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

Etiology And Pathophysiology

AWS represents a complex collection of signs and symptoms that occur as a direct result of the acute cessation or reduction of alcohol intake. The syndrome is best understood as a state of central nervous system (CNS) hyperexcitation, with clinical manifestations ranging from mild tremor to DT, seizure, severe autonomic dysfunction, and death.

Ethanol Pharmacology

Following ingestion, ethanol is rapidly absorbed and distributed, with a volume of distribution near that of total body water (VD 0.6 L/kg). Under typical conditions, approximately 90% of ingested alcohol is absorbed by 60 minutes, though this may be delayed by food in the stomach or co-ingestants. Absorption may also be prevented by the action of gastric mucosal alcohol dehydrogenase (ADH) which oxidizes ethanol and decreases the amount available for absorption.22

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