Alcohol withdrawal

Question 1

What medications can be used in treatment of alcohol withdrawal?

Answer 1

Benzodiazapine
Thiamine + multivitamins
Typical antipsychotics
Anti-epileptics
Beta blockers (not alone)

Question 2

Why would you use an anti-epileptic medication in alcohol withdrawal (rather than a benzo)?

Answer 2

They don’t cause sedation/ respiratory depression

Question 3

What is the benzodiazepine of choice in alcohol withdrawal?

Answer 3

diazepam

Question 4

What route is diazepam administered?

Answer 4

PO, although an initial loading dose of IV diazepam may be reasonable

Question 5

What route is thiamine given?

Answer 5

Often IV/IM to start then PO

Question 6

When would you use a beta-blocker in alcohol withdrawal?

Answer 6

To help treat some of the sympathomimetic adverse effects, never use alone though as it does not affect the seizure threshold

Question 7

When would you use a typical antipsychotic in alcohol withdrawal?

Answer 7

For severe agitation or hallucinations not responding to diazepam.
Haloperidol is probably preferred as it doesn’t seem to lower the seizure threshold