Psychiatric-Mental Health Nurse Practitioner (PMHNP) Purple Book Practice Test

Beyond stopping the offending antipsychotic, a central pharmacologic move in suspected neuroleptic malignant syndrome is to counteract the pathophysiology with targeted drugs. Dantrolene, a skeletal muscle relaxant, helps by reducing calcium release in muscle, which lowers severe rigidity, heat production, and the risk of rhabdomyolysis. Bromocriptine, a dopamine agonist, counteracts the dopamine blockade at receptors and supports rebalancing central dopaminergic activity. These treatments are used with aggressive supportive care (cooling, IV fluids, electrolyte management, and monitoring for complications). While electroconvulsive therapy can be considered in some refractory cases, the immediate pharmacologic step is administering dantrolene or bromocriptine.