Delirium tremens (DT’s) is a more severe alcohol withdrawal syndrome seen after excessive prolonged alcohol use. Prior episodes of DT’s or co morbid medical illness are risk factors for poor outcome. DT’s require rapid and robust medical intervention since, untreated, it can be fatal in up to 20% of cases but if treated this can be reduced to less than 1%.
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Diagnostic criteria alcohol withdrawal delirium include:
A. Disturbance of consciousness with reduced ability to focus, sustain, or shift attention (impaired awareness of person, place and time).
B. A change in cognition or the development of a perceptual disturbance.
C. The disturbance develops over a short period of time and tends to fluctuate during the day.
D. The disturbance developed after alcohol withdrawal (from history, physical exam or laboratory findings)
E. Other medical causes of delirium need to be ruled out.
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CURRENT LESSON OBJECTIVES
- How does alcohol's acute effects + use tolerance relate to alcohol withdrawal syndrome?
- Cite the diagnostic criteria for alcohol withdrawal.
- What are the diagnostic criteria for alcohol withdrawal delirium (delirium tremens)?
- What are the risk factors for more severe withdrawal symptoms like seizures and DTs?
- Describe the time course of withdrawal symptoms.
- List indications for hospitalization for inpatient alcohol withdrawal treatment.
- Describe the rational for the types of withdrawal treatments and the medications used.
- Describe a method used to individually adjust drug dose to treat withdrawal.
- What are 2 important medical complications seen in withdrawal and how do you treat them?
- What are the symptoms of an alcohol hangover and its possible causes and treatment?
- What are 2 important aspects of treatment following withdrawal?
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