Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Pharmacology
Easy
Which of the following drug causes EPS (Extra Pyramidal Symptoms)?
Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Explanation
- Antipsychotic medications, especially first-generation (typical) agents like haloperidol, are the primary drug class known to cause Extrapyramidal Symptoms (EPS).
- The mechanism involves the blockade of D2 dopamine receptors in the nigrostriatal pathway of the brain, which is crucial for regulating motor function.
- This disruption in dopamine signaling leads to a variety of movement disorders, collectively known as EPS.
- EPS can be categorized into acute reactions like dystonia and akathisia, and chronic conditions like tardive dyskinesia.
Why Other Options Were Wrong
- Option B: SSRIs primarily affect serotonin pathways. While rare cases of EPS have been reported, it is not a common or characteristic side effect of this drug class. Their main side effects are gastrointestinal distress, sexual dysfunction, and risk of serotonin syndrome.
- Option C: Mood stabilizers like lithium and valproic acid are used to treat bipolar disorder. While lithium can cause a tremor, this is considered a direct toxic effect and is not the same as the full spectrum of EPS (like dystonia or akathisia) caused by dopamine blockade.
- Option D: Anti-anxiety drugs, such as benzodiazepines, work by enhancing the effect of the neurotransmitter GABA. Their main side effects are sedation, drowsiness, and potential for dependence, not EPS.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Pharmacology: Side Effects of Psychotropic Medications to guide bedside assessment, documentation, and the next nursing action.
- Nurses must diligently monitor patients on antipsychotic therapy for early signs of EPS, such as muscle stiffness, restlessness, or abnormal facial movements.
- Acute dystonia is a medical emergency. If a patient develops sudden neck or jaw spasms, the nurse must report it immediately, as prompt administration of an anticholinergic agent (e.g., benztropine, diphenhydramine) is required to reverse the symptoms.
- Patient education is vital. Nurses should teach patients and their families to recognize and report symptoms of EPS, especially the restlessness of akathisia, which can be highly distressing and increase suicide risk.
How to Approach the Question
- First, identify the key term in the question: 'EPS (Extra Pyramidal Symptoms)'. This refers to a specific set of drug-induced movement disorders.
- Next, review the options, which are all classes of psychotropic medications.
- Recall the primary mechanism and major side effect profile for each drug class.
- Associate 'Antipsychotics' with 'dopamine blockade' and 'movement disorders'. This is a classic, high-yield pharmacology link.
- Contrast this with the other options: SSRIs are linked to serotonin, mood stabilizers like lithium have a unique toxicity profile (tremor, but not classic EPS), and anti-anxiety drugs (benzodiazepines) are linked to GABA and sedation.
- This process of association and elimination clearly identifies Antipsychotics as the class most responsible for causing EPS.
Concept Tested & Keywords
- Concept Tested: Pharmacology: Side Effects of Psychotropic Medications
- Stem keywords: drug, EPS, Extra Pyramidal Symptoms
- Lead-in keywords: Which
- Negative lead-in flag: false
Question ID
Q11VZoyKhQtzba_dd_EV3-
Reference Book
E6 Medicine Davidson Principles Practice 24e p. 1217-1219
E6 Pharmacology KD Tripathi Essentials 9e Part 2 p. 112-114
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 Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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