In a patient who is an alcoholic, which of the following causes delirium tremens?
**Core Concept**
Delirium tremens (DTs) is a severe form of alcohol withdrawal that occurs in individuals who have a history of heavy and prolonged alcohol consumption. It is characterized by altered mental status, hallucinations, and autonomic instability.
**Why the Correct Answer is Right**
The correct answer is benzodiazepines. Benzodiazepines, such as chlordiazepoxide, act on the GABA receptor, enhancing its inhibitory effects on the central nervous system. This helps to mitigate the excitatory effects of glutamate and other neurotransmitters that are released during alcohol withdrawal. By reducing the severity of withdrawal symptoms, benzodiazepines can help prevent the onset of delirium tremens.
**Why Each Wrong Option is Incorrect**
* **Option A:** Disulfiram is a medication used to treat chronic alcoholism by inhibiting the enzyme aldehyde dehydrogenase, which breaks down acetaldehyde. It does not prevent delirium tremens.
* **Option B:** Naltrexone is an opioid receptor antagonist used to treat opioid dependence and alcoholism. It does not have a direct effect on the prevention of delirium tremens.
* **Option D:** Disulphiram may cause severe reactions when mixed with alcohol, but it doesn't prevent delirium tremens.
**Clinical Pearl / High-Yield Fact**
Benzodiazepines are the first-line treatment for delirium tremens, and their use should be continued for at least 3-5 days after the symptoms have resolved to prevent recurrence.
**Correct Answer:** C. Chlordiazepoxide.