although extrapyramidal side effects of two commonly used antiemetics, metoclopramide and prochlorperazine, are well known, it may be difficult for even the experienced practitioner to distinguish some of these extrapyramidal reactions from such psychiatric symptoms as anxiety, depression, or catatonia.

How is acute dystonic reaction treated?

Treatment / Management The most commonly available drugs in the emergency setting for the treatment of acute dystonic reactions are diphenhydramine and benztropine. Symptoms usually improve or resolve dramatically within 10 to 30 minutes of administration of parenteral anticholinergics.

What anticholinergic medications are used to treat extrapyramidal symptoms?

Anticholinergic (antimuscarinic) drugs are prescribed alongside antipsychotic drugs to help prevent unwanted extrapyramidal side effects often associated with antipsychotics. Anticholinergics licensed for use in the United Kingdom are orphenadrine, procyclidine and trihexyphenidyl (BNF 2015).

What causes extrapyramidal symptoms in antipsychotics?

Extrapyramidal symptoms can develop as a result. First-generation antipsychotics commonly caused extrapyramidal symptoms. With second-generation antipsychotics, side effects tend to occur at lower rates. These drugs have less affinity for dopamine receptors and bind loosely and block some serotonin receptors.

What is the extrapyramidal system?

Your extrapyramidal system is a neural network in your brain that helps regulate motor control and coordination. It includes the basal ganglia, a set of structures important for motor function.

What are the factors affecting the efficacy of neuroleptic therapy?

These EPS are a function of biological sensitivity, neuroleptic molecular structure, dose, age, sex, and duration of neuroleptic treatment. Because of their association with EPS, at times irreversible, and their modest efficacy in the non-schizophrenic patients, neuroleptic administration should be limited predominantly to schizophrenic patients.

How do extrapyramidal symptoms affect my quality of life?

In some cases, extrapyramidal symptoms may not affect you too much. In other cases, they might be painful or uncomfortable. They can negatively affect quality of life and contribute to frustration and distress.