OSSSC Nursing Officer-2023
Pharmacology
Easy
The drug which is used to create aversion in alcohol dependence:
Appeared in: OSSSC Nursing Officer-2023
Explanation
- Disulfiram is an alcohol-aversive agent used to maintain abstinence in alcohol dependence.
- It works by inhibiting the enzyme aldehyde dehydrogenase, which is crucial for alcohol metabolism.
- This inhibition leads to a rapid buildup of acetaldehyde when alcohol is consumed.
- The accumulation of acetaldehyde causes a severe, unpleasant physical reaction (Disulfiram-Ethanol Reaction), creating a conditioned aversion to alcohol.
Why Other Options Were Wrong
- Option A: Apomorphine is a dopamine agonist and emetic. While it causes vomiting, it is not the standard or approved medication for creating a conditioned aversion to alcohol.
- Option B: Propranolol is a beta-blocker that manages the autonomic symptoms of alcohol withdrawal (like tremors and tachycardia). It reduces the physical discomfort of withdrawal but does not create an aversion to alcohol.
- Option C: Diazepam is a benzodiazepine used to treat acute alcohol withdrawal. It prevents severe complications like seizures and delirium tremens by managing central nervous system hyperactivity.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Pharmacological management of alcohol dependence, specifically aversion therapy helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Patient education is the most critical nursing intervention. The nurse must warn the patient to avoid all forms of alcohol, including hidden sources like mouthwash, cough syrups, certain sauces, and even some topical products like perfumes.
- Informed consent is mandatory. The patient must fully understand the severe nature of the Disulfiram-Ethanol Reaction before starting therapy.
- The effects of Disulfiram can last for up to 14 days after the last dose. Patients must be aware of this prolonged risk period.
How to Approach the Question
- First, identify the key terms in the question: 'drug', 'aversion', and 'alcohol dependence'. The goal is to find a medication that makes drinking alcohol an unpleasant experience.
- Next, analyze the function of each drug option in the context of substance use.
- Consider Diazepam and Propranolol. Recall that these are commonly used to manage the symptoms of acute alcohol withdrawal, not to create a long-term aversion.
- Evaluate Apomorphine. While it can cause vomiting, it's not the standard choice for alcohol aversion therapy.
- Recall or deduce that Disulfiram works by interfering with alcohol metabolism, causing a severe negative reaction. This mechanism directly matches the concept of 'aversion therapy'.
- Therefore, select Disulfiram as the drug specifically designed to create an aversion to alcohol.
Concept Tested & Keywords
- Concept Tested: Pharmacological management of alcohol dependence, specifically aversion therapy.
- Stem keywords: drug, aversion, alcohol dependence
- Lead-in keywords: used to create
- Negative lead-in flag: false
Question ID
QHhlgG9Y9Aiuhq-p2Dk8Os
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 2183-2185, 2182-2184
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 10933-10935
Practise the full OSSSC Nursing Officer-2023
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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