The primary care nurse practitioner (NP) is performing a physical examination on a patient who has been taking mesoridazine (Serentil) for several weeks to treat schizophrenia. The patient is exhibiting rhythmic movements of the face and jaw
The NP should be concerned that the patient may: a. need a higher dose of mesoridazine.
b. need to change to thioridazine (Mellaril).
c. have developed neuroleptic malignant syndrome.
d. be exhibiting signs of an irreversible adverse effect.
D
Tardive dyskinesia, or abnormal involuntary movements characterized by rhythmic involuntary movements of the tongue, face, mouth, or jaw, may be progressive and irreversible. This condition can occur with all antipsychotics, especially the first-generation antipsychotics. Increasing the dose may increase the symptoms. Thioridazine is another first-generation antipsychotic with a similar adverse-effect profile. Neuroleptic malignant syndrome occurs weeks after initiation and is characterized by fever, catatonia, muscle rigidity, and autonomic instability.
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