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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

Summarizing the four types of Extrapyramidal Symptoms EPS: Acute Dystonia, Akathisia, Pseudoparkinsonism, and Tardive Dyskinesia. For each, show key visual signs e.g., neck s...
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

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