Extrapyramidal symptoms are side effects of?

Appeared in: JSSH Staff Nurse - 2019

Explanation

Antipsychotic medications, especially first-generation (typical) agents like haloperidol and fluphenazine, are the primary cause of extrapyramidal symptoms (EPS).
The mechanism involves the blockade of dopamine D2 receptors in the nigrostriatal pathway of the brain.
This dopamine blockade disrupts the normal balance with acetylcholine, leading to a variety of movement disorders.
Atypical (second-generation) antipsychotics have a lower affinity for D2 receptors and also block serotonin receptors, resulting in a much lower risk of EPS.

Option A: Antimalarial drugs are not associated with extrapyramidal symptoms. Their adverse effect profile involves different systems.
Option B: While EPS can occur with antidepressants in rare cases, it is not a characteristic or common side effect. They are more commonly associated with issues like serotonin syndrome, sexual dysfunction, or weight changes.
Option D: Antianxiety drugs, such as benzodiazepines, do not cause EPS. Their primary side effects are sedation, ataxia, and the potential for tolerance and dependence.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Side effects of psychotropic medications, specifically Extrapyramidal Symptoms (EPS) as background academic context rather than a clinical decision trigger.
Nurses must routinely monitor patients on antipsychotics for EPS using standardized tools like the Abnormal Involuntary Movement Scale (AIMS).
Early detection and reporting of symptoms like muscle stiffness, restlessness, or involuntary movements are critical to prevent progression and ensure patient safety.
Patient education should emphasize the importance of not stopping medication abruptly and reporting any new or unusual movements to their healthcare provider immediately.

How to Approach the Question

First, identify the key term in the question: 'Extrapyramidal symptoms' (EPS).
This is a factual recall question that requires knowledge of pharmacology.
Systematically review the common side effect profiles of each drug class listed in the options.
Recall that antipsychotics work by blocking dopamine receptors, which is the direct cause of EPS.
Eliminate the other options based on their known primary side effects (e.g., sedation for antianxiety drugs, serotonin syndrome for antidepressants).

Concept Tested & Keywords

Concept Tested: Side effects of psychotropic medications, specifically Extrapyramidal Symptoms (EPS).
Stem keywords: Extrapyramidal symptoms, side effects
Lead-in keywords: BEST, MOST RELEVANT CLUE
Negative lead-in flag: false

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E6 Pharmacology KD Tripathi Essentials 9e Part 2 p. 112-114

E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 1 (pp 26-289 of 579) p. 127-129

E6 Pharmacology Nursing Lilley 11e Part 1 p. 281-283

Practise the full JSSH Staff Nurse - 2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.