Alcohol withdrawal resident survival guide: Difference between revisions
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Alcohol withdrawal is defined as an array of signs and symptoms that a chronic alcoholic presents with, when he abruptly ceases alcohol intake. It occurs within 6-48 hours after cessation of alcohol intake. | Alcohol withdrawal is defined as an array of signs and symptoms that a chronic alcoholic presents with, when he abruptly ceases alcohol intake. It occurs within 6-48 hours after cessation of alcohol intake. | ||
== | ===Diagnostic criteria=== | ||
A. Sudden reduction/termination in chronic alcohol intake. | |||
B. Two (or more) of the following, developing within several hours to a few days after criterion A: | |||
1. Autonomic hyperactivity (e.g., sweating or pulse rate > than 100/minute) | |||
2. Hand [[tremors]] | |||
3. [[Insomnia]] | |||
4. Gastrointestinal upset (Nausea or vomiting) | |||
5. Transient visual, tactile, or auditory hallucination s or illusions | |||
6. Psychomotor agitation | |||
7. Anxiety | |||
8. Grand mal seizures | |||
C. The symptoms in criterion B causing clinically significant impairment of patients social, occupational or other aspects of life. | |||
D. The symptoms cannot be better explained by a general medical condition or other mental disorder. | |||
==Management== | ==Management== | ||
Shown below is an algorithm summarizing the approach to <nowiki>[[disease name]]</nowiki>. | Shown below is an algorithm summarizing the approach to <nowiki>[[disease name]]</nowiki>. | ||
{{familytree/start |summary=PE diagnosis Algorithm.}} | {{familytree/start |summary=PE diagnosis Algorithm.}} | ||
{{familytree | | | | | | | | A01 |A01= }} | {{familytree | | | | | | | | A01 |A01=<div style="float: left; text-align: left; line-height: 150% ">'''Characterize the symptoms:'''<br> Minor withdrawal symptoms: 6-12 hours | ||
<div class="mw-collapsible-content"> | |||
<div class="mw-collapsible mw-collapsed"> | |||
❑ Anorexia | |||
❑ Anxiety/Palpitations | |||
❑ Diaphoresis | |||
❑ Gastrointestinal upset | |||
❑ Headache | |||
❑ Insomnia | |||
❑ Tremulousness </div></div> | |||
---- | |||
Alcoholic hallucinosis: 12-24 hours | |||
<div class="mw-collapsible-content"> | |||
<div class="mw-collapsible mw-collapsed"> | |||
❑ Visual hallucinations | |||
❑ Auditory hallucinations | |||
❑ Tactile hallucinations </div></div> | |||
---- | |||
Withdrawal seizures: 24-48 hours | |||
❑ Generalized tonic-clonic seizures | |||
Alcohol withdrawal delirium ([[delirium tremens]]): 48-72 hours | |||
<div class="mw-collapsible-content"> | |||
<div class="mw-collapsible mw-collapsed"> | |||
❑ Hallucinations (predominately visual) | |||
❑ Disorientation | |||
❑ Tachycardia | |||
❑ Hypertension | |||
❑ Low-grade fever | |||
❑ Agitation | |||
❑ Diaphoresis </div></div> | |||
</div>}} | |||
{{familytree | | | | |,|-|-|-|^|-|-|-|-|.| | | }} | {{familytree | | | | |,|-|-|-|^|-|-|-|-|.| | | }} | ||
{{familytree | | | B01 | | | | | | | | B02 | | |B01= |B02= }} | {{familytree | | | B01 | | | | | | | | B02 | | |B01= |B02= }} |
Revision as of 15:10, 9 January 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahmoud Sakr, M.D. [2]
Definition
Alcohol withdrawal is defined as an array of signs and symptoms that a chronic alcoholic presents with, when he abruptly ceases alcohol intake. It occurs within 6-48 hours after cessation of alcohol intake.
Diagnostic criteria
A. Sudden reduction/termination in chronic alcohol intake. B. Two (or more) of the following, developing within several hours to a few days after criterion A: 1. Autonomic hyperactivity (e.g., sweating or pulse rate > than 100/minute) 2. Hand tremors 3. Insomnia 4. Gastrointestinal upset (Nausea or vomiting) 5. Transient visual, tactile, or auditory hallucination s or illusions 6. Psychomotor agitation 7. Anxiety 8. Grand mal seizures C. The symptoms in criterion B causing clinically significant impairment of patients social, occupational or other aspects of life. D. The symptoms cannot be better explained by a general medical condition or other mental disorder.
Management
Shown below is an algorithm summarizing the approach to [[disease name]].
Characterize the symptoms: Minor withdrawal symptoms: 6-12 hours ❑ Anorexia ❑ Anxiety/Palpitations ❑ Diaphoresis ❑ Gastrointestinal upset ❑ Headache ❑ Insomnia ❑ TremulousnessAlcoholic hallucinosis: 12-24 hours ❑ Visual hallucinations ❑ Auditory hallucinations ❑ Tactile hallucinationsWithdrawal seizures: 24-48 hours ❑ Generalized tonic-clonic seizures Alcohol withdrawal delirium (delirium tremens): 48-72 hours ❑ Hallucinations (predominately visual) ❑ Disorientation ❑ Tachycardia ❑ Hypertension ❑ Low-grade fever ❑ Agitation ❑ Diaphoresis | |||||||||||||||||||||||||||||||||