DSSSB 14 August 2024
Pharmacology
Easy
All of the following are antipsychotics, EXCEPT:
Appeared in: DSSSB 14 August 2024
Explanation
- Bromocriptine is a dopamine receptor agonist, which means it activates dopamine receptors.
- Its primary use is in the treatment of conditions caused by dopamine deficiency or prolactin excess, such as Parkinson's disease and hyperprolactinemia.
- Unlike antipsychotics that block dopamine receptors to reduce psychotic symptoms, bromocriptine's mechanism is opposite, making it unsuitable for treating psychosis.
Why Other Options Were Wrong
- Option A: Quetiapine is classified as a second-generation (atypical) antipsychotic.
- Option B: Risperidone is a widely used second-generation (atypical) antipsychotic.
- Option C: Ziprasidone is also a second-generation (atypical) antipsychotic.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological classification of antipsychotic drugs as background academic context rather than a clinical decision trigger.
- Nurses must have a strong understanding of drug classifications to ensure patient safety. Administering a dopamine agonist like bromocriptine to a patient with schizophrenia could worsen their psychotic symptoms.
- Accurate medication knowledge is crucial for anticipating therapeutic effects, managing side effects, and educating patients. For example, a nurse should monitor for hyperglycemia with quetiapine and for QT prolongation with ziprasidone.
- What if? If the patient had Parkinson's disease with psychosis, the treatment would be complex. While bromocriptine treats Parkinson's motor symptoms, it can induce psychosis. In such cases, a low-potency atypical antipsychotic like quetiapine might be cautiously used to manage psychosis without significantly worsening motor function.
How to Approach the Question
- First, identify the question type. This is a knowledge-based 'EXCEPT' question, which asks you to find the outlier in a group.
- Read the stem carefully: 'All of the following are antipsychotics, EXCEPT:'. This means three options are antipsychotics, and one is not.
- Systematically review each option based on your pharmacology knowledge.
- Recall or deduce the class for each drug: Quetiapine (antipsychotic), Risperidone (antipsychotic), Ziprasidone (antipsychotic).
- Identify Bromocriptine. Recall that it is used for conditions like Parkinson's disease and works by stimulating dopamine receptors, which is the opposite action of an antipsychotic.
- Conclude that Bromocriptine is the exception and therefore the correct answer.
Concept Tested & Keywords
- Concept Tested: Pharmacological classification of antipsychotic drugs.
- Stem keywords: antipsychotics, quetiapine, risperidone, ziprasidone, bromocriptine
- Lead-in keywords: EXCEPT
- Negative lead-in flag: Question asks for the exception.
Question ID
Q_V9LaA3JphF6tOOp_ZB5Y
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. 9851-9854
E6 Pharmacology Katzung 16e p. 803-805
E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 2 (pp 290-564 of 579) p. 244-246
Practise the full DSSSB 14 August 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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