A 21-year-old male has recently begun pimozide therapy for Tourette's disorder. His parents bring him to the emergency department. They describe that he has been having “different appearing tics” than before, such as prolonged contraction of the facial muscles. While being examined, he experiences opsichotomus (type of extrapyramidal spasm of the body in which the head and heels are bent backward and the body is bowed forward). Which of the following drugs would be beneficial in reducing these symptoms?

Correct Answer: A

Rationale: Benztropine, an anticholinergic agent, is used to treat extrapyramidal symptoms like dystonia caused by antipsychotic medications.

Correct Answer: D

Rationale: Buspirone (choice A), Alprazolam (choice B), and Baclofen (choice C) are correctly paired (anxiolytic, some antidepressant effect, less sedative muscle relaxant). Oxazepam (choice D), a benzodiazepine, isn't a TCA, making it the incorrect pair. This tests drug classification.

Correct Answer: C

Rationale: Felbamate is primarily metabolized by the CYP1A2 enzyme, making it a suitable choice for patients where CYP1A2 metabolism is desired.

Correct Answer: A

Rationale: Tramadol has dual mechanisms, affecting opioid receptors and inhibiting serotonin/norepinephrine reuptake.

Correct Answer: B

Rationale: Morphine treats MI pain (choice A), postoperative pain (choice C), and pulmonary edema (choice D) by reducing pain and preload. Head injury pain (choice B) contraindicates it due to respiratory depression and ICP risks. This exception guides safe use.