Alcohol Withdrawal Flashcards
1
Q
Alcohol Withdrawal Epidemiology
A
- 6% of alcohol-dependent patients develop clinically relevant symptoms, of which 10% experience delirium tremens
- Up to 1/3 experiencing withdrawal may experience a seizure
2
Q
Alcohol Withdrawal Presentation
A
- May develop in community or in hospital
- Symptoms appear 6-12 hours after alcohol has stopped
- Insomnia, fatigue, anxiety, restlessness, nausea/vomiting, headache, sweating, palpitations, anorexia, depression, craving
- Alcoholic hallucinosis (12-24hrs)
- Withdrawal seizures (24-48 hours)
- DT (48-72 hours)
3
Q
Alcohol Withdrawal Admission Criteria?
A
- Previous DT or withdrawal, age <18, patient situation, WK
- Medication not needed if <15unitsM, <10unitsF per day AND no recent withdrawal symptoms, or patient has no alcohol on breath test and no withdrawal signs or symptoms
4
Q
Alcohol Withdrawal Medication Not Needed When?
A
- <15unitsM, <10unitsF per day AND no recent withdrawal symptoms
- Or patient has no alcohol on breath test and no withdrawal signs or symptoms
5
Q
Alcohol Withdrawal Management?
A
- Benzodiazepines (slow onset of action so less abuse)
- Reducing dose of chlordiazepoxide over 5-7 days
- Keep confirming abstinence
- Five days 20mg, 15mg, 10mg, 5mg, 5mg
- Thiamine deficiency common; Pabrinex (parenteral high potency B complex vitamins)
- DT- ABC, oral lorazepam
- Arrange close follow up from GP and AA
