Predictors of resistant alcohol withdrawal (RAW): A retrospective case-control study

Benedict, Neal; Wong, Adrian; Cassidy, Elizabeth; Lohr, Brian; Pizon, Anthony F.; Smithburger, Pamela L.; Falcione, Bonnie A.; Kirisci, Levent; Kane‐Gill, Sandra L.

doi:10.1016/j.drugalcdep.2018.08.017

Cited by 25 publications

(19 citation statements)

References 42 publications

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“…It is recommended to measure plasma potassium, sodium, glucose, and lactate levels among patients with alcohol intoxication [ 117 ]. Potassium and platelet levels are crucial in predicting the severity of alcohol withdrawal [ 118 , 119 ]. Hypokalemia along with hypochloremia are associated with a higher risk of delirium tremens.…”

Section: Plasma Potassium Deficitmentioning

confidence: 99%

Magnesium, Calcium, Potassium, Sodium, Phosphorus, Selenium, Zinc, and Chromium Levels in Alcohol Use Disorder: A Review

Baj

Flieger

Teresiński

et al. 2020

JCM

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Macronutrients and trace elements are important components of living tissues that have different metabolic properties and functions. Trace elements participate in the regulation of immunity through humoral and cellular mechanisms, nerve conduction, muscle spasms, membrane potential regulation as well as mitochondrial activity and enzymatic reactions. Excessive alcohol consumption disrupts the concentrations of crucial trace elements, also increasing the risk of enhanced oxidative stress and alcohol-related liver diseases. In this review, we present the status of selected macroelements and trace elements in the serum and plasma of people chronically consuming alcohol. Such knowledge helps to understand the mechanisms of chronic alcohol-use disorder and to progress and prevent withdrawal effects, also improving treatment strategies.

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Section: Plasma Potassium Deficitmentioning

confidence: 99%

Magnesium, Calcium, Potassium, Sodium, Phosphorus, Selenium, Zinc, and Chromium Levels in Alcohol Use Disorder: A Review

Baj

Flieger

Teresiński

et al. 2020

JCM

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“…Ñîãëàñíî ëèòåðàòóðíûì äàííûì, â ðÿäå ñëó÷àåâ íà ôîíå ïðèìåíåíèÿ âîçðàñòàþùèõ äîçèðîâîê áåíçîäèàçåïèíîâ íàáëþäàåòñÿ îòñóòñòâèå òåðà-ïåâòè÷åñêîãî ýôôåêòà [3]. Ó ïàöèåíòîâ, ðåçèñòåíòíûõ ê áåíçîäèàçåïèíàì ïðè èõ íàçíà÷åíèè â òåðàïåâòè÷åñêèõ äîçàõ, ðàçâèâàþòñÿ òÿaeåëûå ôîðìû ñèíäðîìà îòìåíû àëêîãîëÿ [4,5].…”

Section: Introductionunclassified

The relationship between the CYP2C19*17 genetic polymorphism and the efficacy and safety of diazepam in patients with alcohol withdrawal syndrome

Скрябин¹,

Застрожин

Grishina

et al. 2020

Bûll. sib. med.

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The aim of our study was to study the relationship between the CYP2C19 genetic polymorphism and the efficacy and safety of diazepam in patients with alcohol withdrawal syndrome in order to develop algorithms for optimizing the therapy of diazepam to reduce the risk of dose-dependent adverse drug reactions and pharmacoresistance.Materials and methods. The study was conducted on 30 Russian male patients suffering from alcohol withdrawal syndrome. For the treatment of anxiety, fear and emotional tension, patients received diazepam in injections at a dosage of 30,0 mg / day for 5 days. Genotyping was performed by real-time polymerase chain reaction with allele-specific hybridization. The efficacy and safety assessment was performed using psychometric scales and scales for assessing the severity of adverse drug reactions: the Clinical Institute Withdrawal Assessment for Alcohol scale, the visual-analogue scale of the craving for alcohol, and the side-effect scale.Results. Based on the results of the study, we revealed the differences in the efficacy of therapy in patients with different CYP2C19 -806C>T genotypes: (CC) –12,0 [–15,0; –8,0], (CT + TT) –7.0 [–14,0; –5,0], p = 0,001. The scores on the UKU scale, which was used to evaluate the safety of therapy, were also different: (CC) 8,0 [6,0; 12,0], (CT + TT) 6,0 [6,0; 12,0], p = 0,006.Conclusion. The relationships between the CYP2C19 genetic polymorphism and the efficacy and safety of diazepam were demonstrated. This should be taken into consideration when prescribing this drug to such patients in order to reduce the risk of adverse drug reactions and pharmacoresistance.

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“…Although the precise pathophysiology of RAW remains unclear, proposed mechanisms include a significant down-regulation of GABA A receptors and a decrease in the sensitivity of these receptors to benzodiazepines. 65,66 Furthermore, in addition to having no effect on the NMDA pathway, the clinical effects of benzodiazepines are dependent on circulating GABA. Given that reduced plasma concentrations of GABA have been noted in individuals with AUD, this may provide an additional explanation for RAW in some patients.…”

Section: Adjunctive Medicationsmentioning

confidence: 99%

<p>Management of Alcohol Withdrawal in the Emergency Department: Current Perspectives</p>

Wolf

Curry

Nacht

et al. 2020

OAEM

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Alcohol withdrawal syndrome (AWS) is a common, heterogenous, and lifethreatening complication of alcohol use disorder (AUD). AUD is a leading cause of worldwide mortality, and many patients with AUD will develop AWS during their ED course. This review summarizes the epidemiology, pathology, and management of AWS and AUD in the emergency setting. The time course of AWS and its impact on ED treatment is emphasized. Once AWS is diagnosed, symptom-triggered benzodiazepine administration remains the most commonly provided treatment but may not be appropriate for patients with significant medical or psychiatric comorbidity or pending discharge. In these cases, ED clinicians may consider short courses of barbiturates or alternative regimens based on novel anticonvulsants. Specific treatment protocols are enumerated for clinical practice. Finally, emergency providers must not only manage acute patients' AWS but also lay the foundation for successful treatment of AUD. An approach to the disposition of the patient with AUD is presented. The authors examine shortcomings in the extant literature and suggest opportunities for further study.

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Predictors of resistant alcohol withdrawal (RAW): A retrospective case-control study

Cited by 25 publications

References 42 publications

Magnesium, Calcium, Potassium, Sodium, Phosphorus, Selenium, Zinc, and Chromium Levels in Alcohol Use Disorder: A Review

Magnesium, Calcium, Potassium, Sodium, Phosphorus, Selenium, Zinc, and Chromium Levels in Alcohol Use Disorder: A Review

The relationship between the CYP2C19*17 genetic polymorphism and the efficacy and safety of diazepam in patients with alcohol withdrawal syndrome

<p>Management of Alcohol Withdrawal in the Emergency Department: Current Perspectives</p>

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