Alcohol withdrawal Flashcards
What is the mechanism for chronic alcohol consumption?
enhances GABA inhibition in the CNS
inhibits NMDA glutamate receptors
what is the mechanism for alcohol withdrawal?
decrease inhibitory GABA
increase NMDA transmission
What are the features of alcohol withdrawal?
symptoms start at 6-12 hours: tremor, sweating, tachycardia, anxiety
seizures
delirium tremens
what is the peak incidence of seizures?
36 hours
what is the peak incidence of delirium tremens?
48-72
hours
what are the symptoms of delirium tremens?
coarse tremor, confusion, delusions, auditory and visual hallucinations, fever, tachycardia
What is the management of alcohol withdrawal?
long-acting benzodiazepines e.g. chlordiazepoxide or diazepam.
Lorazepam may be preferable in patients with hepatic failure.
Typically given as part of a reducing dose protocol
What else maybe considered in alcohol withdrawal treatment?
carbamazepine
What is considered to be not so effective?
phenytoin
