5-Minute Emergency Consult
Withdrawal, Alcohol
Withdrawal, Alcohol is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- Alcohol withdrawal is the most common withdrawal syndrome encountered in the emergency department
- Neuroexcitation is the hallmark of alcohol withdrawal
- Alcohol withdrawal may be life threatening
- More severe symptoms and signs are seen in patients with prior episodes of withdrawal, a process called kindling
- Alcoholism is not uncommon among older adults
- Age-related increase in alcohol sensitivity
- Alcohol-related problems may be misdiagnosed as normal consequences of aging
Etiology
Etiology
- Chronic alcohol use downregulates GABA (inhibitory) receptors, upregulates NMDA (excitatory) receptors
- Abstinence or reduction in use leads to increased adrenergic activity because of these receptor adaptations
- 4 components to alcohol withdrawal:
- Early withdrawal
- Withdrawal seizures
- Alcoholic hallucinosis
- Delirium tremens (DTs)
- DTs occur in 5% of patients experiencing alcohol withdrawal
- DTs have a 5–15% mortality rate
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Basics
Description
Description
- Alcohol withdrawal is the most common withdrawal syndrome encountered in the emergency department
- Neuroexcitation is the hallmark of alcohol withdrawal
- Alcohol withdrawal may be life threatening
- More severe symptoms and signs are seen in patients with prior episodes of withdrawal, a process called kindling
- Alcoholism is not uncommon among older adults
- Age-related increase in alcohol sensitivity
- Alcohol-related problems may be misdiagnosed as normal consequences of aging
Etiology
Etiology
- Chronic alcohol use downregulates GABA (inhibitory) receptors, upregulates NMDA (excitatory) receptors
- Abstinence or reduction in use leads to increased adrenergic activity because of these receptor adaptations
- 4 components to alcohol withdrawal:
- Early withdrawal
- Withdrawal seizures
- Alcoholic hallucinosis
- Delirium tremens (DTs)
- DTs occur in 5% of patients experiencing alcohol withdrawal
- DTs have a 5–15% mortality rate
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Citation
Schaider, Jeffrey J., et al., editors. "Withdrawal, Alcohol." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307348/all/Withdrawal_Alcohol.
Withdrawal, Alcohol. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307348/all/Withdrawal_Alcohol. Accessed January 28, 2023.
Withdrawal, Alcohol. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307348/all/Withdrawal_Alcohol
Withdrawal, Alcohol [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2023 January 28]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307348/all/Withdrawal_Alcohol.
* Article titles in AMA citation format should be in sentence-case
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