A 28-year-old alcoholic man is brought to the emergency department after a binge drinking. The treating physician is concerned about the risk of alcohol withdrawal and associated risk of withdrawal seizures. Which of the following medications would be most helpful in this patient to decrease these risks?

Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: A

Rationale: NSAIDs, such as ibuprofen, aspirin, and naproxen, share a side effect profile linked to their inhibition of COX enzymes, which reduces protective prostaglandins. Gastrointestinal ulceration occurs due to decreased mucus production in the stomach, increasing risks of bleeding or ulcers, a well-known issue with chronic use. Nephropathy results from reduced renal prostaglandin synthesis, impairing kidney perfusion and potentially leading to acute or chronic renal damage. Hepatotoxicity, though less frequent, can arise from metabolic overload in the liver with prolonged high doses. Addiction, however, is not associated with NSAIDs. It's a characteristic of opioids, which stimulate the brain's reward pathways via mu receptors, fostering dependence. NSAIDs lack psychoactive properties and don't induce euphoria or craving, making Addiction the exception. This question tests the ability to differentiate NSAID toxicities from those of other drug classes, vital for safe prescribing and patient counseling on risks.

Correct Answer: C

Rationale: Nalbuphine (choice C), a mixed agonist-antagonist (kappa agonist, mu antagonist), can precipitate withdrawal in morphine addicts by antagonizing mu receptors, displacing morphine and reversing its effects, causing symptoms like anxiety and sweating. Meperidine (choice A), Methadone (choice B), and Fentanyl (choice D), all full mu agonists, maintain opioid effects, not inducing withdrawal unless stopped abruptly. Nalbuphine's antagonistic action at mu receptors in dependent patients makes it the correct choice. This highlights the importance of receptor pharmacology in managing opioid-dependent patients, avoiding unintended withdrawal.

Correct Answer: A

Rationale: Buspirone (choice A) is an anxiolytic acting as a partial agonist at 5-HT1A serotonin receptors, reducing anxiety without sedation, unlike benzodiazepines. Flurazepam (choice B) and Diazepam (choice C) enhance GABAa effects, not serotonin. Chloral hydrate (choice D), a sedative, lacks receptor specificity. Buspirone's unique mechanism avoids dependence, making it distinct in anxiety treatment.