Gastrointestinal Drugs and Medications Q 16
Extrapyramidal symptoms are a side effect of which of the following drugs?
A. ranitidine
B. omeprazole
C. famotidine
D. metoclopramide
Correct Answer: D. metoclopramide
A side effect of metoclopramide is EPS. Tardive dyskinesia an adverse effect, often seen in antipsychotic medications, that generally manifests as grimacing, lip-smacking, and tongue flicking as well as general choreoathetoid movements of the body. Because it can sometimes be irreversible, it is the most threatening potential complication of metoclopramide overdose, and metoclopramide treatment should be discontinued in any patient who develops tardive dyskinesia. Extrapyramidal adverse effects have been observed in metoclopramide overdose, particularly in infants and the elderly, who are at the greatest risk.
Option A: Transient pain at the site of intramuscular (IM) injection has been reported. Transient local burning or itching has been reported with intravenous (IV) administration of ranitidine. The 2015 Beers Criteria list identifies ranitidine as a therapy that may potentially trigger or exacerbate delirium in adults older than 65 years of age. Caution should be used when treating the elderly with ranitidine. Long-term use of ranitidine for greater than 2 years may also be associated with vitamin B12 deficiency.
Option B: Omeprazole is indicated for the short-term treatment of peptic ulcer disease in adults where most patients heal within four weeks. Patients with duodenal ulcer disease and H. pylori infection disease that is active for up to one year may benefit from combination therapy that includes omeprazole with clarithromycin, amoxicillin, and metronidazole. Omeprazole is a proton pump inhibitor. It inhibits the parietal cell H+ / K+ ATP pump, the final step of acid production.
Option C: Famotidine decreases the production of stomach acid, and its pharmacologic activity is used in the treatment of acid-related gastrointestinal conditions. Famotidine is a competitive histamine H-receptor antagonist (H2RA) that binds to the H-receptors located on the basolateral membrane of the parietal cell in the stomach, effectively blocking histamine actions. Its pharmacologic activity results in the inhibition of gastric secretion by suppressing acid concentration and volume of gastric secretion.