Alcohol withdrawal: Inpatient management
Revision as of 17:28, 15 February 2016 by 3amrbadawy (talk | contribs)
Management
Start aggressive Benodiazepine therapy at CIWA score of 8. Consider ICU admission with score >20
Benzodiazepines
- Diazepam (Valium) 5-10mg IV (depending on severity)
- May repeat q5-10min for severe withdrawal (double dose until desired effect achieved)
- Lorazepam (Ativan) 1-4mg IV (depending on severity)
- May repeat q15-20min for severe withdrawal (titrated to effect)
- Rarely causes hepatitis, as opposed to diazepam which may cause a cholestatic hepatitis[1]
Alpha-2 agonists (Dexmedetomidine)
- Decrease severity of sxs, but only supplemental to GABA-ergic first-lines
- Dexmedetomidine drip, start 0.2 mcg/kg/min, likely needing no more than 0.7 mcg/kg/min
Barbituates (Phenobarbital)
- Used when refractory to benzodiazepines
- Phenobarbital 130-260 mg IV q 15-20 minutes
External Links
References
- ↑ National Institute of Diabetes and Digestive and Kidney Diseases. Lorazepam Drug Record. http://livertox.nih.gov/Lorazepam.htm