Alcohol Withdrawal Syndrome: Outpatient Management

被引:0
|
作者
Tiglao, Samuel M. [1 ,2 ,3 ]
Meisenheimer, Erica S. [1 ,2 ,3 ]
Oh, Robert C. [4 ,5 ]
机构
[1] Madigan Army Med Ctr, Tacoma, WA 98431 USA
[2] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA
[3] Univ Washington, Seattle, WA 98195 USA
[4] Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA
[5] Univ Washington, Seattle, WA USA
关键词
DETOXIFICATION; METAANALYSIS; DISORDERS;
D O I
暂无
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Approximately one-half of patients with alcohol use disorder who abruptly stop or reduce their alcohol use will develop signs or symptoms of alcohol withdrawal syndrome. The syndrome is due to overactivity of the central and autonomic nervous systems, leading to tremors, insomnia, nausea and vomiting, hallucinations, anxiety, and agitation. If untreated or inadequately treated, withdrawal can progress to generalized tonic-clonic seizures, delirium tremens, and death. The three-question Alcohol Use Disorders Identification Test-Consumption and the Single Alcohol Screening Question instrument have the best accuracy for assessing unhealthy alcohol use in adults 18 years and older. Two commonly used tools to assess withdrawal symptoms are the Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised, and the Short Alcohol Withdrawal Scale. Patients with mild to moderate withdrawal symptoms without additional risk factors for developing severe or complicated withdrawal should be treated as outpatients when possible. Ambulatory withdrawal treatment should include supportive care and pharmacotherapy as appropriate. Mild symptoms can be treated with carbamazepine or gabapentin. Benzodiazepines are first-line therapy for moderate to severe symptoms, with carbamazepine and gabapentin as potential adjunctive or alternative therapies. Physicians should monitor outpatients with alcohol withdrawal syndrome daily for up to five days after their last drink to verify symptom improvement and to evaluate the need for additional treatment. Primary care physicians should offer to initiate long-term treatment for alcohol use disorder, including pharmacotherapy, in addition to withdrawal management. (Copyright (C) 2021 American Academy of Family Physidans.)
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页码:253 / 262
页数:10
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