SCTIMST Staff Nurse - 2016
Pharmacology
Easy
Extra pyramidal symptoms are a complication of the treatment with which of the following drugs?
Appeared in: SCTIMST Staff Nurse - 2016
Explanation
- Extrapyramidal symptoms (EPS) are movement disorders caused by the blockade of dopamine D2 receptors in the brain's nigrostriatal pathway.
- Antipsychotic drugs, especially first-generation (typical) agents like haloperidol, are the primary class of medications known to cause this adverse effect.
- EPS includes a range of symptoms from acute, painful muscle spasms (dystonia) to chronic, irreversible movements (tardive dyskinesia).
- The mechanism is directly related to the therapeutic action of these drugs in treating psychosis, which also involves dopamine blockade.
Why Other Options Were Wrong
- Option B: Antidepressants primarily work on serotonin and norepinephrine systems. While they can rarely cause akathisia (restlessness), they do not cause the full range of classic EPS like dystonia or parkinsonism.
- Option C: Anti-anxiety drugs, such as benzodiazepines, enhance the effect of the neurotransmitter GABA. Their main side effects are sedation, ataxia, and risk of dependence, not EPS.
- Option D: Anti-malarial drugs work by interfering with processes specific to the malaria parasite. Their side effect profile is unrelated to the dopamine pathways involved in EPS.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Pharmacology: Adverse Effects of Antipsychotic Medications to guide bedside assessment, documentation, and the next nursing action.
- Nurses must monitor patients on antipsychotics for EPS using standardized tools like the Abnormal Involuntary Movement Scale (AIMS), especially for tardive dyskinesia.
- Acute dystonia is a medical emergency. The nurse must be prepared to administer PRN anticholinergic medications (like benztropine) immediately to prevent airway compromise from laryngeal spasms.
- Patient education is crucial. Patients and families should be taught to report any muscle stiffness, restlessness, or unusual movements to the healthcare provider promptly.
How to Approach the Question
- First, identify the key term in the question: 'Extra pyramidal symptoms' (EPS).
- Recognize that EPS refers to a specific set of drug-induced movement disorders.
- Systematically review the provided drug classes in the options.
- Recall the primary mechanism of action and hallmark side effects for each class.
- Connect EPS directly to the dopamine-blocking action of antipsychotic medications.
- Eliminate the other options because their mechanisms (e.g., affecting serotonin, GABA, or malaria parasites) do not lead to EPS.
Concept Tested & Keywords
- Concept Tested: Pharmacology: Adverse Effects of Antipsychotic Medications
- Stem keywords: Extra pyramidal symptoms, complication, treatment, drugs
- Lead-in keywords: which of the following
- Negative lead-in flag: false
Question ID
QXQiygcmVLUdEhk8mmmcwd
Reference Book
E6 Pharmacology Katzung 16e p. 810-812
E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 1 (pp 26-289 of 579) p. 127-129
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 13807-13809
Practise the full SCTIMST Staff Nurse - 2016
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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