PGIMER Chandigarh NO - 2015
Child Health Nursing (Pediatrics)
Easy
which drugs may be used in children to treat enuresis?
Appeared in: PGIMER Chandigarh NO - 2015
Explanation
- Tricyclic antidepressants (TCAs), such as imipramine, are FDA-approved for treating nocturnal enuresis in children.
- The mechanism of action is thought to be related to their anticholinergic properties, which help relax the bladder muscle, thereby increasing its capacity.
- TCAs may also alter sleep patterns, leading to lighter sleep, which can help the child awaken to the sensation of a full bladder.
- They are generally considered a second or third-line treatment option after behavioral interventions and other medications like desmopressin have been tried.
Why Other Options Were Wrong
- Option A: Hypnotics (sleeping pills) are not used to treat enuresis. While they induce sleep, they can deepen it, making it even harder for a child to wake up to void, potentially worsening the problem.
- Option C: Anti-anxiety drugs are not a standard treatment for primary nocturnal enuresis. Enuresis is typically a developmental or physiological issue, not primarily an anxiety-driven one.
- Option D: Major tranquilizers, or antipsychotics, are powerful medications used for severe psychiatric conditions like psychosis or bipolar disorder. They are not indicated for enuresis and have a significant side effect profile.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological treatment for pediatric enuresis as background academic context rather than a clinical decision trigger.
- The nurse's primary role is patient and family education, especially regarding the high risk of cardiotoxicity with TCA overdose. Emphasize that the medication must be stored securely away from children.
- Monitor for and educate parents about potential side effects, including dry mouth, constipation, drowsiness, and mood changes.
- Reinforce that medication is often a temporary solution and works best when combined with behavioral strategies like fluid restriction in the evening and scheduled voiding.
How to Approach the Question
- First, identify the core of the question: It asks for a drug class used to treat enuresis in children.
- This is a factual recall question. Access your knowledge about the common treatments for pediatric bedwetting.
- Evaluate each option. Consider the primary use for each drug class.
- Recall that while behavioral therapy is first-line, certain medications are used as second-line options. Desmopressin and tricyclic antidepressants are the most well-known.
- Compare your recalled knowledge with the options provided. 'Tricyclic antidepressants' is a direct match.
- Eliminate the other options by confirming their primary indications (hypnotics for sleep, anti-anxiety for anxiety, major tranquilizers for psychosis), which do not include enuresis.
Concept Tested & Keywords
- Concept Tested: Pharmacological treatment for pediatric enuresis.
- Stem keywords: drugs, children, enuresis
- Lead-in keywords: which
Question ID
Qiro0_X674B6soPKlGtKov
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. 12849-12851, 13282-13284
E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1099-1101
Practise the full PGIMER Chandigarh NO - 2015
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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