=> Tardive dyskinesia (TD),
- => The major symptoms of NMS are rigidity; highfever; autonomic
- instability such as unstable blood pressure,diaphoresis, and pallor;
- delirium; and elevated levelsof enzymes, particularly creatine
- phosphokinase. confused, mute
a syndrome of permanent involuntary movements, is most commonlycaused by the long-term use of conventional antipsychoticdrugs.include involuntary movements of the tongue,facial and neck muscles, upper and lower extremities, andtruncal musculature. Tongue thrusting and protruding, lipsmacking, blinking, grimacing, and other excessive unnecessaryfacial movements are characteristic. After it has developed,TD is irreversible, although decreasing or discontinuingantipsychotic medications can arrest its progression. Unfortunately, antipsychotic medications can mask the beginningsymptoms of TD; that is, increased dosages of the antipsychoticmedication cause the initial symptoms to disappeartemporarily. As the symptoms of TD worsen, however, they“break through” the effect of the antipsychotic drug.Preventing TD is one goal when administering antipsychotics.This can be done by keeping maintenance dosagesas low as possible, changing medications, and monitoringthe client periodically for initial signs of TD using a standardizedassessment tool such as the Abnormal InvoluntaryMovement Scale
- => Anticholinergic side effects
- often occur with the use of antipsychotics and includeorthostatic hypotension, dry mouth, constipation, urinaryhesitance or retention, blurred near vision, dry eyes, photophobia,nasal congestion, and decreased memory. Theseside effects usually decrease within 3 to 4 weeks but do notentirely remit. The client taking anticholinergic agents forEPS may have increased problems with anticholinergicside effects. Using calorie-free beverages or hard candymay alleviate dry mouth; stool softeners, adequate fluidintake, and the inclusion of grains and fruit in the diet mayprevent constipation.
=> also increase blood prolactin
levels. Elevated prolactin may cause breastenlargement and tenderness in men and women; diminishedlibido, erectile and orgasmic dysfunction, and menstrualirregularities; and increased risk for breast cancer,and may contribute to weight gain.
sugar free fluids and candy for dry mouth, prevent constipation (exeercise, fluids, fiber), suncreen for photosensitivity, monitor drowsiness (avoid driving and dangerous activties)