124: ETOH Withdrawal

Caring for patients withdrawing from alcohol can be challenging to say the least. In this episode, host Sarah Lorenzini shares a case of a patient recovering from emergency surgery, and highlights the subtle but critical signs of alcohol withdrawal—like anxiety, tremors, confusion, tachycardia, and hypertension—that often go unrecognized until symptoms escalate.

Key topics covered in this episode include:

• The pathophysiology of alcohol withdrawal, focusing on how chronic alcohol use disrupts the balance between the brain’s inhibitory GABA and excitatory glutamate neurotransmitter systems.
• A detailed timeline of alcohol withdrawal symptoms, from early signs (6-12 hours) to severe complications like delirium tremens (48-72 hours).
• The importance of compassionate, non-judgmental care for patients with alcohol use disorder (AUD) during withdrawal, and why judgment rarely leads to positive change.
• The role of CIWA-Ar scoring to assess withdrawal severity and guide treatment, including common medications like benzodiazepines and the emerging use of phenobarbital for symptom management.
• Critical reminders to carefully evaluate all symptoms and avoid misattributing every instance of confusion or agitation to alcohol withdrawal, ensuring comprehensive care.

Tune in to learn how to recognize and manage alcohol withdrawal, keep patients safe, and provide the compassionate care they need during this vulnerable time.

Mentioned in this episode:

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