Distill the management of inpatient alcohol withdrawal down to its core with Dr. Shawn Cohen (@ShawnCohen_MD, Yale University). This episode is full of practical pearls, and we discuss the ins and outs of managing alcohol withdrawal in the hospital setting. Learn how to triage patients in the hospital, which benzodiazepines to select, the pathophysiology of alcohol withdrawal, and phenobarbital for the management of alcohol withdrawal.
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Credits
Producer, writer, show notes, cover art, and infographic: Zina Huxley-Reicher, MDHosts: Carolyn Chan, MD and Zina Huxley-Reicher, MDReviewer: Payel Jhoom Roy, MD, MScShowrunner: Carolyn Chan, MDTechnical Production: PodpasteGuest: Dr. Shawn Cohen
Show Segments
Intro 0:00Guest bio - 3:17Case 1- 5:20Alcohol withdrawal pathophysiology - 6:10Kindling effect - 9:05Diagnosing alcohol withdrawal and clinical withdrawal scales - 10:12Severe alcohol withdrawal definition - 15:26 Triaging a patient - 16:50Medication management for alcohol withdrawal syndrome- 19:37Decisions between benzodiazepines and phenobarbital and formulation - 23:47Choices of benzodiazepines in hepatic impairment - 26:30 Symptom triggered vs. fixed protocol - 28:10Benzodiazepine resistant alcohol withdrawal - 33:33Timeline of alcohol withdrawal syndrome symptoms - 42:38ICU management of alcohol withdrawal - 46:27Discharge planning and management of alcohol use disorder - 48:50Take home points - 51:45Lightning round- 53:43Outro - 56:01