Extra – pyramidal symptoms are side effects of - RRB Staff Nurse Jaipur-6th June 2018

RRB Staff Nurse Jaipur-6th June 2018

Pharmacology

Easy

Appeared in: RRB Staff Nurse Jaipur-6th June 2018

Explanation

Extrapyramidal symptoms (EPS) are a well-known group of movement-related side effects caused by antipsychotic medications.
These drugs work by blocking dopamine D2 receptors. This blockade in the nigrostriatal pathway of the brain, which controls motor function, leads to the development of EPS.
First-generation (typical) antipsychotics have a higher affinity for D2 receptors and are therefore more likely to cause EPS than second-generation (atypical) antipsychotics.

Option B: Antimanic agents, such as lithium, are not primarily associated with extrapyramidal symptoms. Their characteristic neurological side effect is a fine hand tremor.
Option C: Antidepressants, like SSRIs and TCAs, primarily act on serotonin and norepinephrine. While they can have neurological side effects, the classic EPS profile is not a characteristic or common one.
Option D: Anti-Parkinsonian agents are used to treat, not cause, extrapyramidal symptoms. They work by increasing dopamine levels or blocking acetylcholine to restore balance in the motor system.

Visual 1: Chart - A chart listing the different types of Extrapyramidal Symptoms (dystonia, akathisia, parkinsonism, tardive dyskinesia) with their key signs and typical onset time after starting an antipsychotic.
Visual 2: Diagram - A simplified diagram of the brain showing the nigrostriatal dopamine pathway and illustrating how D2 receptor blockade by antipsychotics leads to movement side effects.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacology: Side Effects of Antipsychotic Medications (Extrapyramidal Symptoms) as background academic context rather than a clinical decision trigger.
A crucial nursing responsibility is to monitor patients on antipsychotics for the emergence of EPS. Early identification and reporting can prevent significant distress and complications.
Nurses often administer medications like benztropine (Cogentin) or diphenhydramine (Benadryl) to manage acute dystonic reactions, which can be frightening for the patient.
The Abnormal Involuntary Movement Scale (AIMS) is a key assessment tool used by nurses to screen for and track the severity of tardive dyskinesia in patients on long-term antipsychotic therapy.

How to Approach the Question

First, identify the core concept in the question stem: 'Extra-pyramidal symptoms' (EPS). This is a specific term related to drug side effects.
Recognize this as a factual recall question from pharmacology. The goal is to link a specific side effect profile to a drug class.
Systematically review the options. Think about the primary mechanism and most famous side effects of each drug class.
Recall or deduce that 'antipsychotics' are known for blocking dopamine, a key neurotransmitter for motor control. This makes them the most likely cause of movement disorders like EPS.
Eliminate the other options. Anti-Parkinsonian agents do the opposite (increase dopamine activity), so they treat EPS. Antidepressants and antimanics have different primary side effect profiles.

Concept Tested & Keywords

Concept Tested: Pharmacology: Side Effects of Antipsychotic Medications (Extrapyramidal Symptoms)
Stem keywords: Extra – pyramidal symptoms, side effects
Lead-in keywords: are

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