UPPSC-2021
Pharmacology
Easy
Which of the following drugs causes extrapyramidal symptoms as side effects?
Appeared in: UPPSC-2021
Explanation
- Antipsychotic drugs, particularly first-generation (typical) agents, are the primary class of medications 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 balance of neurotransmitters controlling movement.
- EPS encompasses a range of movement disorders including acute dystonia, akathisia, drug-induced parkinsonism, and tardive dyskinesia.
- While newer, atypical antipsychotics have a lower risk, they can still cause EPS, especially at higher doses.
Why Other Options Were Wrong
- Option A: Antidepressants, such as SSRIs, are primarily associated with side effects like gastrointestinal upset, sexual dysfunction, and sleep changes, not EPS.
- Option C: Anti-anxiety drugs, like benzodiazepines, are known for causing sedation, drowsiness, and having a potential for dependence and withdrawal symptoms. They do not cause EPS.
- Option D: Mood stabilizers like lithium can cause a fine hand tremor, which is a neurological side effect, but it is not classified as an extrapyramidal symptom. Other side effects include polyuria, polydipsia, and thyroid dysfunction.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacology: Side Effects of Psychotropic Medications as background academic context rather than a clinical decision trigger.
- Nurses must conduct a baseline assessment for movement disorders before starting a patient on antipsychotics, using tools like the Abnormal Involuntary Movement Scale (AIMS).
- Patient education is critical. Teach patients and families to report any new stiffness, restlessness, muscle spasms, or unusual facial movements immediately.
- Be prepared for emergencies. Acute dystonia, especially laryngeal dystonia, is a medical emergency requiring prompt administration of an anticholinergic agent like benztropine or diphenhydramine.
How to Approach the Question
- First, identify the core concept in the question stem, which is 'extrapyramidal symptoms' (EPS).
- Recognize that this is a factual recall question asking for the drug class most famously associated with this specific side effect profile.
- Systematically review the options, mentally linking each drug class to its most common side effects.
- Recall or deduce that antipsychotics work on dopamine pathways, and disruption of the nigrostriatal dopamine pathway is the direct cause of EPS.
- Eliminate the other options by confirming their primary side effects (e.g., sedation for anti-anxiety, tremor for mood stabilizers, GI issues for antidepressants) are different from EPS.
- Select 'Antipsychotic drugs' as the class directly and classically linked to extrapyramidal symptoms.
Concept Tested & Keywords
- Concept Tested: Pharmacology: Side Effects of Psychotropic Medications
- Stem keywords: drugs, extrapyramidal symptoms, side effects
- Lead-in keywords: Which
- Negative lead-in flag: false
Question ID
Q-sFgZQSguD2qbmZ1pkS7Z
Reference Book
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
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 2209-2211
Practise the full UPPSC-2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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