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NBME 23 Answers

nbme23/Block 1/Question#23 (31.8 difficulty score)
A 35-year-old man comes to the physician ...
Anticholinergic agentπŸ”
tags: neuro parkinsons 

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 +8 
submitted by mcl(597),
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To nxdpea on ,hist hwat ew ntikh nhppaes iwht sPrknoia'ns esisade d(na ssanamiionnpik)r is an liabncmea bnwteee aipdeonm and nolyhilae.cect It sekma rome essen if ouy olok ta tish rida,gma agyinp crtliaupar netttinao ot het dnecirti .paythwa soLs of rmcdaigoinpe (DA) nosenur ofmr eth suatnibtsa grian (cS)N tusserl ni noctasnt atvnioatic of osthe AhC ctieenrsg urn,esno iwhch lailtetymu surstle in ioitniinbh of uahmtals ofrm nnattgiiii es.tevmmon erThoefre, guisn seolhrgitniacnic help whit kanrsaoipmsinni scednayro ot lohla.d

mcl  Also, you don't wanna use sinemet since that would be counterproductive +2  
drzed  Whaaat? How could increasing levels of dopamine in a psychotic patient possibly be a bad thing? +  



 +5 
submitted by thomasalterman(150),
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enprhxydleTiih nad ztpirneBoen rae saurnsmiciiatnc htat acn traet eht eigsrtn rmrtoe adn igridyit fo nosia.spkrnim

mousie  haloperidol induced Parkinson's... ? adding a anticholinergic can counter these adverse effects of the antipsychotic .. ? +3  
fulminant_life  @mousie yeah it balances the dopamine-cholinergic imbalance caused by the antipsychotics +  
kai  +So antipsychotics induce Extrapyramidal side effects which is drug induced Parkinson = low Dopamine High Ach, and you would treat this with anticholinergic (Benztropine).This is neurologic. +Antipsychotics also produce non-neurologic, systemic anti-cholinergic effects like dry mouth, sedation, hypotension etc +  



 +1 
submitted by abhishek021196(61),

One of the tx strategies for drug induced Parkisonism or otherwise is to Curb excess cholinergic activity. Done by Benz-tropine, trihexyphenidyl (Antimuscarinic; improves tremor and rigidity but has little effect on bradykinesia in Parkinson disease). Park your Mercedes-Benz.