A nurse is providing teaching to a patient who has alcohol use disorder and a new prescription for disulfiram (Antabuse). Which information should the nurse include in the teaching?

Choice A rationale Disulfiram does not mitigate the physical or psychological symptoms of alcohol withdrawal. Withdrawal manifestations, such as tremors, tachycardia, and potential seizures, are managed with benzodiazepines or alpha-blockers. Disulfiram is used for maintenance of sobriety after the acute withdrawal phase has passed. Normal vital signs during withdrawal management include a heart rate below 100 beats per minute and blood pressure within a range of 120÷80 mmHg. It provides no relief for the autonomic hyperactivity. Choice B rationale Disulfiram is an aversive conditioning agent and does not pharmacologically reduce the craving for alcohol. Medications like naltrexone or acamprosate are typically used to reduce the desire to drink or the reward felt from alcohol consumption. Disulfiram works strictly through a biological threat mechanism. The patient still experiences the desire to drink but is deterred by the knowledge of the severe physical reaction that will occur if they ingest alcohol while the medication is in their system. Choice C rationale Disulfiram inhibits the enzyme aldehyde dehydrogenase, which is necessary for the metabolism of alcohol. When alcohol is consumed, acetaldehyde levels in the blood rise significantly, causing a toxic reaction. Symptoms include flushing, throbbing headache, respiratory difficulty, nausea, and tachycardia. This unpleasant physical effect serves as a powerful deterrent. Patients must be taught to avoid all alcohol sources, including mouthwash and vanilla extract, to prevent this reaction. It is a form of behavioral therapy through biological punishment. Choice D rationale Disulfiram has no anticonvulsant properties and does not prevent seizures during the alcohol withdrawal process. Alcohol withdrawal seizures are a medical emergency typically occurring within 6 to 48 hours after the last drink. They are prevented by the administration of cross-tolerant substances like Diazepam or Lorazepam. Disulfiram therapy should only be initiated after the patient has been abstinent for at least 12 hours and has passed the high-risk window for acute withdrawal complications like seizures or delirium tremens.