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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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submitted by mcl(597),
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To dxaepn no shit, awht ew ktnhi npashep itwh ios'nsnPakr eedssia d(na ismirpnaoaisnkn) si na cmlaaienb nebewet moanpedi adn n.loyclieteahc tI amkes omre snsee if yuo oklo ta tsih i,aarmdg ygniap traclrauip onatitent ot het trenciid hwyaatp. soLs fo midneiorcpga ()AD nrnuoes mfro eth isaastubnt nragi N(cS) teslurs in ntanstco aotavitcin fo sehto ChA ensiecgrt seounn,r whhic tllaeymitu ruestsl ni noiiibihtn fo utlhamas romf itniaintig eeo.smmnvt reoerhTfe, sinug eoinatcicgnlihrs hlep ihtw isikoannaspnirm ynoesracd ot .hdlalo

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? +  

submitted by thomasalterman(150),
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eihixdrelpyhnT adn onnzpeeBtir era mcnraaiscuisitn hatt nac atter het trinsge rtomer and itigdyri of

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 +  

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.