A 45-year-old male presents to the emergency department with tremors, profuse sweating, and anxiety. He reports having his last alcoholic drink 36 hours ago after years of heavy drinking. Which of the following is the most appropriate initial intervention?
Administer haloperidol
Administer benzodiazepines
Start IV fluid resuscitation
Order a psychiatric consult
The correct answer is to administer benzodiazepines. In alcohol withdrawal syndrome, benzodiazepines are the first-line treatment to manage symptoms and prevent progression to more severe complications like seizures or delirium tremens. Benzodiazepines work by enhancing the effect of GABA, the primary inhibitory neurotransmitter in the brain, which helps to reduce anxiety, tremors, and the risk of seizures.
While IV fluids are important in managing dehydration often associated with alcohol withdrawal, they are not the most critical initial intervention. Haloperidol, an antipsychotic, is not typically used as a first-line treatment for alcohol withdrawal and may lower the seizure threshold. Ordering a psychiatric consult, while potentially beneficial later in treatment, is not the most urgent action needed to address the patient's acute withdrawal symptoms.
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