机构:
Madigan Army Med Ctr, Tacoma, WA 98431 USA
Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA
Univ Washington, Seattle, WA 98195 USAMadigan Army Med Ctr, Tacoma, WA 98431 USA
Tiglao, Samuel M.
[1
,2
,3
]
Meisenheimer, Erica S.
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机构:
Madigan Army Med Ctr, Tacoma, WA 98431 USA
Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA
Univ Washington, Seattle, WA 98195 USAMadigan Army Med Ctr, Tacoma, WA 98431 USA
Meisenheimer, Erica S.
[1
,2
,3
]
Oh, Robert C.
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机构:
Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA
Univ Washington, Seattle, WA USAMadigan Army Med Ctr, Tacoma, WA 98431 USA
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
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.)
机构:
Univ Arizona, Maricopa Med Ctr, Dept Med, Phoenix, AZ 85008 USA
Arizona State Univ W, Coll Med, Dept Internal Med, Phoenix, AZ 85069 USA
Mayo Clin, Coll Med, Dept Internal Med, Scottsdale, AZ USAUniv Arizona, Maricopa Med Ctr, Dept Med, Phoenix, AZ 85008 USA
Carlson, Richard W.
Kumar, Nivedita N.
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机构:
Legacy Salmon Creek Med Ctr, Dept Med, Vancouver, WA USAUniv Arizona, Maricopa Med Ctr, Dept Med, Phoenix, AZ 85008 USA
Kumar, Nivedita N.
Wong-Mckinstry, Edna
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机构:
Univ Arizona, Dept Med, Coll Med, Tucson, AZ USA
Univ Arizona, Coll Med, Dept Internal Med, Tucson, AZ 85724 USAUniv Arizona, Maricopa Med Ctr, Dept Med, Phoenix, AZ 85008 USA
Wong-Mckinstry, Edna
Ayyagari, Srikala
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Univ Calif San Diego, Sch Med, Dept Hosp Med, San Diego, CA 92103 USAUniv Arizona, Maricopa Med Ctr, Dept Med, Phoenix, AZ 85008 USA
Ayyagari, Srikala
Puri, Nitin
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机构:
Virginia Commonwealth Univ, Inova Fairfax Hosp, Dept Internal Med, Falls Church, VA USAUniv Arizona, Maricopa Med Ctr, Dept Med, Phoenix, AZ 85008 USA
Puri, Nitin
Jackson, Frank K.
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机构:
Univ Arizona, Maricopa Med Ctr, Dept Med, Phoenix, AZ 85008 USA
Midwestern Univ, Glendale, AZ USAUniv Arizona, Maricopa Med Ctr, Dept Med, Phoenix, AZ 85008 USA
Jackson, Frank K.
Shashikumar, Shivaramaiah
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机构:
St Louis Univ, Dept Med, St Johns Mercy Med Ctr, St Louis, MO 63103 USA
St Louis Univ, Mercy Crit Care Training Program, St Louis, MO 63141 USAUniv Arizona, Maricopa Med Ctr, Dept Med, Phoenix, AZ 85008 USA
机构:
E Tennessee State Univ, James H Quillen Coll Med, Dept Family Med, Johnson City, TN 37614 USAE Tennessee State Univ, James H Quillen Coll Med, Dept Family Med, Johnson City, TN 37614 USA
Bayard, M
McIntyre, J
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E Tennessee State Univ, James H Quillen Coll Med, Dept Family Med, Johnson City, TN 37614 USAE Tennessee State Univ, James H Quillen Coll Med, Dept Family Med, Johnson City, TN 37614 USA
McIntyre, J
Hill, KR
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E Tennessee State Univ, James H Quillen Coll Med, Dept Family Med, Johnson City, TN 37614 USAE Tennessee State Univ, James H Quillen Coll Med, Dept Family Med, Johnson City, TN 37614 USA
Hill, KR
Woodside, J
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机构:
E Tennessee State Univ, James H Quillen Coll Med, Dept Family Med, Johnson City, TN 37614 USAE Tennessee State Univ, James H Quillen Coll Med, Dept Family Med, Johnson City, TN 37614 USA