The most common drug used in the treatment of mania is?

IGNOU PB Bsc Nsg Entrance-2017

Pharmacology

Easy

Appeared in: IGNOU PB Bsc Nsg Entrance-2017

Explanation

Lithium is a mood stabilizer and is considered the first-line, 'gold standard' treatment for acute mania and for long-term prevention of manic and depressive episodes in bipolar disorder.
While it has a slow onset of action (1-2 weeks), it is highly effective in controlling the underlying mood disturbance.
Its primary role is to stabilize mood, reducing the intensity and frequency of manic episodes.
Despite the development of newer drugs, lithium remains a cornerstone of treatment for mania.

Option A: Benzodiazepines (BDZ) are central nervous system depressants used for their sedative and anxiolytic effects.
Option C: Imipramine is a tricyclic antidepressant (TCA). Antidepressants are generally contraindicated or used with extreme caution in patients with mania or bipolar disorder.
Option D: Serenace (Haloperidol) is a typical antipsychotic drug. While used in mania, it is not the primary mood-stabilizing treatment.

Clinical Relevance

Nursing practice connection: Knowing Pharmacological Management of Mania helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A key nursing responsibility is monitoring for lithium toxicity due to its narrow therapeutic index. Early signs include nausea, vomiting, diarrhea, thirst, polyuria, and fine hand tremors. Late signs are severe and include ataxia, confusion, and seizures.
Patient education is critical. Nurses must teach patients and their families about the importance of regular blood tests, maintaining consistent fluid and salt intake, and recognizing and reporting signs of toxicity immediately.
What if? If a patient on lithium reports having severe diarrhea and vomiting for two days, the nurse should instruct the patient to hold the next dose of lithium and contact their prescriber immediately. Dehydration and sodium loss from GI illness can cause lithium levels to rise to toxic levels quickly.

How to Approach the Question

First, identify the core of the question: it asks for the 'most common' drug for 'mania'. This points to a first-line or classic treatment.
Next, analyze the options by classifying each drug: BDZ (sedative/anxiolytic), Lithium (mood stabilizer), Imipramine (antidepressant), Serenace (antipsychotic).
Recall the primary treatment for mania. The goal is to stabilize the mood, not just sedate the patient or treat psychosis.
Recognize that Lithium is the classic mood stabilizer specifically indicated for mania.
Eliminate the other options based on their primary roles: BDZs and Serenace are for acute symptom control (agitation/psychosis), and Imipramine is contraindicated as it can worsen mania. This confirms Lithium as the correct answer.

Concept Tested & Keywords

QucHRbCYdxcI9c1F4LHbqw

E6 Pharmacology KD Tripathi Essentials 9e Part 2 pp. 118-120, 115-117

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 271-273