Dystonic/Extra-pyramidal Reaction Protocol

Question 1

Signs and symptoms of dystonic reaction?

Answer 1

eye deviation in all directions, protrusion of the tongue, forced jaw opening or spasms, facial grimacing, deviation of the heads, difficulty speaking

Question 2

Differentials for dystonic/extra-pyramidal reaction

Answer 2

conversion disorder (psych stress manifestation physical) mandible dislocation, hypocalcemia, hypomagnesemia, meningitis, status epitilepticus, stroke, tetanus, drug toxicity

Question 3

Walk through the dystonic reaction protocol BLS to ALS

Answer 3

DRABCDE, oxygen, suction, glucose, cardiac monitor, IV, diphenhydramine 25-50 mg IV/IM.

Question 4

Name the examples of medications that can cause dystonic reactions

Answer 4

amitryptoline, amoxapine, bupropion, clomipramide, doxepine, trimipramine, trazodone, chloropromazine, clozapine, fluphenazine, haldol, perphenazine, promazine, trifluoperazine, lithium, midazolam, phenytoin, promethazine, verapamil, xanax, buspar, metoclopramide, prochlorperazine.

Question 5

Who is most at risk for these reactions?

Answer 5

males under the age of 45