Family Nurse Practitioner Exam

What is the first-line treatment consideration for managing acute alcohol withdrawal delirium?

1. Intubation

2. Benzodiazepines

3. Avoidance of physical restraints to decrease agitation

4. Antipsychotics

The correct answer is: Benzodiazepines

Benzodiazepines are considered the first-line treatment for managing acute alcohol withdrawal delirium due to their ability to effectively reduce withdrawal symptoms and prevent the progression to more severe complications such as seizures and delirium tremens (DTs). Benzodiazepines help to mimic the effects of alcohol on the central nervous system, providing sedation and anxiolytic effects, which are crucial in managing the patient's agitation, tremors, and anxiety often seen during withdrawal. The use of benzodiazepines is supported by clinical guidelines that recommend these medications for their well-documented efficacy in alleviating withdrawal symptoms and improving patient outcomes. They can be safely administered with careful monitoring, especially during the initial phase of treatment when withdrawal symptoms are likely to peak. In contrast, intubation is not a standard treatment for alcohol withdrawal delirium unless the patient cannot maintain their airway due to severe agitation or decreased consciousness. Avoidance of physical restraints is important in the management of agitation; however, it does not address the underlying issue of withdrawal itself. Antipsychotics are not first-line agents for alcohol withdrawal delirium; while they may be used to manage severe agitation or psychosis, they do not address the core withdrawal symptoms and can have adverse effects, especially in patients