Delirium tremens medical therapy: Difference between revisions

Jump to navigation Jump to search
Line 7: Line 7:
*For sedation, [[benzodiazepines]] are the first choice.  
*For sedation, [[benzodiazepines]] are the first choice.  
*Long-acting [[benzodiazepines]] such as, [[diazepam]] and [[chlordiazepoxide]] are preferred over short-acting [[benzodiazepine]] to achieve a stable serum level.
*Long-acting [[benzodiazepines]] such as, [[diazepam]] and [[chlordiazepoxide]] are preferred over short-acting [[benzodiazepine]] to achieve a stable serum level.
*There are three options for the [[treatment]] of delirium tremens,
*There are three approved techniques for the use of [[benzodiazepines]] in these [[patients]] in order to achieve
**Front loading (Most preferred)
**Front loading (Most preferred)
**Symptom-triggered
**Symptom-triggered

Revision as of 15:56, 10 August 2023

Delirium Tremens Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Delirium Tremens from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Delirium tremens medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Delirium tremens medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Delirium tremens medical therapy

CDC on Delirium tremens medical therapy

Delirium tremens medical therapy in the news

Blogs on Delirium tremens medical therapy

Directions to Hospitals Treating Delirium tremens

Risk calculators and risk factors for Delirium tremens medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]

Overview

Medical Therapy

  • The mainstay of treatment for delirium tremens is supportive care and sedation.
  • For sedation, benzodiazepines are the first choice.
  • Long-acting benzodiazepines such as, diazepam and chlordiazepoxide are preferred over short-acting benzodiazepine to achieve a stable serum level.
  • There are three approved techniques for the use of benzodiazepines in these patients in order to achieve
    • Front loading (Most preferred)
    • Symptom-triggered
    • Fixed-dose (Least preferred)


Contraindication: In case of liver impairment or lack of IV access, lorazepam is preferred over diazepam.



Pharmacotherapy is symptomatic and supportive. Typically the patient is kept sedated with benzodiazepines, such as diazepam (Valium), lorazepam (Ativan) or oxazepam (Serax) and in extreme cases low-levels of antipsychotics, such as haloperidol until symptoms subside. Older drugs such as paraldehyde and clomethiazole were the traditional treatment but these have now largely been superseded by the benzodiazepines, although they may still be used as an alternative in some circumstances. Acamprosate is often used to augment treatment, and is then carried on into long term use to reduce the risk of relapse. If status epilepticus is present, seizures are treated accordingly. Controlling environmental stimuli can also be helpful, such as a well-lit but relaxing environment to minimize visual misinterpretations such as the visual hallucinations mentioned above.

References

Template:WH Template:WS