Disulfiram is used in?

Appeared in: NORCET 2 - 2021 (shift-1)

Explanation

Disulfiram is an aversion therapy agent used in the management of chronic alcoholism.
It works by irreversibly inhibiting the enzyme aldehyde dehydrogenase, which is crucial for alcohol metabolism.
If a person on disulfiram consumes alcohol, there is a rapid buildup of acetaldehyde, leading to a severe, unpleasant physical reaction (Disulfiram-Ethanol Reaction).
The purpose of the therapy is to create a strong deterrent against alcohol consumption through fear of this reaction.

Option A: Disulfiram is not used to treat schizophrenia. In fact, it can exacerbate psychosis in individuals with psychotic disorders due to its effect on dopamine metabolism.
Option C: Disulfiram is not an approved or effective treatment for smoking cessation.
Option D: This option is incorrect because disulfiram is only indicated for chronic alcoholism among the choices provided.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological management of substance use disorders as background academic context rather than a clinical decision trigger.
Patient education is a paramount nursing responsibility. A patient's lack of knowledge about hidden sources of alcohol can lead to an accidental and potentially life-threatening Disulfiram-Ethanol Reaction.
Nurses must assess for contraindications before administration, including severe heart disease, liver failure, psychosis, and pregnancy.
What if? If a patient on disulfiram is brought to the emergency department with flushing, vomiting, and hypotension after a 'toast at a wedding,' the nurse's priority is to manage the ABCs (Airway, Breathing, Circulation), provide supportive care for the reaction (e.g., IV fluids for hypotension), and notify the provider immediately. This is a medical emergency.

How to Approach the Question

First, identify the drug mentioned in the question stem: 'Disulfiram'.
Access your knowledge of pharmacology. Recall the primary indication and mechanism of action for this specific drug.
Disulfiram is a classic medication used in addiction treatment. Its main purpose is to create an aversion to alcohol.
Evaluate each option based on this core fact.
Option A (Schizophrenia): This is a psychotic disorder treated with antipsychotics. Disulfiram is not an antipsychotic.
Option B (Chronic alcoholism): This matches the known indication for disulfiram as an aversion therapy.

Concept Tested & Keywords

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Practise the full NORCET 2 - 2021 (shift-1)

Attempt every question from this paper in a timed mock, then review the full solution for each one.