Rum Fits to DTs- Spectrum and Treatment of Alcohol Withdrawal
Sep 25, 2023
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Explore the spectrum and treatment of alcohol withdrawal in the Emergency Department, including the importance of recognizing and managing withdrawal symptoms effectively. Learn about the classification of withdrawal severity, treatment strategies with benzodiazepines, psychosocial support, and dosing recommendations for symptom management.
During alcohol withdrawal, imbalances in brain receptors cause symptoms like hyper-excitation and seizures.
Recognizing and treating concurrent conditions is crucial in managing patients with alcohol withdrawal.
Deep dives
Understanding Alcohol's Effect on the Brain
Alcohol acts as a neurodepressant affecting major brain receptors GABA and glutamate. Chronic exposure to alcohol leads to upregulation of glutamate and downregulation of GABA, allowing individuals to function at high alcohol levels. During alcohol withdrawal, the imbalance results in symptoms like hyper-excitation, tachycardia, hypertension, tremors, and seizures.
Considering Concurrent Conditions in Alcohol Withdrawal
Patients experiencing alcohol withdrawal may also have concurrent conditions like dehydration, hypoglycemia, low thiamine, and hypomagnesemia. These conditions can complicate the withdrawal process and require additional treatments. Recognizing and addressing these concurrent diseases is crucial in managing patients presenting with alcohol withdrawal.
Staging and Treating Alcohol Withdrawal
Alcohol withdrawal progresses through stages with symptoms appearing within 6-12 hours post-drink cessation. Treatment varies based on the severity of symptoms and patient history. The use of benzodiazepines is common in managing withdrawal, with considerations for different agents based on patient needs. Naltrexone can aid in craving reduction during sobriety maintenance.
Alcohol use disorder and withdrawal in the Emergency Department is as commonplace as a turkey sandwich. Despite this, there is wide variation on how we categorize and treat withdrawal. In this podcast, we organize withdrawal symptoms and structuralize an approach to the withdrawing patient.