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Identification and Management of Alcohol Withdrawal Syndrome

机译:戒酒综合症的识别与管理

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摘要

Symptoms of alcohol withdrawal syndrome (AWS) may develop within 6-24 h after the abrupt discontinuation or decrease of alcohol consumption. Symptoms can vary from autonomic hyperactivity and agitation to delirium tremens. The gold-standard treatment for AWS is with benzodiazepines (BZDs). Among the BZDs, different agents (i.e., long-acting or short-acting) and different regimens (front-loading, fixed-dose or symptom-triggered) may be chosen on the basis of patient characteristics. Severe withdrawal could require ICU admission and the use of barbiturates or propofol. Other drugs, such as alpha(2)-agonists (clonidine and dexmetedomidine) and beta-blockers can be used as adjunctive treatments to control neuroautonomic hyperactivity. Furthermore, neuroleptic agents can help control hallucinations. Finally, other medications for the treatment for AWS have been investigated with promising results. These include carbamazepine, valproate, sodium oxybate, baclofen, gabapentin and topiramate. The usefulness of these agents are discussed.
机译:突然停药或饮酒量减少后的6-24小时内,可能会出现戒酒综合症(AWS)的症状。症状可能从自主神经过度活跃和躁动到ir妄。 AWS的黄金标准疗法是使用苯二氮卓类(BZD)。在BZD中,可以根据患者的特征选择不同的药物(即长效或短效)和不同的治疗方案(前负荷,固定剂量或症状触发)。严重撤药可能需要入ICU并使用巴比妥类药物或异丙酚。其他药物,例如α(2)-激动剂(可乐定和右美托咪定)和β-受体阻滞剂,可以用作辅助治疗,以控制神经自主神经亢进。此外,抗精神病药可以帮助控制幻觉。最后,对用于治疗AWS的其他药物进行了研究,结果令人鼓舞。这些包括卡马西平,丙戊酸盐,羟丁酸钠,巴氯芬,加巴喷丁和托吡酯。讨论了这些试剂的有效性。

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