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what are the only 2 substances that have life-threatening withdrawal
alcohol and benzos
triad for wernecke’s encephalopathy
ophthalmoplegia
confusion
ataxia
korsakoff’s psychosis
(caused by thiamine/B1 deficiency from alcohol)
anterograde amnesia
retrograde amnesia
confabulation
stages of alcohol withdrawal
minor withdrawal (6-12 hours) → tremors, irritability, anxiety, headache, tachycardia, insomnia
alcoholic hallucinations (12-24hours) → auditory & visual (sometimes tactile too)
withdrawal seizure (24-28 hours) → generalized tonic-clonic seizure
delirium tremens (48-96 hours) → delirium, severe autonomic instability, disorientation, hallucinations, agitation
1st line for alcoholic withdrawal
benzos
order of supportive management for alcohol withdrawal
thiamine BEFORE glucose
how to treat hallucinations in alcohol withdrawal
antipsychotic with taper (haloperidol 5 mg)
which protocol is used for alcohol use
CIWA