A man presents with inoperable carcinoma and back pain. His pain has been well controlled with morphine but he develops vomiting. Morphine was stopped and he was started on metoclopramide and fentanyl patches. He then develops neck stiffness and fever. What is the cause of these symptoms?
a. Metoclopramide
b. Fentanyl
c. Morphine
d. Meningitis
e. Metastasis
Ans. The key is A. Metoclopramide. [Extrapyramidal effects like neck stiffness is common side effect of metoclopramide and also there may occur rise of temperature].