Alcohol withdrawal

Question 1

Main treatment

Answer 1

Chlordiazepoxide or diazepam
Primary care = fixed dose regimen
Secondary/inpatient = fixed dose or symptom triggered

Alternatives = carbamazepine or clomethiazole

Question 2

Seizures

Answer 2

Lorazepam

Question 3

Delirium tremends

Answer 3

Oral lorazepam
- If persistent OR patient declines oral = parenteral lorazepam or haloperidol

Question 4

Wernicke’s encelopathy

Answer 4

Thiamine (B1)
- Patients with alcohol dependence, malnourished or liver disease are at high risk

Question 5

Alcohol dependence

Answer 5

Acamprosate or Naltrexone

Alternative = disulfiram

Question 6

Disulfiram

Answer 6

Unpleasant reaction to small amounts of alcohol
- Throbbing headache
- N + V
- Flushing
- Tachycardia
- Palpitations

Question 7

Reduction of alcohol consumption in patients without withdrawal symptoms

Answer 7

Nalmefene
- Patients at high drinking risk who do not require immediate detoxification