A patient taking a first-generation antipsychotic (FGA) medication develops severe parkinsonism and is treated with amantadine (Symmetrel). The amantadine is withdrawn 2 months later, and the parkinsonism returns
The nurse will expect the provider to:
a. give anticholinergic medications.
b. make a diagnosis of idiopathic parkinsonism.
c. resume the amantadine indefinitely.
d. try a second-generation antipsychotic (SGA).
ANS: D
Neuroleptic-induced parkinsonism is treated with some of the same drugs used for idiopathic parkinsonism, such as amantadine. If parkinsonism is severe, switching to an SGA may help, because the risk of parkinsonism is much lower with these drugs. An anticholinergic medication may be used initially. A recurrence of parkinsonism when the drug is withdrawn does not indicate idiopathic parkinsonism. These drugs should not be used indefinitely.
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