39 Alcohol Withdrawal
39.1 What this covers
- Who’s at risk?
- Timeline and Terms
- Treating
39.2 Learning objectives
- Who’s at risk?
- Timeline and Terms
- Treating
- Phenobarbital
39.3 Bottom line / summary
- PAWSS score - https://www.mdcalc.com/prediction-alcohol-withdrawal-severity-scale
- Reasons to go to an ICU?
- If high risk for severe withdrawal (aka legit history of prior seizures or confounding seizure disorder, withdrawal symptoms with detectable BAL - consider long acting in addition to symptom driven protocol)
- Withdrawal Seizures - 0-48 hours (12-24 after cessation highest risk)
- Note: this might be delayed if getting GABA dsrugs
39.4 Approach
- Delirium tremens? (Hemodynamic instability, agitation and hallucinations)
- Using Ativan every 1-2 hours
- CIWA scores in the 20s that aren’t all symptom trigger
- Concerns about over sedation / airway protection.
- Up front dose of 10 mg/kg
39.5 Red flags / when to escalate
- TODO: List red flags that require urgent escalation.
39.6 Common pitfalls
- TODO: Capture common errors or missed steps.
39.7 References
- https://www.mdcalc.com/prediction-alcohol-withdrawal-severity-scale
- https://www.vumc.org/trauma-and-scc/sites/default/files/publicfiles/Protocols/TICU%20Substance%20Abuse%20PMG.pdf
- https://emcrit.org/ibcc/etoh/
39.8 Source notes
39.8.1 Alcohol Withdrawal
40 Alcohol Withdrawal
40.1 Who’s at risk?
PAWSS score - https://www.mdcalc.com/prediction-alcohol-withdrawal-severity-scale
Reasons to go to an ICU?
- Delirium tremens? (Hemodynamic instability, agitation and hallucinations)
- Using Ativan every 1-2 hours
- CIWA scores in the 20s that aren’t all symptom trigger
- Concerns about over sedation / airway protection.
If high risk for severe withdrawal (aka legit history of prior seizures or confounding seizure disorder, withdrawal symptoms with detectable BAL - consider long acting in addition to symptom driven protocol)
40.2 Timeline and Terms
Withdrawal Seizures - 0-48 hours (12-24 after cessation highest risk)
Note: this might be delayed if getting GABA dsrugs
Delirium tremens - onset 48-96h after cessation
Alcohol Hallucinosis? Perceptual disturbances after cessation of drinking that is not associated with withdrawal and persists a lot longer.
40.3 Treating
40.3.1 Phenobarbital
Advantages: pharmacokinetics (2-4 day half life means auto-taper), predictable levels due to reliable distribution, IV onset 5 minutes, peak 15 so can be redosed q15-30. Also hits glutamate receptors so likely better mono therapy that benzo. 1:1 PO to IV conversion
Disadvantage: synergistic with Benzos for respiratory depression. Long half life means diagnosis should be right.
Usage:
MONOTHERAPY (or if minimal use of bento):
- Up front dose of 10 mg/kg
- Soft stop around 20 mg/kg
- Hard stop around 30 mg/kg
If you give 10mg/kg up front and there is not response, you can repose 130-260 mg q15-30 minutes until RAAS 0 or -1 or maximum hit.
RESCUE THERAPY
Probably skip the bolus and start with 130 or 260 mg doses.
Vanderbilt Protocol: https://www.vumc.org/trauma-and-scc/sites/default/files/public_files/Protocols/TICU%20Substance%20Abuse%20PMG.pdf
IBCC protocol https://emcrit.org/ibcc/etoh/