JODHPUR AIIMS SNO-2018
Pharmacology
Easy
Which of the following drugs is used for the treatment of nocturnal enuresis?
Appeared in: JODHPUR AIIMS SNO-2018
Explanation
- Imipramine is a tricyclic antidepressant (TCA) that is FDA-approved for treating nocturnal enuresis (bedwetting) in children over the age of 6.
- Its therapeutic effect is primarily due to its strong anticholinergic properties, which cause relaxation of the bladder's detrusor muscle, leading to increased bladder capacity.
- Additionally, Imipramine may lighten the stage of sleep or enhance arousal to the sensation of a full bladder, helping the child to wake up to use the toilet.
Why Other Options Were Wrong
- Option B: Chlorpromazine is a typical antipsychotic medication used to manage symptoms of psychosis, such as in schizophrenia. Its mechanism of action and side effect profile are not appropriate for treating enuresis.
- Option C: Trazodone is an antidepressant that is highly sedating and is most commonly used to treat major depression and insomnia. It is not indicated for nocturnal enuresis.
- Option D: Sertraline is a Selective Serotonin Reuptake Inhibitor (SSRI). While effective for depression and anxiety, it does not possess the significant anticholinergic effects that make Imipramine useful for enuresis.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Pharmacological management of nocturnal enuresis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Nurses must educate parents to administer Imipramine about one hour before the child's bedtime to ensure peak effect during the night.
- A baseline electrocardiogram (ECG) is recommended before starting Imipramine and periodically thereafter, as it carries a risk of cardiotoxicity, including arrhythmias.
- It is critical to warn parents about the high risk of lethality in case of an overdose. The medication must be stored securely and kept out of the reach of children.
How to Approach the Question
- First, identify the key condition in the question: 'nocturnal enuresis' (bedwetting).
- Next, understand the task: identify which of the listed medications is used for its treatment.
- Review the options, which are all psychotropic drugs. Recall the primary indications for each drug or drug class.
- Imipramine is a tricyclic antidepressant (TCA), Chlorpromazine is an antipsychotic, and Sertraline is a selective serotonin reuptake inhibitor (SSRI).
- Recall that TCAs, specifically Imipramine, have a well-known indication for nocturnal enuresis due to their potent anticholinergic side effects.
- Select Imipramine as the drug that matches the therapeutic use required by the question.
Concept Tested & Keywords
- Concept Tested: Pharmacological management of nocturnal enuresis.
- Stem keywords: nocturnal enuresis, treatment, drug
- Lead-in keywords: Which
- Negative lead-in flag: false
Question ID
QKzkKxGg6txPv0uvtCv-jP
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, 12337-12339
E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1099-1101
Practise the full JODHPUR AIIMS SNO-2018
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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