The drug of choice to treat alcohol withdrawal symptoms is:

Appeared in: AIIMS Delhi NO-2016

Explanation

Chlordiazepoxide is a long-acting benzodiazepine, which is the first-line drug class for managing acute alcohol withdrawal.
It works by potentiating the inhibitory effects of the neurotransmitter GABA, thereby calming the central nervous system hyperactivity that occurs when alcohol is stopped.
The primary goal of using Chlordiazepoxide is to prevent severe complications such as withdrawal seizures and delirium tremens (DTs).
Its long half-life provides a self-tapering effect, leading to a smoother withdrawal process with less risk of breakthrough symptoms.

Option B: Disulfiram is used for alcohol deterrence (aversion therapy) in abstinent patients, not for managing acute withdrawal symptoms.
Option C: Naloxone is an opioid antagonist used exclusively for the emergency reversal of opioid overdose.
Option D: Naltrexone is used to reduce cravings and prevent relapse in patients who have already been detoxified from alcohol or opioids.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacological management of acute alcohol withdrawal to guide bedside assessment, documentation, and the next nursing action.
Accurate and timely management of alcohol withdrawal is a critical nursing responsibility to prevent life-threatening outcomes. Failure to treat can lead to mortality rates as high as 5% in patients who develop delirium tremens.
Nurses are responsible for using standardized tools like the CIWA-Ar scale to objectively assess withdrawal severity, administer benzodiazepines as prescribed, and monitor for treatment effectiveness and over-sedation.
It is crucial to administer thiamine before or with glucose solutions to prevent precipitating Wernicke's encephalopathy, a severe neurological disorder caused by thiamine deficiency.

How to Approach the Question

Identify the key phrase in the question: "treat alcohol withdrawal symptoms." This specifies the need for a drug to manage the acute phase of detoxification.
Differentiate between drugs used for acute withdrawal, craving reduction/maintenance, and aversion therapy.
Analyze the options: Benzodiazepines (like Chlordiazepoxide) are the standard for acute withdrawal. Disulfiram is for aversion. Naltrexone is for craving reduction. Naloxone is for opioid overdose.
Eliminate options that do not treat the acute physiological symptoms of withdrawal. Disulfiram, Naloxone, and Naltrexone are all used in different contexts related to substance use but not for acute alcohol withdrawal management.
Select the option that directly addresses the CNS hyperactivity of alcohol withdrawal. Chlordiazepoxide, a benzodiazepine, fits this role perfectly.

Concept Tested & Keywords

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E6 Pharmacology Katzung 16e pp. 628-630, 632-634

E6 Medicine Harrison 22e Part 2 p. 1584-1586

Practise the full AIIMS Delhi NO-2016

Attempt every question from this paper in a timed mock, then review the full solution for each one.