A 49-year-old man with severe alcohol use disorder presents with confusion, ataxia, and poor oral intake for 3 days. Vitals: BP 118/76, HR 102, RR 16, Temp 37.2°C, SpO2 98%. Laboratory studies show serum glucose 52 mg/dL and thiamine level 1.2 nmol/L (normal >5.3). He denies nystagmus. Intravenous dextrose-containing fluids are planned. Which medication should be administered first to prevent Wernicke encephalopathy?
- A)ThiamineGABARITO
- B)Vitamin C
- C)Pyridoxine
- D)Folate
- E)Cyanocobalamin
Explicação
Thiamine deficiency is common in alcohol use disorder, and giving glucose before thiamine can worsen Wernicke encephalopathy. Thiamine should be administered before or with dextrose in high risk patients. Ver explicação completa e trilha adaptativa →