DELIRIUM TREMENS

 

Etiology: 

  1. ETOH affects GABA activity.

S & S:

  1. Withdrawal- occurs within hours and can occur at any ETOH level. Irritability and tremors are present.
     
  2. Hallucinations- visual or/and auditory hallucinations.
     
  3. Rum Fits- grand mal seizure after ETOH  w/d. This occurs  7-48 hrs s/p WD.
     
  4. Delirium- occurs > 48-72hrs.  temp, HR, BP, clouded and waxing MS.

DX:

  1. Based on history and symptoms

Treatment:

  1. IVF NS: Switch to D5NS after giving thiamine
     
  2. Benzodiazepines: Control both the seizures and w/d symptoms. Lorazepam (Ativan ) works rapidly and has reliable  absorption when given IM if IV is not available. Do not expect complete normalization of  VS with benzodiazepines.
     
  3. Thiamine 100 mg.
     
  4. MgSO4 2gm IV.

 

[BACK]