Alcohol Withdrawal

Question 1

Mechanism of alcohol withdrawal

Answer 1

chronic alcohol consumption enhances GABA mediated inhibition in the CNS
=> inhibits NMDA-type glutamate receptors

alcohol withdrawal is due to decreased inhibitory GABA
=> increased NMDA glutamate transmission

Question 2

When do symptoms of alcohol withdrawal first start?

Answer 2

6-12 hours

Question 3

Initial symptoms of alcohol withdrawal

Answer 3

tremor
sweating
tachycardia
anxiety

Question 4

Peak incidence of seizures in alcohol withdrawal (timing)

Answer 4

36 hours

Question 5

Peak incidence of delirium tremens in alcohol withdrawal

Answer 5

48-72 hours

Question 6

Symptoms of delirium tremens

Answer 6

coarse tremor
confusion
delusions
auditory and visual hallucinations
Fever
tachycardia

Question 7

Management of alcohol withdrawal

Answer 7

GMAWS protocol
Long-acting benzos: chlordiazepoxide or lorazepam

Question 8

Lorazepam may be preferable in patients with hepatic failure. TRUE/FALSE?

Answer 8

TRUE