Alcohol withdrawal
Summary
Definition
History and exam
Key diagnostic factors
- alcohol use
- change in mental status
- hallucinations
- seizures
- delusions
- hypertension or hypotension
- fever or hypothermia
- hyperglycemia or hypoglycemia
- features of clinical instability
Other diagnostic factors
- tremor
- nausea and vomiting
- anorexia
- anxiety/restlessness
- emotional lability
- insomnia
- irritability
- diaphoresis
- headache
- fine tremor
- agitation
- tachycardia
Risk factors
- history of alcohol withdrawal syndrome (AWS) and alcohol withdrawal delirium
- abrupt withdrawal of alcohol
Diagnostic tests
1st tests to order
- BUN and serum creatinine
- LFTs
- ethanol concentration
- electrolyte panel
- CBC
Tests to consider
- CT of head
- chest x-ray
- electroencephalogram (EEG)
- blood-borne virus screen
Treatment algorithm
all patients
Contributors
Expert advisers
Hong K. Kim, MD, MPH
Associate Professor
Department of Emergency Medicine
University of Maryland School of Medicine
Baltimore
MD
Declarações
HKK declares that he has no competing interests.
Nicholas J. Connors, MD
Program Director
HCA Healthcare/Mercer University/Trident Medical Center
Emergency Medicine Residency Program
Charleston
SC
Declarações
NJC declares that he has no competing interests.
Revisores
Kinjal Sethuraman, MD, MPH
Associate Director
International Emergency Medicine
Long Island Jewish Hospital
New York
NY
Declarações
KS declares that he has no competing interests.
Paul S. Haber, MD
Royal Prince Alfred Hospital and Discipline of Medicine
The University of Sydney
Sydney
Australia
Declarações
PSH is an author of a reference cited in this topic.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Bayard M, McIntyre J, Hill KR, et al. Alcohol withdrawal syndrome. Am Fam Physician. 2004 Mar 15;69(6):1443-50.Texto completo Resumo
American Society of Addiction Medicine. The ASAM clinical practice guideline on alcohol withdrawal management. J Addict Med. 2020 May/Jun;14(3s suppl 1):1-72.Texto completo Resumo
Bråthen G, Ben-Menachem E, Brodtkorb E, et al. Chapter 29: alcohol-related seizures. EFNS guidelines of alcohol-related seizures. In: Gilhus NE, Barnes MP, Brainin M, eds. European handbook of neurological management. 2nd ed, v1. Oxford, UK: Blackwell Publishing; 2011:429-36.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. Text revision. (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Sympathomimetic toxicity
- Encephalitis
- Meningitis
Mais Diagnósticos diferenciaisDiretrizes
- The ASAM clinical practice guideline on alcohol withdrawal management
- Assessment and management of alcohol dependence and withdrawal in the acute hospital
Mais DiretrizesCalculadoras
Alcohol Consumption Screening AUDIT Questionnaire
Mais CalculadorasFolhetos informativos para os pacientes
Alcohol withdrawal
Mais Folhetos informativos para os pacientes
Conectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal