Antiparkinsonian Mental Health Nursing Unit V

1. Presented by:
Mr. P. Vethadhas M.Sc (N),
Assistant Professor,
Dept.of Mental Health Nursing.

2. Antiparkinsonian Agents
In clinical practice anticholinergic drugs, amantadine
and the antihistamines have their primary use astreatments
formedication-induced movement disorders, particularly
neurolepticinduced parkinsonism, acute dystonia and
medication-induced tremor.

3. Anticholinergics
 Trihexyphenidyl
 Benztropine
 Biperiden

4. Dopaminergic Agents
 Bromocriptine
 Carbidopa / Levodopa

5. Monoamine Oxidase Type B Inhibitors
 Selegiline

6. Trihexyphenidyl (Artane, Trihexane, Trihexy,
Pacitane)
Indications
• Drug-induced parkinsonism.
• Adjunct in the management of parkinsonism.

7. Dosage
1-2 mg per day orally initially.
Maximum dose up to 15 mg/ day in divided doses.

8. Mechanism of Action
It acts by increasing the release of dopamine from
presynaptic vesicles, blocking the re-uptake of dopamine
into presynaptic nerve terminals or by exerting an agonist
effect on postsynaptic dopamine receptors. Trihexyphenidyl
reaches peak plasma concentrations in 2-3 hours after oral
administration and has a duration of action of up to 12 hours.

9. Side Effects
Dizziness
Nervousness
Drowsiness
Weakness
Headache
Confusion
Blurred vision
Mydriasis

10. Side Effects
Tachycardia
Orthostatic hypotension
Dry mouth
Nausea
Constipation
Vomiting
Urinary retention and decreased sweating

11. Nurse's Responsibilities
• Assess parkinsonian and extrapyramidal symptoms. Medication
should be tapered gradually.
• Caution patient to make position changes slowly to minimize
orthostatic hypotension.
• Instruct the patient about frequent rinsing of mouth and good oral
hygiene.
• Caution patient that this medication decreases perspiration, and
over-heating may occur during hot weather.

12. Nurse's Responsibility in the
Administration of Benzodiazepines
• If IM administration is preferred give deep IM.
• For IV administration do not mix with any other drug.
• Give slow IV as respiratory or cardiac arrest can occur;
monitor vital signs during IV administration.
• Prevent extravasations since it can cause phlebitis and
venous thrombosis.