J.G.'s physician comes to the ICuto assess J.G. and tells you to "watch out" because J.G. is about to go into alcohol withdrawal delirium. the physician writes several medication orders. What medications are commonly prescribed for patients withdrawing from alcohol? Select all that apply.
a. Benzodiazepines, such as chlordiazepoxide (Librium)
b. Naltrexone (Revia), an opioid-reversal agent
c. Acamprosate (Campral), an alcohol deterrent agent
d. Clonidine (Catapres), an alpha-adrenergic blocker
e. Antiepileptic drugs, such as carbamazepine (Tegretol)
. Disulfiram (Antabuse), an alcohol deterrent agent
g. Atenolol (Tenormin), a beta-adrenergic blocker
Explain the rationale for each of the drugs used during acute alcohol withdrawal.
What chronic health problems are associated with alcoholism?
What laboratory tests might the physician order to assess for nutritional deficiencies or other
medical problems J.G. is experiencing?
Answers: a, d, e, g
Naltrexone, acamprosate, and disulfiram are used once the acute stage of alcohol withdrawal
delirium has subsided. The naltrexone helps reduce alcohol craving. The acamprosate and disulfiram
both work to help with adherence to abstinence from alcohol.
• Benzodiazepines, such as chlordiazepoxide (Librium), help reduce withdrawal symptoms, stabilize
VS, and prevent seizures.
• Clonidine (Catapres), an alpha-adrenergic blocker, is given to reduce the symptoms of autonomic
withdrawal.
• Antiepileptic drugs (carbamazepine [Tegretol]) are given to prevent the seizures that often occur
with withdrawal.
• Beta-adrenergic blockers (atenolol [Tenormin]) help stabilize VS, decrease craving, and reduce the
symptoms of autonomic withdrawal.
GI:Acute gastritis, pancreatitis, hepatitis, cirrhosis of the liver, esophageal varices, hemorrhoids,
ascites, vitamin B deficiencies (specifically thiamine, B12 , and folic acid)
Cardiovascular:portal hypertension, heart failure
Respiratory:susceptibility to pneumonia and other respiratory tract infections as a result of
respiratory depression and depressed cough reflex
Neurologic:central nervous system depression, peripheral neuropathy, interference with nerve
conduction, Wernicke encephalopathy (an inflammatory, hemorrhagic, degenerative condition of
the brain caused by thiamine deficiency), and Korsakoff psychosis (form of amnesia; inability to
learn new skills; disorientation)
Reproductive system:prostatitis
Fetus during pregnancy:fetal alcohol syndrome and other congenital defects
Nutritional problems:poor general nutrition; deficiencies in vitamins, particularly A, B, D, and K
(increasing bruising and bleeding tendency); deficiencies in magnesium and potassium levels
(might cause delirium, cardiac dysrhythmias, seizures); anemia and decreased white blood cells
(might cause an increased susceptibility to infection)
Complete blood count; chemistry panel with prealbumin; lipid profile; thiamine, folate, B 12, iron, magnesium levels; urinalysis; and hepatitis screen
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