Alcohol Withdrawal Case Flashcards
2 electrolyte imbalances commonly seen w. etoh withdrawal
K+
Mg
first line tx for etoh withdrawal and withdrawal sz
barbituates - phenobarbital
can supplement w. benzos
3 benefits of barbs over benzos
less risk of respiratory depression
longer half life
no withdrawal
dosing for phenobarbital is based on (2)
CIWA
SEWS
DOC if pt is actively seizing
benzos
t/f: ativan is the most effective benzo for etoh withdrawal
f! they are all equally effective
2 long acting benzos
diazepam (valium)
chloradiazepoxide (librium)
mc used op med to prevent etoh withdrawal seizures and sx control
chlordiazepoxide - librium
long acting benzos can be __toxic
hepato
2 short acting benzos
lorazepam (ativan)
oxazepam (serax)
short acting benzos are less __ toxic and have fewer __ effects
hepato
sedative
dosing consideration for benzos for acute etoh withdrawal
all should be front-loaded
3 benzos used for withdrawal
lorazepam (ativan)
valium (diazepam)
librium (chloradiazepoxide)
2 benzos used for seizures
lorazepam (ativan)
valium (diazepam)
alpha agonist that can be useful for acute mild-mod etoh withdrawal
clonidine
effect of clonidine in acute etoh withdrawal
decreases sx
lowers bp/HR
what two meds reduce complications in acute etoh w/d
thiamine
folate
dosing consideration for IV thiamine
home taper for 3 days
seizure risk with etoh withdrawal timeline
6-72 hr
etoh withdrawal timeline
- 8 hr -> anxiety, insomnia, nausea, abd pain
- 1-3 days -> htn, increased body temp
- 1 week -> hallucinations, fever, sz, agitation
t/f: etoh withdrawal can last weeks if left untreated
t!
what cessation medication can never be given to an intoxicated pt
disulfram (antabuse)
unwanted s.e of antabuse begin __ after etoh consumption
10-30 min
management of inpatient acute etoh withdrawal (4)
admit
barb load
correct lytes
thiamine and folate
