KPSC Staff Nurse - 2018
Pharmacology
Medium
The extrapyramidal side effect of antipsychotic agents are managed with following group of drugs except?
Appeared in: KPSC Staff Nurse - 2018
Explanation
- Barbiturates are central nervous system (CNS) depressants primarily used for sedation, anesthesia, or seizure control.
- They do not act on the dopamine or acetylcholine pathways involved in the pathophysiology of extrapyramidal symptoms (EPS).
- Administering barbiturates would cause unnecessary sedation and risk of respiratory depression without addressing the underlying movement disorder.
Why Other Options Were Wrong
- Option A: This option is incorrect because certain dopamine-modulating drugs are used to manage EPS.
- Option B: This option is incorrect because anticholinergic drugs are a primary treatment for several types of EPS.
- Option C: This option is incorrect because some antihistamines are used to manage acute EPS.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological management of extrapyramidal side effects (EPS) from antipsychotic medications as background academic context rather than a clinical decision trigger.
- Nurses must be vigilant in monitoring patients on antipsychotics for EPS, using tools like the Abnormal Involuntary Movement Scale (AIMS) for early detection.
- Prompt recognition and reporting of symptoms like muscle stiffness, restlessness, or spasms are crucial for timely intervention, patient comfort, and safety.
- What if? If a patient develops akathisia (severe restlessness) instead of dystonia, the most appropriate treatment would be a beta-blocker like propranolol or a benzodiazepine, as anticholinergics are often less effective for this specific symptom.
How to Approach the Question
- First, identify the negative keyword 'except'. This signals that you must find the option that does NOT fit the condition described.
- The question asks about drugs used to manage extrapyramidal side effects (EPS) from antipsychotics.
- Recall the pathophysiology of EPS: it's caused by a blockade of dopamine receptors, leading to an imbalance with acetylcholine.
- Evaluate each option based on this mechanism. Treatments will either increase dopamine activity or block acetylcholine.
- Anticholinergics block acetylcholine. Antihistamines (like diphenhydramine) have anticholinergic effects. Dopamine agents (like amantadine) increase dopamine.
- Consider the mechanism of Barbiturates. They are general CNS depressants (GABA agonists) and do not target the specific dopamine-acetylcholine imbalance of EPS. This makes them the outlier and the correct answer.
Concept Tested & Keywords
- Concept Tested: Pharmacological management of extrapyramidal side effects (EPS) from antipsychotic medications.
- Stem keywords: extrapyramidal side effect, antipsychotic agents, managed with
- Lead-in keywords: except
- Negative lead-in flag: The question asks for the option that is an EXCEPTION.
Question ID
Q1euYQ3MpL4GhkIEiciguG
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 9899-9901
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1887-1889
Practise the full KPSC Staff Nurse - 2018
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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