3.5 Management of Abuse Disorders

nickelson study guide

primary tx for ethanol (alcohol) w/d

benzodiazepines

tx for ethanol (alcohol w/d) if the pt has cirrhosis

lorazepam or oxazepam

tx for ethanol w/d if a pt needs seizure contrl

phenobarbital

supportive tx for ethanol w/d

thiamine

folate

multivitamin

fluids

prophylaxis tx for ethanol w/d

oral chlordiazepoxide

what agents help pts stay off alcohol?

naltrexone, acamprosate, disulfiram

how is symptom triggered alcohol w/d treatment done?

only give benzos if pt has symptoms, based on the CIWA-Ar, needs assessments q10-15 mins if severe cases

stable pts need assessments q hr adn then every 4-6 hrs

pros of symptom triggered tx for alcohol w/d

less total meds, shorter duration of treatment, more pt specific, land mark trial evidence

cons of symptom triggered alcohol w/d tx

closer monitoring, more time and effort on staff, frequent reassessments

how is prophylaxis of alcohol w/d done?

give IV benzos on a fixed schedule regardless of symptoms

pros of prophylaxis for alcohol w/d

prevents w/d from occuring in high risk pts

less frequent assessments

cons of prophylaxis of alcohol w/d

higher total drug exposure, over sedation, not as patient specific as symptom based