Dr Reddy presented a CPC today on treatment of alcohol withdrawal. The May 1, 2003 NEJM has a review of drug and ETOH withdrawal. It summarizes the data in support of symptom triggered (CIWA)rather than scheduled therapy and als runs through other withdrawal scenarios such as stimulants and opioids.
If you care for patients later in the course who already have alcohol withdrawal delirium (DTs) higher doses of benzos for treatment (rather than prevention) and closer monitoring are required. This article from Archives of Internal Medicine Jul 12, 2004 summarizes the clinical trail data as of 2004. Basically high dose benzos and frequent monitoring until symptoms are controlled are the key interventions. Neuroleptics are adjuncts, and beta blockers should be used infrequently, if at all, and only for persistent hypertension when other medical therapy has been tried.
The following links show all the good studies that support the use of oral or IV ethanol to treat/prevent alcohol withdrawal symptoms:
Get my point?
Review of topics covered in morning report, M&m, and core conferences with links to supplemental reading material.
Subscribe
Posts
Comments
No comments:
Post a Comment