The drug of choice to treat Bulimia nervosa is:

ESIC Nursing Officer - 2019 (Shift-2)

Mental Health Nursing

Easy

Appeared in: ESIC Nursing Officer - 2019 (Shift-2)

Explanation

Antidepressants, specifically Selective Serotonin Reuptake Inhibitors (SSRIs), are the first-line pharmacological treatment for bulimia nervosa.
Fluoxetine is the most studied and only FDA-approved medication for this condition. It has been shown to reduce the frequency of binge-eating and purging behaviors.
The effective dosage of fluoxetine for bulimia nervosa (e.g., 60 mg/day) is typically higher than the dosage used for treating depression.
The best clinical outcomes are seen when SSRIs are used in combination with psychotherapy, such as Cognitive-Behavioral Therapy (CBT).

Option B: Thiamine is a vitamin (B1) used to treat or prevent Wernicke-Korsakoff syndrome, a neurological condition primarily associated with chronic alcohol use, not as a primary treatment for bulimia nervosa.
Option C: Benzodiazepines are anxiolytics and are not effective for the core symptoms of bulimia (binging and purging). They also carry a high risk of dependence and are generally avoided as a primary treatment.
Option D: IV Glucose 10% is used to correct hypoglycemia (low blood sugar). It is a treatment for a potential metabolic complication, not a treatment for the underlying psychiatric disorder of bulimia nervosa.

Visual 1: Flowchart: Treatment algorithm for Bulimia Nervosa, showing psychotherapy (CBT) and pharmacotherapy (SSRIs) as primary interventions.
Visual 2: Infographic: Side effects of purging behaviors (e.g., dental erosion, hypokalemia, parotid gland swelling) to highlight the importance of treatment.

Clinical Relevance

Nursing practice connection: Knowing Pharmacological treatment of Bulimia Nervosa helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
The primary nursing role involves medication administration, patient education about the medication's purpose and side effects, and monitoring for therapeutic effects (reduction in binge/purge episodes).
Nurses must vigilantly monitor for severe medical complications of bulimia, such as hypokalemia, which can lead to life-threatening cardiac arrhythmias. This includes assessing vital signs, monitoring lab values, and reporting abnormalities promptly.
A crucial safety point is knowing that the antidepressant bupropion is contraindicated in patients who purge due to an increased risk of seizures.

How to Approach the Question

First, identify the core question: It asks for the 'drug of choice' for a specific psychiatric disorder, 'Bulimia nervosa'. This is a factual recall question.
Scan the options. The options are different classes of drugs or treatments.
Recall or deduce the primary pathology of bulimia nervosa. It's a psychiatric disorder involving cycles of binging and purging, often linked to mood and impulse control issues.
Evaluate each option based on this understanding. Antidepressants, particularly SSRIs, are known to be effective for mood and obsessive-compulsive behaviors, which aligns with the features of bulimia.
Eliminate the other options by identifying their primary use: Thiamine for alcohol-related conditions, Benzodiazepines for acute anxiety, and IV Glucose for hypoglycemia. These do not address the root cause of bulimia.
Conclude that the most appropriate pharmacological class for treating the core symptoms of bulimia nervosa is antidepressants (SSRIs).

Concept Tested & Keywords

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