Alcohol withdrawal

Question 1

features of alcohol withdrawl?

Answer 1

start at 6-12 hours: tremor, sweating, tachycardia, anxiety

peak incidence of seizures at 36 hours

peak incidence of delirium tremens is at 48-72 hours: auditory and visual hallucinations, fever, tachycardia

Question 2

MX ?

Answer 2

patients with a history of complex withdrawals from alcohol (i.e. delirium tremens, seizures, blackouts) should be admitted to hospital for monitoring until withdrawals stabilised

Question 3

first line for alcoholi withdraws ?

Answer 3

first-line: long-acting benzodiazepines e.g. chlordiazepoxide or diazepam.

carbamazepine also effective in treatment of alcohol withdrawal

Question 4

when is lorazepam preferred in alcoholics ?

Answer 4

Lorazepam may be preferable in patients with hepatic failure- part of a reducing dose protocol