HPSSC Staff Nurse - 2021
Pharmacology
Easy
Which of the following drugs causes EPS (Extra Pyramidal Symptoms)?
Appeared in: HPSSC Staff Nurse - 2021
Explanation
- Antipsychotic medications are the primary class of drugs known to cause Extrapyramidal Symptoms (EPS).
- The mechanism involves the blockade of dopamine D2 receptors in the nigrostriatal pathway of the brain, which disrupts the normal regulation of motor function.
- First-generation (typical) antipsychotics like haloperidol and chlorpromazine have a higher affinity for D2 receptors and thus carry a higher risk of causing EPS compared to second-generation (atypical) antipsychotics.
Why Other Options Were Wrong
- Option B: SSRIs are primarily associated with side effects like GI distress, sexual dysfunction, and serotonin syndrome. They do not cause the classic spectrum of EPS, although akathisia can occur rarely.
- Option C: Mood stabilizers like lithium and valproate cause neurological side effects such as tremor, ataxia, and cognitive slowing, which are distinct from the specific syndromes of EPS (dystonia, parkinsonism, tardive dyskinesia).
- Option D: Anti-anxiety drugs, particularly benzodiazepines, do not cause EPS. They are CNS depressants and can cause sedation and dependence. Some benzodiazepines are even used to treat akathisia, a type of EPS.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacology: Adverse Effects of Psychotropic Medications as background academic context rather than a clinical decision trigger.
- Nurses play a critical role in monitoring patients on antipsychotics for EPS using standardized tools like the Abnormal Involuntary Movement Scale (AIMS) at baseline and regular intervals.
- Patient education is vital. Patients and families should be taught to recognize and report symptoms like stiffness, restlessness, or involuntary movements immediately.
- Acute dystonia, with muscle spasms in the neck or throat, is a medical emergency. The nurse must be prepared to administer ordered anticholinergic medication (e.g., benztropine, diphenhydramine) and ensure the patient's airway is patent.
How to Approach the Question
- First, identify the core concept of the question, which is identifying the drug class that causes a specific side effect (Extrapyramidal Symptoms).
- Review each option and categorize the drug class: Antipsychotics, Antidepressants (SSRI), Mood stabilizers, and Anti-anxiety agents.
- Recall the major side effect profiles for each of these psychotropic drug classes.
- Connect the specific side effect, EPS, to its known causative agent. Recall that dopamine blockade is the mechanism for EPS and that antipsychotics are the primary class that works this way.
- Eliminate the other options by recalling their distinct side effect profiles (e.g., SSRIs cause GI/sexual side effects, benzodiazepines cause sedation).
Concept Tested & Keywords
- Concept Tested: Pharmacology: Adverse Effects of Psychotropic Medications
- Stem keywords: EPS, Extra Pyramidal Symptoms, drugs
- Lead-in keywords: Which
- Negative lead-in flag: false
Question ID
QhzdbGi6FkB_4AsAtchpB1
Reference Book
E6 Pharmacology KD Tripathi Essentials 9e Part 2 p. 112-114
E6 Medicine Davidson Principles Practice 24e p. 1217-1219
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 HPSSC Staff Nurse - 2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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