A 56-year-old alcoholic woman presents to the ED seeking detoxification from alcohol. Her reported consumption is 750 mL of vodka daily. Her last drink was 15 hours prior, at 4:30 PM the previous afternoon. Upon presentation to the ED, she is found to be tachycardic, with a heart rate of 139 beats/min; and hypertensive, with blood pressure of 172/84 mm Hg. She is diaphoretic and has a severe tremor. She is unable to hold a glass of water without spilling its contents. The patient denies any history of illicit drug use and states that she has no history of alcohol withdrawal seizures or delirium tremens. She receives 1 liter of intravenous normal saline and an intravenous dose of 5 mg of diazepam. Fifteen minutes later, her tremor is worsening and her vital signs have failed to improve. What treatment modalities should you choose for her worsening symptoms?
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