Acute dystonia (EPS & FATAL) - severe spasm of the tongue, neck face and back, manage airway, give benztropine or diphenhydramine, Call RRT, Pseudo parkinsonism (EPS) - bradykinesia, rigidity, shuffling gait, drooling, tremors, Akathisia (EPS) - inability to sit or stand still, pacing / agitation, Tardive dyskinesia (TD) (EPS) - LATE EPS, involuntary movements of tongue and face (lip smacking) arms, legs and trunk. Does not go away, even after stopping the med, Neuroendocrine effects - Gynecomastia, wt gain, menstrual irregularities, galactorrhea (nipple discharge w/o breast feeding), Neuroleptic malignant syndrome (FATAL) - sudden high fever, BP fluctuations, diaphoresis, tachycardia, muscle rigidity, decreased LOC, coma. Can occur during first week of tx. Stop the med, apply cooling blankets, give antipyretics, dantrolene to relax muscles, transfer to ICU, Orthostatic hypotension - should decrease over 2-3 weeks, monitor BP, increase fluids to maintain hydration and decrease dizziness with movement, Sedation - should diminish in a few weeks, take a bedtime, no driving till this subsides, Seizures - report seizure activity to provider, may need an increase in antiseizure meds, Sever dysrhythmias - obtain baseline EKG and K levels, Sexual dysfunction - can happen in all genders, Skin Effects - photosensitivity, wear sunscreen, protective layers, avoid direct sunlight, Liver impairment - monitor ATL, AST, observe for s/s liver dysfunction and report, Agranulocytosis (FATAL) - Happens with clozapine - monitor for s/sx of infection. Obtain CBC and DC med if WBC is less than 3000,

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