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  #1  
Old 05-17-2011
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Arrow Kill those rats and snakes around me!

A 52 year old man with h/o alcoholism, pancreatitis, cholecystitis undergoes a cholecystectomy. Over the next 2 days, his sedation is reduced and extubated. 2 days later, he develops nausea vomiting malaise, he tells the nurse to "kill those rats and snakes around him".. His pulse is 120/min, BP 150/100 mm Hg, RR 21/min, temp 98.4. Per abdomen exam non tender soft, healing incision area. What is the appropriate drug u would like to give to this patient?

a. chlordiazepoxide
b. disulfiram
c. thiamine
d. 0.9% saline
e. nothing.
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  #2  
Old 05-17-2011
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a. chlordiazepoxide
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Old 05-17-2011
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Definitely A of the answer choices. This is clearly alcohol withdrawal - but we have many newer benzos that are used more often clinically.. If any showed up as an answer choice that might be hard to separate...
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Old 05-17-2011
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delerium tremens on 3rd day of alchohol withdrawal has to have waxing and waning conciousness by definition no ?:S
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Old 05-17-2011
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Yes. Chlorediazepoxide!This patient is experiencing alcohol withdrawal. Visual and tactile hallucinations are common.
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Old 05-18-2011
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Correct Answer

Yes..
A is the right answer. Chlordiazepoxide and lorazepam are given for alcohol withdrawal syndrome.

Disulfiram is used to discourage alcohol abuse by enhancing the negative effects by inhibiting aldehyde dehydrogenase.

0.9 percent saline is usually used as adjunctive to Bzds, but does not reverse the symptoms.

Thiamine, used in treatment of Wernicke encephalopathy.
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Old 06-09-2011
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Quote:
Originally Posted by mle2resident View Post
A 52 year old man with h/o alcoholism, pancreatitis, cholecystitis undergoes a cholecystectomy. Over the next 2 days, his sedation is reduced and extubated. 2 days later, he develops nausea vomiting malaise, he tells the nurse to "kill those rats and snakes around him".. His pulse is 120/min, BP 150/100 mm Hg, RR 21/min, temp 98.4. Per abdomen exam non tender soft, healing incision area. What is the appropriate drug u would like to give to this patient?

a. chlordiazepoxide
b. disulfiram
c. thiamine
d. 0.9% saline
e. nothing.


A VERYYY similar question to this was on my exam today and i got it right thanks to you!! it was a women who saw rats in the same scenario and they asked what it was.. i knew it was delerium cz i solved this question here!!! THANKYOUU and God bless
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  #8  
Old 06-09-2011
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Quote:
Originally Posted by samran.haider View Post
A VERYYY similar question to this was on my exam today and i got it right thanks to you!! it was a women who saw rats in the same scenario and they asked what it was.. i knew it was delerium cz i solved this question here!!! THANKYOUU and God bless
Post your experience!
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  #9  
Old 06-09-2011
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Yes please, post your experience!

Quote:
Originally Posted by samran.haider View Post
A VERYYY similar question to this was on my exam today and i got it right thanks to you!! it was a women who saw rats in the same scenario and they asked what it was.. i knew it was delerium cz i solved this question here!!! THANKYOUU and God bless
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