benztropine / benzatropine (Cogentin)

see also:

• extrapyramidal reactions such as oculogyric crisis, dystonic reactions, akathisia

• benztropine is a compound with parts of atropine and parts of diphenhydramine
• it thus has anticholinergic properties and antihistamine properties
• it is mainly used parenterally in the emergent Rx of acute extrapyramidal reactions such as oculogyric crisis, dystonic reactions, akathisia and parkinsonism but not for tardive dyskinesia
• it has a long duration of action

• children aged under 3yrs as they are very susceptible to anti-muscarinic anticholinergic agents
• HS

• children as at risk of anticholinergic toxicity
• avoid driving or operating machinery
• anticholinergic risk of sinus tachycardia, urinary retention, glaucoma, delirium, psychosis and paralytic ileus
• hot weather as may cause anhydrosis and risk of heat illness and heat stroke
• not known if it is excreted in breast milk - avoid in lactation
• category B2 in pregnancy - no known adverse effects but only use if needed

• adults:
  • 1-2mg im or iv is usually sufficient for most cases of drug-induced reactions