GI drugs: metoclopramide extrapyramidal effects: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · GI drugs: metoclopramide extrapyramidal effects

Sample item

A 22-year-old woman given intravenous metoclopramide for vomiting develops involuntary upward deviation of the eyes and neck spasm. How is this reaction best treated?

AObservation only, as it is dopaminergic excessBIntravenous diphenhydramine or benztropineCIntravenous atropineDIntravenous haloperidol

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Intravenous diphenhydramine or benztropine

Metoclopramide blocks central D2 receptors and can cause acute dystonia, particularly in young women and children. Anticholinergics such as benztropine or antihistamines with anticholinergic action rapidly reverse it.

Option by option

A. Observation only, as it is dopaminergic excess
The cause is dopamine blockade, not excess, and treatment is needed.
B. Intravenous diphenhydramine or benztropine (correct)
Correct. Anticholinergic therapy relieves acute dystonia.
C. Intravenous atropine
Atropine is not the standard agent for dystonia.
D. Intravenous haloperidol
Haloperidol is a D2 blocker and would worsen it.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Intravenous diphenhydramine or benztropine. Metoclopramide blocks central D2 receptors and can cause acute dystonia, particularly in young women and children.

Why is "Observation only, as it is dopaminergic excess" not the answer?

The cause is dopamine blockade, not excess, and treatment is needed.

Why is "Intravenous atropine" not the answer?

Atropine is not the standard agent for dystonia.

Why is "Intravenous haloperidol" not the answer?

Haloperidol is a D2 blocker and would worsen it.

What concept does this question test?

It tests GI drugs: metoclopramide extrapyramidal effects in Pharmacology. Anticholinergics such as benztropine or antihistamines with anticholinergic action rapidly reverse it.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study GI drugs: metoclopramide extrapyramidal effects?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.