A person with violent behavior and agitation was dia-gnosed to have Schizophrenia and was receiving haloperi!dol. Following this he developed rigidity and inability to move his eyes. Which of the following drugs should be added to his treatment intravenously for this condition?
Ans: C. Promethazine(Ref: Harrison I9/e p2624, 18/e p3544; Katzung I 3/e p500-501, I2/e p495).This case suggestive of acate muscular dystonia in schizophrenia patient.Due to rigidity & inabilily to move eyes after haloperidol use.Treatment:IM anticholinergic (benztropine).IV/IM antihistaminic (diphenhydramine hydrochloride) - Relieves symptoms.Promethazine (25-50 mg IV or IM) - used less frequently but readily available.Acute Muscular Dystonia:Features:Bizarre muscle spasms, mostly involving linguo-facial muscles-grinacing, toicollis, locked jaw.Occurs within few hours of single dose or at most in first week of therapy.More common in children below 10 years & in girls, paicularly after parenteral administration.Treatment:Central anticholinergic, promethazineo or hydroryzine.
Diazepam
Resperidone
Promethazine
Haloperidol