DSSSB - 29 August 2019 (Shift-2)
Pharmacology
Easy
The Hydrocarbon, butyl nitrate comes under which group of drugs involved in substance abuse?
Appeared in: DSSSB - 29 August 2019 (Shift-2)
Explanation
- Butyl nitrate is a volatile alkyl nitrite, a substance that is abused by inhaling its vapors.
- The primary route of administration for psychoactive effects is inhalation, which places it in the category of inhalants.
- These substances, commonly known as 'poppers', cause rapid vasodilation, leading to a brief sensation of warmth, euphoria, and muscle relaxation.
- The classification of abused drugs is based on their pharmacological effects and route of administration; butyl nitrate fits the profile of an inhalant.
Why Other Options Were Wrong
- Option A: Steroids are anabolic agents used to build muscle, not volatile substances inhaled for a psychoactive high.
- Option B: Stimulants (e.g., cocaine, amphetamines) increase central nervous system activity, causing alertness and energy, which is a different mechanism and effect profile than the vasodilation caused by nitrites.
- Option D: Narcotics (opioids) are primarily depressants used for analgesia. They act on opioid receptors and do not share the chemical properties or primary effects of butyl nitrate.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of abused substances as background academic context rather than a clinical decision trigger.
- Nurses should recognize that individuals abusing nitrite inhalants ('poppers') may present with acute symptoms like flushing, severe headache, dizziness, and syncope due to sudden vasodilation and hypotension.
- A significant risk of nitrite inhalation is methemoglobinemia, a condition where hemoglobin is oxidized and cannot transport oxygen effectively. This presents as cyanosis unresponsive to oxygen therapy and is a medical emergency.
- What if? A young patient presents with confusion, bluish discoloration of the skin (cyanosis), and a reported blood pressure of 80/50 mmHg after being at a party. If the nurse suspects inhalant abuse, they should anticipate orders for 100% oxygen, blood tests to check for methemoglobin levels, and potential administration of the antidote, methylene blue.
How to Approach the Question
- First, identify the key substance in the question: 'butyl nitrate'.
- Recall or deduce the common method of use and its primary purpose in substance abuse. The chemical name suggests a volatile substance, and 'nitrates'/'nitrites' are known to be inhaled ('poppers').
- The act of inhaling a substance for its psychoactive effect is the definition of an inhalant.
- Review the given options: Steroids, Stimulants, Inhalants, Narcotics.
- Match the substance and its method of use to the most appropriate category. Butyl nitrate is a classic example of an inhalant.
Concept Tested & Keywords
- Concept Tested: Classification of abused substances
- Stem keywords: butyl nitrate, substance abuse, group of drugs
- Lead-in keywords: comes under which group
- Negative lead-in flag: false
Question ID
QKcAr7cHtI_NJC8JzR6Odz
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) pp. 4487-4489, 4458-4460
E6 Medicine Davidson Principles Practice 24e p. 164-166
Practise the full DSSSB - 29 August 2019 (Shift-2)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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