Match each clinical presentation of an antipsychotic-induced adverse effect to the primary pharmacological mechanism of its most appropriate targeted medical treatment.
- An inpatient psychiatric unit requests a consultation for a 29-year-old male who developed a sustained, painful upward deviation of his eyes and severe neck spasms shortly after receiving intramuscular haloperidol.Muscarinic cholinergic receptor antagonism
- During a routine follow-up, a 36-year-old female treated with aripiprazole reports an intense, distressing sensation of inner restlessness and is unable to stop pacing the examination room.Beta-adrenergic receptor antagonism
- A 55-year-old male with a twenty-year history of typical antipsychotic exposure presents with newly onset, involuntary chewing motions, lip-smacking, and choreoathetoid movements of his fingers.Reversible inhibition of the vesicular monoamine transporter 2
- Emergency responders bring in a 31-year-old female on high-dose fluphenazine who exhibits profound altered sensorium, generalized lead-pipe muscle rigidity, diaphoresis, and a temperature of 40.1°C (104.2°F).Direct agonism of central dopamine receptors
Answer
Acute dystonia matches with muscarinic cholinergic receptor antagonism; akathisia matches with beta-adrenergic receptor antagonism; tardive dyskinesia matches with reversible inhibition of the vesicular monoamine transporter 2; and neuroleptic malignant syndrome matches with direct agonism of central dopamine receptors.
Each pair correctly links the specific extrapyramidal or systemic side effect of antipsychotic therapy to the mechanism of action of its definitive or first-line pharmacological treatment.
Step-by-Step Solution
Key Concept
Management of antipsychotic adverse effects requires diagnosing the specific extrapyramidal or systemic symptom and selecting the appropriate targeted counteracting pharmacological mechanism.