Alcohol Withdrawal Case

Question 1

2 electrolyte imbalances commonly seen w. etoh withdrawal

Answer 1

K+
Mg

Question 2

first line tx for etoh withdrawal and withdrawal sz

Answer 2

barbituates - phenobarbital

can supplement w. benzos

Question 3

3 benefits of barbs over benzos

Answer 3

less risk of respiratory depression
longer half life
no withdrawal

Question 4

dosing for phenobarbital is based on (2)

Answer 4

CIWA
SEWS

Question 5

DOC if pt is actively seizing

Answer 5

benzos

Question 6

t/f: ativan is the most effective benzo for etoh withdrawal

Answer 6

f! they are all equally effective

Question 7

2 long acting benzos

Answer 7

diazepam (valium)
chloradiazepoxide (librium)

Question 8

mc used op med to prevent etoh withdrawal seizures and sx control

Answer 8

chlordiazepoxide - librium

Question 9

long acting benzos can be __toxic

Answer 9

hepato

Question 10

2 short acting benzos

Answer 10

lorazepam (ativan)
oxazepam (serax)

Question 11

short acting benzos are less __ toxic and have fewer __ effects

Answer 11

hepato
sedative

Question 12

dosing consideration for benzos for acute etoh withdrawal

Answer 12

all should be front-loaded

Question 13

3 benzos used for withdrawal

Answer 13

lorazepam (ativan)
valium (diazepam)
librium (chloradiazepoxide)

Question 14

2 benzos used for seizures

Answer 14

lorazepam (ativan)
valium (diazepam)

Question 15

alpha agonist that can be useful for acute mild-mod etoh withdrawal

Answer 15

clonidine

Question 16

effect of clonidine in acute etoh withdrawal

Answer 16

decreases sx
lowers bp/HR

Question 17

what two meds reduce complications in acute etoh w/d

Answer 17

thiamine
folate

Question 18

dosing consideration for IV thiamine

Answer 18

home taper for 3 days

Question 19

seizure risk with etoh withdrawal timeline

Answer 19

6-72 hr

Question 20

etoh withdrawal timeline

Answer 20

1. 8 hr -> anxiety, insomnia, nausea, abd pain
2. 1-3 days -> htn, increased body temp
3. 1 week -> hallucinations, fever, sz, agitation

Question 21

t/f: etoh withdrawal can last weeks if left untreated

Answer 21

t!

Question 22

what cessation medication can never be given to an intoxicated pt

Answer 22

disulfram (antabuse)

Question 23

unwanted s.e of antabuse begin __ after etoh consumption

Answer 23

10-30 min

Question 24

management of inpatient acute etoh withdrawal (4)

Answer 24

admit
barb load
correct lytes
thiamine and folate