Question about

[Jamiu22]

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A 27-year-old man is brought to the emergency department by ambulance. Paramedics report that he was found sitting on the sidewalk speaking as though engaged in a heated argument, but nobody else was around. They say that the patient appeared to be in distress and that he was quite disheveled. The man is evaluated by a psychiatrist, admitted to the hospital, and started on a medication to treat his symptoms. Two days later a medical student notices that the patient has painful spasms in his neck muscles.

A. Benztropine
B. Dantrolene
C. Diazepam
D. Fluphenazine
E. Prochlorperazine

For someone typically taking antidopaminergic they get Acute dystonia, Akinesia, Akathesia, and Tardive dyskenisia... my impression is that you treat Acute dystonia with either Dantrolene or Anticholinergic..... and while you treat the latter 3 (Akinesia, Akathesia and TD) with dopermine agonist..


So with this question, I chose Dantrolene but RX says that the answer is Benztropine... can someone please explain this to me? Thanks.

 

[withrye]

I hadn't read that dantrolene was a drug used for dystonia. I think the better drug is an anticholinergic or antihistamine, with benztropine being best.

 

[Jamiu22]

I hadn't read that dantrolene was a drug used for dystonia. I think the better drug is an anticholinergic or antihistamine, with benztropine being best.

Thanks.. that makes sense... Benztropine is an anticholinergic (in my mind, I read Bromocriptine)..your explanation was more on point that RXs.

So in the setting of antipsychotics, you treat Neuroleptic Malignant syndrome (NMS) with Dantrolene (sicne in NMS you get muscle rigidity and hyperthermia)....

It's a little difficult for me to separate the symptoms of NMS from other extrapyramidal effects.

 

[addo]

Somebody with extrapyramidal symptoms will be up and about, ok maybe they wont be all up and about, but they will be relatively ok compared to someone with NMS, who would most likely be hospitalized with fever, encephalopathy, muscle rigidity, in delirum and other symptoms and signs that taken together are life threatening.

 

[Jamiu22]

Somebody with extrapyramidal symptoms will be up and about, ok maybe they wont be all up and about, but they will be relatively ok compared to someone with NMS, who would most likely be hospitalized with fever, encephalopathy, muscle rigidity, in delirum and other symptoms and signs that taken together are life threatening.

Thansk Addo... it totally makes sense what you are saying! It's an easier to put it for memory say.

SDN is golden!!!