Alcohol Withdrawal Flashcards
What is the mechanism of alcohol withdrawal?
Decreased inhibitory GABA
Increased NMDA glutamate transmission
How does a patient present after 6-12 hours of alcohol withdrawal?
- Tremor
- Sweating
- Tachycardia
- Anxiety
How does a patient present after 36 hours of alcohol withdrawal?
Peak incidence of seizures
What happens at 72 hours of alcohol withdrawal?
Delirium tremens
How does a patient with delirium tremens present?
- coarse tremors
- Fluctuating confusion
- Disorientation in time and place
- Memory impairment
- Tactile hallucination- bugs crawling on your skin
- Psychotic phenomenon e.g. hallucinations, Delusional
What is the first line management of alcohol withdrawal?
Long-acting benzodiazepine
What are examples of long acting benzodiazepine?
Chlordiazepoxide (main)
Diazepam
What is the management of alcohol withdrawal seizures?
Rapid-acting benzodiazepine
What is an example of a rapid acting benzodiazepine?
IV lorazepam
What is the management of delirium tremens?
Oral Lorazepam
What vitamin are most alcoholics deficient in?
Thiamine (vitamin B1)
(magnesium)
