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Alcohol Withdrawal Syndrome: Improving Outcomes Through Early Identification And Aggressive Treatment Strategies (Critical Care Issue)

June 2015

Abstract

Alcoholism is a prevalent medical and psychiatric disease, and, consequently, alcohol withdrawal is encountered frequently in the emergency department. This issue reviews the pathophysiol­ogy of the alcohol withdrawal syndrome, describes the 4 manifes­tations of alcohol withdrawal, and looks at the available evidence for optimal treatment of alcohol withdrawal in its diverse pre­sentations. Patients commonly manifest hyperadrenergic signs and symptoms, necessitating admission to the intensive care unit, intravenous benzodiazepines, and, frequently, adjunctive phar­macotherapy. An aggressive front-loading approach with benzo­diazepines is proposed and the management of benzodiazepine-resistant disease is addressed.

Key words: ethanol, alcoholic, alcohol withdrawal syndrome, alcohol withdrawal seizure, hallucinosis, hallucinations, delirium tremens, DT, benzodiazepines, tremor, hallucinosis, CIWA

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