Which drug is used in Aversion Therapy for Alcoholism?

Bihar CHO - 2021

Pharmacology

Easy

Appeared in: Bihar CHO - 2021

Explanation

Disulfiram is specifically indicated as an agent for aversion therapy in the treatment of alcohol use disorder.
It works by inhibiting the enzyme aldehyde dehydrogenase, which is a key enzyme in the metabolism of alcohol.
When a person taking Disulfiram consumes alcohol, a toxic metabolite called acetaldehyde accumulates in the blood to levels up to 10 times higher than normal.
This accumulation triggers a severe, unpleasant physical response known as the Disulfiram-Alcohol Reaction (DER), which includes symptoms like nausea, vomiting, flushing, and palpitations, thereby creating a conditioned aversion to alcohol.

Option A: Benztropine is an anticholinergic medication. Its primary use is to treat Parkinson's disease and manage extrapyramidal side effects (like dystonia and parkinsonism) caused by antipsychotic drugs. It has no role in alcohol aversion therapy.
Option B: Bromocriptine is a dopamine agonist. It is used to treat conditions caused by high prolactin levels (hyperprolactinemia), acromegaly, and Parkinson's disease. It does not create an aversion to alcohol.
Option D: Dantrolene is a direct-acting skeletal muscle relaxant. Its most critical use is as the primary treatment for malignant hyperthermia, a life-threatening reaction to certain general anesthetics. It is also used for managing severe muscle spasticity.

Clinical Relevance

Nursing practice connection: Knowing Pharmacological management of alcoholism using aversion therapy helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A nurse's primary role in Disulfiram therapy is comprehensive patient education. This includes warning about all hidden sources of alcohol in foods, liquids, and even topical products (e.g., aftershave, mouthwash) to prevent an accidental reaction.
Before starting treatment, it is crucial to obtain informed consent and verify that the patient has been abstinent from alcohol for at least 12 hours. The patient must be motivated and understand the severe consequences of drinking while on the medication.
The Disulfiram-Alcohol Reaction can be a medical emergency. Patients should be instructed to seek immediate medical help if a reaction occurs and should carry an identification card stating they are on Disulfiram therapy.

How to Approach the Question

First, identify the key terms in the question: 'Aversion Therapy' and 'Alcoholism'. This tells you to look for a drug that causes a negative or unpleasant effect when combined with alcohol.
Next, review the four drug options and recall their primary pharmacological class and indication.
Consider Benztropine (anticholinergic for EPS), Bromocriptine (dopamine agonist), and Dantrolene (muscle relaxant for malignant hyperthermia). Recognize that their mechanisms are unrelated to alcohol metabolism or creating an aversion.
Recall or deduce that Disulfiram is the classic drug known for its severe interaction with alcohol, which is the basis of aversion therapy.
By eliminating the options with unrelated uses, you can confidently select Disulfiram as the drug whose purpose matches the therapeutic strategy described in the question.

Concept Tested & Keywords

Concept Tested: Pharmacological management of alcoholism using aversion therapy.
Stem keywords: Aversion Therapy, Alcoholism, drug
Lead-in keywords: Which
Negative lead-in flag: false

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