What is A known alcoholic is brought to the emergency department by his wife. The person has not consumed alcohol for the past two days due to religious reasons. The person complained of nausea, vomiting and dizziness. On the second day, he developed seizures, that progressed to generalized tonic clonic seizures (GTCs). Which of the following would be the best medication to manage the seizures of the patients? and explain in detail?
Ans. c. Diazepam (Ref: Niraj Ahuja 6th/39-40; Kaplan Synopsis 10th/396)'Long acting benzodiazepines such as chlordiazepoxide and diazepam or short acting such as lorazepam can be used to treat mild-moderate uncomplicated alcohol withdrawal.''Chlordiazepoxide is preferred over diazepam for treatment of alcohol withdrawal syndrome.'Management ofAlcohol IntoxicationAlcohol WithdrawalDelirium TremensDrugs used are:* Lorazepam (can worsen the vitals due to CNS depression)* Haloperidol (can lower seizure threshold)Other drugs which may be used:* Ziprasidone* Olanzapine* All patients should be given multiple oral vitamin B1 including 50-100 mg of thiamine daily for a week.* Replace alcohol (CNS depressant) with any other CNS depressant.* Benzodiazepines are commonly used.* Chlordiazepoxide is drug of choice because of its long half-life.* High dose benzodiazepines or antipsychotics are recommended.* Anticonvulsants are not given to control seizures seen in delirium tremens.