BSF Staff Nurse - 2015
Pharmacology
Medium
Abrupt withdrawal from barbiturates could cause a person to experience?
Appeared in: BSF Staff Nurse - 2015
Explanation
- Abrupt cessation of barbiturates, which are CNS depressants, leads to a rebound hyperexcitability of the central nervous system.
- This over-excitation can manifest as severe and life-threatening symptoms as the brain is no longer suppressed by the drug.
- Grand mal seizures are a major symptom of severe barbiturate withdrawal, occurring in up to 75% of patients withdrawing from high doses.
- Seizures typically appear on the second or third day of abstinence and are a medical emergency.
Why Other Options Were Wrong
- Option B: Ataxia, or impaired coordination, is a hallmark sign of barbiturate intoxication (overdose) due to its CNS depressant effects.
- Option C: Diarrhea is not associated with barbiturate withdrawal. It is a classic symptom of opioid withdrawal.
- Option D: Urticaria (hives) is an immunological response indicating an allergy or hypersensitivity to a substance.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Symptoms of abrupt barbiturate withdrawal as background academic context rather than a clinical decision trigger.
- Nurses must educate patients that barbiturates should never be stopped abruptly. A medically supervised tapering schedule is essential to prevent life-threatening complications like seizures.
- A primary nursing responsibility for a patient undergoing barbiturate withdrawal is to implement seizure precautions. This includes padding side rails, ensuring airway equipment (suction, oxygen) is at the bedside, and minimizing environmental stimuli.
- What if the patient was withdrawing from an opioid instead of a barbiturate? The nurse's priority would shift from seizure prevention to managing symptoms like severe muscle cramps, nausea, vomiting, and diarrhea. While extremely uncomfortable, opioid withdrawal is generally not life-threatening in the same way as barbiturate withdrawal.
How to Approach the Question
- First, identify the key elements of the question: the drug class is 'barbiturates' and the clinical event is 'abrupt withdrawal'.
- Recall the primary action of barbiturates: they are Central Nervous System (CNS) depressants.
- Apply the principle of pharmacological withdrawal: abruptly stopping a depressant drug typically causes a rebound effect, leading to CNS hyperexcitability.
- Evaluate each option in the context of CNS hyperexcitability:
- Seizure is a classic sign of severe CNS hyperexcitability.
- Ataxia (impaired coordination) is a sign of CNS depression, which is the effect of the drug itself (intoxication), not withdrawal.
Concept Tested & Keywords
- Concept Tested: Symptoms of abrupt barbiturate withdrawal
- Stem keywords: Abrupt withdrawal, barbiturates
- Lead-in keywords: could cause
Question ID
QxusN_D1LQGnk_sfSVN6RD
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 4633-4635
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 965-967, 2134-2136
Practise the full BSF Staff Nurse - 2015
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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