Wednesday 10 April 2013

Alcohol withdrawal



- Delirium tremens can occur 48-96 hours after withdrawal of alcohol and is associated with increased mortality. The clinical triad includes delirium, tremors and autonomic instability. DTs are treated with benzodiazepines - neuroleptics should be avoided because they can lower the seizure threshold and precipitate arrhythmias (long QT)

- Hallucinations that occur within 12-24 hours (with normal vitals) are from alcoholic hallucinosis. They should resolve by 48 hours and are treated conservatively 

- Giving lorazepam 2 mg IV after an alcohol withdrawal seizure has been shown to decrease recurrent seizures in this RCT


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