AIIMS Nagpur NO- 2020
Pharmacology
Easy
Thiamine has been prescribed for an alcoholic patient. The rationale for administration of this medication is the prevention of:
Appeared in: AIIMS Nagpur NO- 2020
Explanation
- Chronic alcohol use significantly impairs the body's ability to absorb and utilize thiamine (Vitamin B1), a crucial nutrient for brain function.
- This deficiency can lead to Wernicke-Korsakoff syndrome, a severe neurological disorder that presents in two stages: acute Wernicke's encephalopathy and chronic Korsakoff's psychosis.
- Wernicke's encephalopathy is a medical emergency characterized by confusion, ataxia (unsteady gait), and ophthalmoplegia (abnormal eye movements).
- If untreated, it can progress to Korsakoff's psychosis, a chronic and often irreversible memory disorder.
- Administering thiamine is a critical preventative measure to avoid the development of this debilitating condition in at-risk patients.
Why Other Options Were Wrong
- Option B: Thiamine does not treat the acute symptoms of alcohol withdrawal, such as tremors, agitation, and seizures.
- Option C: Alcoholic dementia refers to a more global, long-term cognitive decline. While thiamine deficiency contributes to overall brain damage, its specific preventative role is for the distinct amnestic disorder of Wernicke-Korsakoff syndrome.
- Option D: Huntington's disease is an inherited genetic disorder that causes the progressive breakdown of nerve cells in the brain.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Pharmacological prevention of complications in chronic alcoholism to guide bedside assessment, documentation, and the next nursing action.
- A critical nursing priority is to administer thiamine BEFORE or concurrently with glucose-containing intravenous fluids. Giving glucose first can deplete the body's remaining thiamine stores and precipitate or worsen Wernicke's encephalopathy.
- Nurses should assess all patients with a history of alcohol misuse for signs of nutritional deficiencies and advocate for prophylactic thiamine.
- What if? A patient with a history of heavy drinking is admitted with confusion, an unsteady gait, and nystagmus (involuntary eye movements). The priority nursing action is to anticipate and prepare for the immediate administration of parenteral (IV or IM) thiamine, as these are classic signs of acute Wernicke's encephalopathy.
How to Approach the Question
- First, identify the key elements of the question: the drug (Thiamine), the patient population (alcoholic patient), and the purpose (prevention).
- The core of the question is asking for the specific complication of alcoholism that thiamine prevents.
- Recall the major physiological effects of chronic alcoholism, particularly its impact on nutrition and vitamin absorption.
- Connect thiamine (Vitamin B1) deficiency specifically to its known neurological consequences.
- Evaluate the options: Wernicke-Korsakoff syndrome is the classic neurological disorder caused by thiamine deficiency in alcoholics. The other options are either treated differently (withdrawal), are a more general condition (dementia), or are unrelated (Huntington's).
Concept Tested & Keywords
- Concept Tested: Pharmacological prevention of complications in chronic alcoholism
- Stem keywords: Thiamine, alcoholic patient, prevention
- Lead-in keywords: rationale for administration
Question ID
QOmjvrF4QzY9KRudwjN9sV
Reference Book
E6 Pharmacology Katzung 16e p. 624-626
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 4236-4238
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 917-919
Practise the full AIIMS Nagpur NO- 2020
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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