135A CASE REPORT OF FLUNARIZINE INDUCEDPARKINSONISM IN A TERTIARY CARE TEACHING HOSPITAL, TIRUPATHI, ANDHRA PRADESH, INDIAThe Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V), defines Drug Induced Parkinsonism as the presence of resting tremor, muscular rigidity, akinesia or bradykinesia. Drug-induced-parkinsonism [DIP] has been known for more than 60 years, the most common cause of Parkinsonism [PK] worldwide is Idiopathic Parkinson’s Disease (IPD). The causes of secondary PK i.e., DIP is particularly due to atypical antipsychotics, antiepileptic, calcium antagonists [flunarizine (fz), cinnarizine (cz)], gastrointestinal prokinetics. These drugs mainly block dopamine (DA) receptors or deplete dopamine stores produce a functional dopaminergic deficit state that impairs DA function directly or indirectly. The Pathophysiology of DIP is related to drug-induced changes in the basal ganglia motor circuit secondary to DA receptor blockade. Here we are presenting a case report on flunarizine induced parkinsonism in 44year female patient who has presented with chief complaints of slow walking in the past 6 months, tremors of both upper limbs, bradykinesia, decreased sleep and decreased interaction, excessive menstrual bleeding and with past history of depression with hypothyroidism and migraine. DIP may have a significant and longstanding effect on patient’s daily activities, and should be cautious when prescribing DA receptor blockers and close monitoring towards patients neurological signs, especially for Parkinsonism and other movement disorders. Flunarizine drug induced Parkinsonism is rare but it is reversible condition. Early diagnosis and management can reduce the morbidity and mortalityrobin.george793@gmail.comcasereport1012020Drug-induced-Parkinsonism (DIP),flunarizine (fz),Dopamine (DA),Tremors,BradykinesiaSujitha S,Priyanka S,Robin GeorgePharm D Intern, Department of Pharmacology, Sri Padmavathi Medical College hospital SVIMS-SPMC(W),Pharm D Intern, Department of Pharmacology, Sri Padmavathi Medical College hospital SVIMS-SPMC(W),Assistant Professor, Department of Pharmacy Practice, Seven Hills College of Pharmacy, Venkatramapuram, Tirupati, Andhra Pradesh -517561, India