A 42-year-old man is brought to the emergency department with symptoms of acute alcohol withdrawal. He has a history of chronic alcohol abuse and reports his last drink was 32 hours ago. On examination, he appears agitated, diaphoretic, and tremulous. His vital signs show tachycardia and hypertension. The physician decides to initiate treatment with Lorazepam.
Which of the following best describes why Benzodiazepines are used to treat alcohol withdrawal?
They inhibit the metabolism of alcohol in the liver
They block the reuptake of dopamine in the central nervous system
They have no potential for abuse or dependence
They enhance the effects of GABA in the central nervous system
The Correct Answer is D
A. They inhibit the metabolism of alcohol in the liver: Benzodiazepines do not affect alcohol metabolism. Enzymes like alcohol dehydrogenase and aldehyde dehydrogenase are responsible for metabolizing alcohol, and benzodiazepines have no role in this process.
B. They block the reuptake of dopamine in the central nervous system: This mechanism is more characteristic of stimulant drugs like cocaine or certain antidepressants. Benzodiazepines act primarily on GABAergic pathways and do not target dopamine reuptake.
C. They have no potential for abuse or dependence: Benzodiazepines carry a well-documented risk of dependence and abuse, especially with long-term use or in individuals with a history of substance use disorders. Their use in alcohol withdrawal is carefully managed due to this risk.
D. They enhance the effects of GABA in the central nervous system: Benzodiazepines potentiate GABA, the brain’s primary inhibitory neurotransmitter, which helps to stabilize the CNS, reduce seizures, and manage agitation during alcohol withdrawal. This GABAergic action compensates for the decreased inhibitory tone seen in alcohol-dependent individuals during withdrawal.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. "You should see benefits within days of starting your atorvastatin.": Atorvastatin works by lowering LDL cholesterol, but measurable improvements in lipid levels typically take several weeks. Immediate effects are unlikely, and full benefits depend on adherence and time.
B. "You may consume grapefruit juice freely while on this medication.": Grapefruit juice inhibits CYP3A4 enzymes in the liver and intestines, which can lead to increased levels of atorvastatin in the blood. This raises the risk of adverse effects, particularly muscle toxicity.
C. "Report any muscle pain, weakness, or tenderness to your healthcare provider immediately.": These symptoms may indicate myopathy or rhabdomyolysis, a rare but serious adverse effect of statins. Early reporting allows for prompt evaluation and potential discontinuation of the drug to prevent complications.
D. "You can use an NSAID prior to taking your atorvastatin to prevent flushing.": Flushing is not a common side effect of atorvastatin; this teaching applies to niacin, not statins. Using NSAIDs prophylactically for atorvastatin is unnecessary and not clinically indicated.
Correct Answer is A
Explanation
A. "Increase your fluid intake to 2–3 liters per day.": Increased fluid intake helps dilute uric acid levels and promotes renal excretion, reducing the risk of kidney stones—a common complication in patients taking allopurinol. Maintaining hydration is a key part of long-term gout management.
B. "Discontinue the medication once symptoms improve.": Allopurinol is a maintenance medication meant to prevent gout flares by lowering uric acid levels over time. Stopping it when symptoms improve can lead to rebound hyperuricemia and recurrent attacks.
C. "Double the dose if a dose is missed.": Doubling a missed dose can increase the risk of toxicity, including skin rash, liver dysfunction, and hypersensitivity reactions. If a dose is missed, it should be taken as soon as remembered unless it's almost time for the next dose.
D. "Take the medication only during acute gout attacks.": Allopurinol is not intended for acute gout relief; it can actually worsen or trigger flares when initiated during an attack. It is used for chronic urate-lowering therapy and should be taken consistently.
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