🧵 How well do you know your dopamine antagonists? 💊💊
1/ Using these drugs safely requires that clinicians & patients appreciate their important #AdverseEffects, which are not always well understood
👉🏽ti.ubc.ca/letter139
#MedEd #prescribing #deprescribing #medsafety
2/ #AdverseEffects may include:
⚠️ Drug-induced #Parkinsonism
-↘️ or slowed movements, rigidity/tremor/unsteadiness, facial expression loss
⚠️ #Akathisia
-intense internal restlessness or desire to move (which may be mistaken for anxiety)
👉🏽Pt videos: ti.ubc.ca/letter139
3/ #AdverseEffects may include:
⚠️Acute dystonic reaction
-sudden, involuntary, often painful muscle spasm
⚠️Dyskinesia
-repetitive, involuntary movements...can be associated with cognitive decline
👉🏽Pt experience videos: ti.ubc.ca/letter139
#MedEd #ptsafety #drugsafety
4/ Are “atypical #antipsychotics” different?
Clozapine causes fewer extrapyramidal symptoms, but other toxicities limit use
Newer 💊 such as olanzapine, quetiapine, risperidone, & many later drugs retain potential to cause serious neurological, metabolic, other problems #MedEd
5/ Avoid serious harms when #prescribing dopamine antagonists:
⚠️Prescribe only when essential
↘️Use lowest effective dose
⏳Cautious time-limited prescribing for ppl w/ psychotic disorders & for some LTC residents after non-drug options exhausted
👉🏽ti.ubc.ca/letter139
6/ CONCLUSIONS:
👨🏽🏫 Learn/teach dopamine blockade symptoms/signs
⚠️ Exclude causation by DA antagonists before applying terms like "restless legs" to pts
🩺 Look/listen for drug-induced Parkinsonism, akathisia, movement disorders during pt exams
💊 Reassess tx dose/duration
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