NORCET 3 - 2022 (Shift-2)
Pharmacology
Medium
Which of the following drugs used in mania EXCEPT?
Appeared in: NORCET 3 - 2022 (Shift-2)
Explanation
- Sertraline is a Selective Serotonin Reuptake Inhibitor (SSRI), a class of antidepressant drugs.
- It is primarily used to treat depression, anxiety disorders, and obsessive-compulsive disorder.
- In patients with bipolar disorder, antidepressants like sertraline are used cautiously and typically with a mood stabilizer because they can induce a switch from a depressive state to a manic or hypomanic state.
- Therefore, sertraline is not a treatment for mania; it is the exception among the given options.
Why Other Options Were Wrong
- Option A: Lithium is a primary, first-line mood-stabilizing agent used for treating acute manic episodes and for long-term maintenance therapy in bipolar disorder.
- Option C: Haloperidol is a typical antipsychotic drug used to manage the acute symptoms of mania, such as severe agitation, aggression, and psychosis.
- Option D: Carbamazepine is an anticonvulsant drug that also functions as a mood stabilizer. It is used as an alternative to lithium for treating acute mania and for prophylaxis in bipolar disorder, especially in patients who are rapid cyclers or do not respond to lithium.
Related Visual
- Visual 1: Chart: A comparative chart showing different classes of drugs used for bipolar disorder, highlighting their roles in manic vs. depressive phases.
- Visual 2: Infographic: An infographic illustrating the mechanism of action of mood stabilizers (like Lithium) versus SSRIs (like Sertraline) in the brain.
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological management of mania in bipolar disorder as background academic context rather than a clinical decision trigger.
- A critical nursing responsibility is to understand that administering an antidepressant alone to a patient with undiagnosed or known bipolar disorder can precipitate a manic episode, which is a patient safety risk.
- Nurses must meticulously monitor patients on lithium for signs of toxicity (e.g., coarse tremors, confusion, ataxia) as it has a narrow therapeutic index (0.8–1.2 mEq/L for acute mania).
- When administering haloperidol, nurses should watch for extrapyramidal side effects (EPS) like dystonia and akathisia.
How to Approach the Question
- First, identify the keyword 'EXCEPT'. This tells you to look for the option that is different from the others in the context of the question.
- The question asks about drugs used for 'mania'. You need to find the drug that is NOT used for mania.
- Review each option's drug class and primary indication.
- Lithium is a well-known mood stabilizer for mania.
- Haloperidol is an antipsychotic used for acute mania.
- Carbamazepine is an anticonvulsant/mood stabilizer for mania.
Concept Tested & Keywords
- Concept Tested: Pharmacological management of mania in bipolar disorder.
- Stem keywords: drugs, mania
- Lead-in keywords: EXCEPT
- Negative lead-in flag: This is a negative-lead question (EXCEPT), requiring you to identify the option that does NOT fit the criteria.
Question ID
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Practise the full NORCET 3 - 2022 (Shift-2)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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