Alcohol Withdrawal

Question 1

Timeline:
symptoms after 8 hrs
symptoms after 1-3 days
symptoms after 1 week

Answer 1

Anxiety, Nausea, insomnia, abdominal pain
High BP, increased body temperature
Hallucinations, fever, seizures, & agitation

symptoms start at 6-12 hours
peak incidence of seizures at 36 hours
peak incidence of delirium tremens is at 72 hours

Question 2

Detoxification Rx? 1st and 2nd line? How many days?

Answer 2

Benzodiazepines:
Chlordiazepoxide (5-7 days)
Can give diazepam

Question 3

What else is given after admission?

Answer 3

Thiamine/Parbrinex (complex vitamins)

Question 4

Why is thiamine/pabrinex given?

Answer 4

Prevent Wernicke’s

Question 5

What can be given if hx of withdrawal seizures?

Answer 5

Carbamezapine

Question 6

What medication can be given for maintenance? (3)

Answer 6

Acamprosate - stops craving
Naltrexone
Disufiram - makes them feel sick when drinking

Question 7

Psychological Mx? (2)

Answer 7

Couples therapy

AA