NORCET -4 , 2023
Pharmacology
Easy
A patient is developed mild urticaria and breathlessness. Which of the following medicine would not be prescribed for this patient at this time?
Appeared in: NORCET -4 , 2023
Explanation
- Chlorpromazine is a typical antipsychotic medication primarily used for psychiatric conditions like schizophrenia.
- It is not indicated for the treatment of acute allergic reactions such as urticaria and breathlessness.
- Its side effect profile, including sedation and the potential for hypotension, makes it unsuitable and potentially harmful in this acute clinical scenario.
Why Other Options Were Wrong
- Option B: Hydrocortisone is a corticosteroid used to reduce inflammation.
- Option C: Chlorpheniramine is a first-generation H1 antihistamine that directly blocks histamine receptors.
- Option D: Dexamethasone is a potent, long-acting corticosteroid used to suppress the inflammatory response.
Related Visual
- Visual 1: Diagram: Pathophysiology of a Type I hypersensitivity reaction, showing mast cell degranulation and the release of inflammatory mediators like histamine.
- Visual 2: Chart: A comparison of the drug classes used in allergic reactions (Antihistamines, Corticosteroids, Epinephrine) and their respective mechanisms of action.
Clinical Relevance
- Nursing practice connection: Use the key finding related to Pharmacological management of acute allergic reactions (Type I hypersensitivity) to guide bedside assessment, documentation, and the next nursing action.
- Nurses must be able to rapidly identify signs of an allergic reaction and anticipate the correct pharmacological interventions to ensure patient safety.
- Administering an inappropriate medication, like an antipsychotic, can delay life-saving treatment and worsen the patient's condition by causing adverse effects like hypotension.
- What if? If the patient's breathlessness progressed to stridor and hypotension (signs of anaphylaxis), the immediate priority medication would be intramuscular Epinephrine, followed by antihistamines and corticosteroids.
How to Approach the Question
- First, analyze the patient's symptoms: 'mild urticaria' and 'breathlessness' are classic signs of a systemic allergic reaction.
- Next, identify the question's core task, which is to find the medication that is NOT used for this condition (a negative question).
- Review each medication's primary drug class and indication.
- Chlorpheniramine is an antihistamine. Hydrocortisone and Dexamethasone are corticosteroids. These are all standard treatments for allergic reactions.
- Identify the outlier. Chlorpromazine is an antipsychotic medication.
- Conclude that Chlorpromazine is the medication that would not be prescribed for an allergic reaction.
Concept Tested & Keywords
- Concept Tested: Pharmacological management of acute allergic reactions (Type I hypersensitivity).
- Stem keywords: mild urticaria, breathlessness, prescribed
- Lead-in keywords: not
- Clinical cues: The combination of a skin reaction (urticaria) and a respiratory symptom (breathlessness) indicates a systemic allergic reaction.
- Negative lead-in flag: Question asks which medication would NOT be prescribed.
Question ID
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Practise the full NORCET -4 , 2023
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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