RUHS, Jaipur, M.Sc Nursing Entrance Exam-2021
Pharmacology
Easy
Drug of choice for delirium tremens is?
Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2021
Explanation
- Benzodiazepines are the first-line treatment for delirium tremens (DTs), a severe form of alcohol withdrawal.
- Diazepam is a long-acting benzodiazepine that effectively manages the central nervous system hyperexcitability seen in alcohol withdrawal.
- Its primary action is to enhance the effect of the inhibitory neurotransmitter GABA, thereby preventing seizures, reducing agitation, and stabilizing autonomic hyperactivity.
- The goal is to substitute the effect of alcohol with a cross-tolerant medication that can be safely tapered.
Why Other Options Were Wrong
- Option B: Chlorpromazine is a phenothiazine antipsychotic that is contraindicated in alcohol withdrawal because it significantly lowers the seizure threshold and can cause severe hypotension, increasing the risk of complications.
- Option C: Haloperidol is not a first-line treatment for DTs. While it can manage agitation and hallucinations, it lowers the seizure threshold, which is a major risk in alcohol withdrawal. It provides no cross-tolerance with alcohol.
- Option D: Reserpine is an older antihypertensive and antipsychotic agent that is not used in the modern management of delirium tremens. It does not address the underlying pathophysiology of alcohol withdrawal.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Pharmacological management of delirium tremens (alcohol withdrawal) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- A nurse's primary role is the frequent and accurate assessment of withdrawal symptoms using a validated tool like the CIWA-Ar scale to guide medication titration and prevent under- or over-sedation.
- Patient safety is paramount. This includes seizure precautions, creating a calm and quiet environment, and frequent reorientation to reduce agitation and confusion.
- Nurses must be vigilant in monitoring vital signs for autonomic instability and advocating for appropriate pharmacological management.
How to Approach the Question
- Identify the core of the question: it asks for the 'drug of choice' for a specific condition, 'delirium tremens'.
- Recognize that delirium tremens is a severe form of alcohol withdrawal, a medical emergency.
- Recall the pathophysiology of alcohol withdrawal: it's a state of CNS hyperexcitability due to the loss of GABAergic inhibition from alcohol.
- Evaluate the options based on their mechanism of action. The correct drug must be a CNS depressant that is cross-tolerant with alcohol, meaning it can substitute for alcohol's effects.
- Benzodiazepines (like Diazepam) fit this profile perfectly. They enhance GABA activity.
- Eliminate the other options by considering their risks in this specific context (e.g., lowering seizure threshold, causing hypotension).
Concept Tested & Keywords
- Concept Tested: Pharmacological management of delirium tremens (alcohol withdrawal)
- Stem keywords: Drug of choice, delirium tremens
- Lead-in keywords: is
- Negative lead-in flag: false
Question ID
Qh6FaXTiUZwFYbW15CdceG
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. 13842-13844, 7723-7725, 14353-14355
Practise the full RUHS, Jaipur, M.Sc Nursing Entrance Exam-2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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