Toxicity, Medication-Induced Dystonic Reactions Treatment & Management

  • Author: Geofrey Nochimson, MD; Chief Editor: Asim Tarabar, MD   more...
 
Updated: Dec 7, 2010
 

Emergency Department Care

Emergency interventions other than pharmacologic treatment rarely are required.

Securing the airway is necessary only rarely, when laryngeal and pharyngeal dystonic reactions place the patient at risk of imminent respiratory arrest.

Pharmacologic treatment resolves the reaction.

Proceed to Medication
 
 
Contributor Information and Disclosures
Author

Geofrey Nochimson, MD  Consulting Staff, Department of Emergency Medicine, Sentara Careplex Hospital

Geofrey Nochimson, MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Samuel M Keim, MD  Associate Professor, Department of Emergency Medicine, University of Arizona College of Medicine

Samuel M Keim, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Public Health Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Michael J Burns, MD  Instructor, Department of Emergency Medicine, Harvard University Medical School, Beth Israel Deaconess Medical Center

Michael J Burns, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Emergency Physicians, American College of Medical Toxicology, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD  Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital

Disclosure: Nothing to disclose.

References
  1. Fahn S. The varied clinical expressions of dystonia. Neurol Clin. Aug 1984;2(3):541-54. [Medline].

  2. Marsden CD, Jenner P. The pathophysiology of extrapyramidal side-effects of neuroleptic drugs. Psychol Med. Feb 1980;10(1):55-72. [Medline].

  3. McCormick MA, Manoguerra AS. Dystonic reaction. In: Harwood-Nuss A, et al, eds. Clinical Practice of Emergency Medicine. Lippincott Williams & Wilkins; 1991:510-511.

  4. Fines RE, Brady WJ, DeBehnke DJ. Cocaine-associated dystonic reaction. Am J Emerg Med. Sep 1997;15(5):513-5. [Medline].

  5. Kumor K. Cocaine withdrawal dystonia. Neurology. May 1990;40(5):863-4. [Medline].

  6. Barach E, Dubin LM, Tomlanovich MC, Kottamasu S. Dystonia presenting as upper airway obstruction. J Emerg Med. May-Jun 1989;7(3):237-40. [Medline].

  7. Demetropoulos S, Schauben JL. Acute dystonic reactions from "street Valium". J Emerg Med. Jul-Aug 1987;5(4):293-7. [Medline].

  8. Elliott ES, Marken PA, Ruehter VL. Clozapine-associated extrapyramidal reaction. Ann Pharmacother. May 2000;34(5):615-8. [Medline].

  9. Herrstedt J. Risk-benefit of antiemetics in prevention and treatment of chemotherapy-induced nausea and vomiting. Expert Opin Drug Saf. May 2004;3(3):231-48. [Medline].

  10. Jhee SS, Zarotsky V, Mohaupt SM, et al. Delayed onset of oculogyric crisis and torticollis with intramuscular haloperidol. Ann Pharmacother. Oct 2003;37(10):1434-7. [Medline].

  11. Piecuch S, Thomas U, Shah BR. Acute dystonic reactions that fail to respond to diphenhydramine: think of PCP. J Emerg Med. May-Jun 1999;17(3):527. [Medline].

  12. Roberge RJ. Antiemetic-related dystonic reaction unmasked by removal of a scopolamine transdermal patch. J Emerg Med. Apr 2006;30(3):299-302. [Medline].

  13. Schumock GT, Martinez E. Acute oculogyric crisis after administration of prochlorperazine. South Med J. Mar 1991;84(3):407-8. [Medline].

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