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In this episode, we review the high-yield topic of Alcohol Withdrawal from the Psychiatry section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Acute Alcohol Withdrawal from the Psychiatry section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the November 2025 Emergency Medicine Practice article, Diagnosis and Management of Emergency Department Patients With Alcohol Withdrawal SyndromeEpidemiology & Background Rising ED visits related to alcohol use. Mortality rates and spectrum of patient presentations. Importance of high suspicion and complexity of cases.Pathophysiology & Mechanisms Alcohol metabolism and neurochemical changes. Differential diagnosis: Conditions that mimic alcohol withdrawal.Prehospital & EMS Considerations Role of EMS in triage and initial management. Use of sobering centers vs. ED transport. Prehospital administration of benzodiazepines (IM midazolam).History & Risk Assessment Key questions to assess risk for alcohol withdrawal syndrome. Importance of patient history, medication use, and comorbidities. Discussion on patient honesty and rapport.Physical Exam & Scoring Systems DSM-5 criteria for alcohol withdrawal. Use of CIWA-AR, BAWS, and PAWSS scoring systems. Importance of objective measurement for monitoring and disposition.Complications & Special PresentationsComplicated alcohol withdrawal: Hallucinosis, seizures, delirium tremens. Diagnostic workup: Labs, imaging, and co-ingestions. Special populations: End-stage liver disease, pregnancy, intubated patients.Treatment Strategies Mainstay: Benzodiazepines (types, dosing, and protocols). Phenobarbital: Indications, dosing, and evidence. Adjunctive therapies: Thiamine, glucose, magnesium. Alternative/adjunct medications: Gabapentin, ketamine, dexmedetomidine, baclofen.Clinical Pearls & Practice Changes Early, aggressive therapy to prevent complications. Symptom-based vs. fixed-schedule treatment. Gabapentin as an alternative or adjunct. Anti-craving medications for relapse prevention.Disposition & Protocols Use of scoring systems for safe discharge, observation, or admission. Importance of protocolized approaches and community resources.Summary & Take-Home Points Five key practice-changing points. Clinical pathway.Emergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode1080. In this episode, I'll discuss using gabapentin to reduce benzodiazepine use in patients hospitalized with alcohol withdrawal.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode1070. In this episode, I’ll discuss respiratory depression from phenobarbital when used for alcohol withdrawal syndrome. The post 1070: Another Phenobarbital for Alcohol Withdrawal Study That Completely Misses the Point appeared first on Pharmacy Joe.
Today, Ali and Asif talk about comedian Nate Bargatze (3:03). The guys start off by discussing when they first heard of Bargatze as well as his early life. They then go over his work ethic and the fact that Nate is a “clean comic”. Ali and Asif then discuss Nate auditioning for The Daily Show, his failed ABC pilot, and a potential movie career. They then go over his amazing comedy style and his hilarious George Washington SNL sketch. Nate Bargatze struggled with alcohol abuse so in the second half, they discuss alcohol withdrawal (30:25). Asif starts off by discussing how common it is and who is at risk for alcohol withdrawal. Asif goes over the criteria for alcohol use disorder and what is going on in the brain during withdrawal. Ali then asks Asif about the different types of severity of alcohol withdrawal. Asif then talks about the short term treatment of withdrawal and medications that can be used to promote abstinence. The opinions expressed are those of the hosts, and do not reflect those of any other organizations. This podcast and website represents the opinions of the hosts. The content here should not be taken as medical advice. The content here is for entertainment and informational purposes only, and because each person is so unique, please consult your healthcare professional for any medical questions. Music courtesy of Wataboi and 8er41 from PixabayContact us at doctorvcomedian@gmail.comFollow us on Social media:Twitter: @doctorvcomedianInstagram: doctorvcomedianShow Notes: Comedian Nate Bargatze on Breaking Arena Records, Going Viral From ‘SNL' & Staying Non-Political: ‘You Don't Need Me to Add to That' https://www.billboard.com/culture/events/comedian-nate-bargatze-on-breaking-arena-records-saturday-night-live-and-staying-non-political-1235742263/The Nicest Man in Stand-Up: https://web.archive.org/web/20210917104340/https://www.theatlantic.com/magazine/archive/2021/10/nate-bargatze-nicest-stand-up/619812/Nate Bargatze Conquered Comedy. Hollywood is Next: https://www.hollywoodreporter.com/tv/tv-features/nate-bargatze-interview-stand-up-comedy-acting-1236085644/Alcohol Use: Managing alcohol withdrawal: https://www.camh.ca/en/professionals/treating-conditions-and-disorders/alcohol-use/alcohol-use---treatment/treatment---managing-alcohol-withdrawalAlcohol Withdrawal Syndrome: https://www.ncbi.nlm.nih.gov/books/NBK441882/Alcohol Withdrawal Syndrome: Outpatient Management: https://www.aafp.org/pubs/afp/issues/2021/0900/p253.htmlDelirium Tremens (DTs) Clinical Presentation: https://emedicine.medscape.com/article/166032-clinical Hosted on Acast. See acast.com/privacy for more information.
Dr Anirudh Kumar discusses practical aspects of assessment and management of alcohol withdrawal syndrome in this episode.Please see the following resource referenced in today's podcast:CIWA-Ar ScaleFollow us on Instagram!Join our Discord server or follow our podcast via our Linktree!
Alcohol withdrawal can be unpredictable and potentially dangerous without proper medical care. Understanding what happens during detox and why professional supervision matters can help you or a loved one prepare for this critical first step in recovery. Visit https://sayarc.com to learn more. Addiction Resource Center LLC. City: Yuba City Address: 1002 Live Oak Blvd. Website: https://sayarc.com
Is it possible that the cutting edge therapy for alcohol withdrawal care is one of the older tools in our bag? Possibly! In this chapter, one of the rising stars, Dr. Brandy Hernandez, Emergency Pharmacist, discusses the case for phenobarbital for helping patients for with their acute alcohol withdrawal symptoms. Find out when it may be preferable, what we don't know yet, what the pitfalls are, and more!
In this episode, Kevin and Dr. Wolf delve into a critical but often underestimated condition: alcohol withdrawal syndrome (AWS). They challenge the assumptions and biases emergency nurses may bring to patient care, particularly in identifying withdrawal symptoms in individuals who don't fit the "typical" profile. The discussion emphasizes the importance of early recognition, exploring how biases can cloud clinical judgment and hinder effective decision-making. Kevin and Dr. Wolf also provide essential insights into screening, scoring, and treating AWS, equipping emergency nurses with the knowledge needed to improve patient outcomes for this potentially life-threatening condition. MD Calc CIWA -AR https://www.mdcalc.com/calc/1736/ciwa-ar-alcohol-withdrawal Prediction of Alcohol Withdrawal Severity Scale https://www.mdcalc.com/calc/10102/prediction-alcohol-withdrawal-severity-scale#pearls-pitfalls Follow us on: Facebook: https://www.facebook.com/Art-of-Emergency-Nursing-276898616569046/ YouTube: https://www.youtube.com/channel/UCJTnz4phtCTjojTIDJo2afA?view_as=subscriber Twitter: @AoenPodcast Instagram: https://www.instagram.com/artofemergencynursing/ To support the show: Leave an honest review on iTunes. Your ratings and reviews greatly contribute to the success of the podcast, and I appreciate each and every one of them. Subscribe on Apple Podcasts, Google Podcasts, or your preferred podcast platform to never miss an episode. Thank you for being a part of our AOEN community!
In the December 2024 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss managing alcohol withdrawal in the emergency department and evaluation and management of spontaneous intracranial hemorrhage. As always, you'll also hear about the hot topics covered in CDEM's regular features, including a boy with pharyngitis and a rash in Clinical Pediatrics, a reverse total shoulder arthroplasty dislocation in Orthopedics and Trauma, a zipper injury in The Critical Procedure, diagnosis and treatment of sexually transmitted infections in The LLSA Literature Review, and a newborn with bloody stool in The Critical Image.
Podcast summary of articles from the November 2024 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include CPR, COPD, Prolonged QT syndrome, SVT, thrombolytics for pulmonary embolisms, and phenobarbital for alcohol withdrawal. Guest speaker is Dr. Kinda Sweidan.
Each month, EMedHome.com presents EMCast, the 90-minute podcast hosted by Dr. Amal Mattu, the premier educator in Emergency Medicine. Subscribe to EMedHome.com for an array of clinical content that will impact every shift. This month's EMCast covers:(1) Alcohol Withdrawal, Cannabinoid Hyperemesis Syndrome(2) Vasopressors in the ED(3) Non-Invasive Ventilation in the ED
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode955. In this episode, I'll discuss the use of phenobarbital in severe alcohol withdrawal. The post 955: Has Everyone Gotten the Mechanism of Phenobarbital in Alcohol Withdrawal Wrong? appeared first on Pharmacy Joe.
This week, Dr Chris and Relebongile find out how dietary salt affects the body, how loneliness and loss of a loved one can cause ill-health, what a blind person "sees" in their mind's eye, how broken fingers heal, how many cigarettes does it take to get hooked, and why does alcohol withdrawal cause shaking and tremors... Like this podcast? Please help us by supporting the Naked Scientists
This week, Dr Chris and Relebongile find out how dietary salt affects the body, how loneliness and loss of a loved one can cause ill-health, what a blind person "sees" in their mind's eye, how broken fingers heal, how many cigarettes does it take to get hooked, and why does alcohol withdrawal cause shaking and tremors... Like this podcast? Please help us by supporting the Naked Scientists
Send us a Text Message.Hey, hey, all you Vipers, let's send a big Happy Birthday shout-out to Mr Weedman today! Mr & Mrs Weedman are getting normal with the help of some juicy Green Crack from their friend Matty's home garden. Together they talk about their past week of fun and events, they tell some fun stories and then they get down to delivering great information from the world of cannabis. Mr Weedman talks about the popularity of disposable THC cartridges, he explains the infused pre-roll trend, and he breaks down terpenes - think terpenes 101. He also delivers cannabis news from all around this wild world. Mrs Weedman shares a study on the possibility of cannabis helping with menopause symptoms, a study on the effects of cannabis when dealing with alcohol withdrawal, and a great article on CBD lotion being linked to reduced UV-ray skin damage. Thanks for listening and as always, hit us up!TWITTER: @weedman420podIG: @weedman420chronicles2.0YouTube: Weedman420 ChroniclesEMAIL: weedman420chronicles@gmail.comSHOP: www.eightdecades.comIG: @eightdecadesEMAIL: eightdecadesinfo@gmail.com#ImHigh #Cannabis #StomptheStigma #HomeGrow #FreethePlant #Stoners #Burners #rosin #liverosin #Potheads #Vipers #CannabisEducation #CannabisResearch #Weed #Marijuana #LegalizeIt #CannabisNews #CBD #Terpenes #Podcast #CannabisPodcast #eightdecades #LPP #Lifestyle #HealthyLifestyle #NaturalMedicine #PlantMedicine #News #Research #MedicalMarijuana #Infused #420 #Education #Health #Wellness #WorldNews #Gardening #budtender #kief #hemp #dabs #hash #joints #edibles #gummies #tincture #vapes #esters #pauliesayssmokesmart Article Links:* https://www.fingerlakes1.com/2024/07/22/the-popularity-surge-of-disposable-thc-carts-among-consumers/* https://www.greenstate.com/health/ask-dr-leigh-cannabis-and-menopause/* https://www.greenstate.com/explained/terpene-chart/* https://www.greenstate.com/lifestyle/fuzzy-joints/* https://www.psypost.org/new-research-sheds-light-on-cannabinoids-impact-on-anxiety-during-alcohol-withdrawal/* https://www.greenstate.com/news/home-grow-rights/COPYRIGHT 2021 WeedMan420Chronicles©
Withdrawal is pretty obvious, the symptoms that we experience when we quit drinking. There is a lot more to it though. In this episode you'll learn about why we have withdrawal symptoms and how alcohol impacts the central nervous system. Then I will focus on kindling and how withdrawal can become worse the more cycles we go through, and how returning to drinking during the withdrawal period puts stress on the brain and strengthens the associations we have with alcohol leading to more intense cravings the next time we try to quit. If you are stuck in the back and forth then this is an important episode to listen to. This episode is part of a 9 episode series for Dry July 2024. Make sure to follow my podcast so you don't miss the rest of the series. Dry July Sober Powered Skills Special Dry July Course https://www.soberpowered.com/skills Sober Support: Community & Meetings: Living a Sober Powered Life https://www.soberpowered.com/membership Anger Management Program https://www.soberpowered.com/anger Weekly emails on Thursdays https://www.soberpowered.com/email Free resources https://www.soberpowered.com/free Thank you for supporting this show by supporting my sponsors. Learn more: https://www.soberpowered.com/sponsors If you enjoyed this episode please consider buying me a coffee to support my work https://www.buymeacoffee.com/soberpowered Sources are posted on my website Disclaimer: all of the information described in this podcast is my interpretation of the research combined with my opinion. This is not medical advice. Learn more about your ad choices. Visit megaphone.fm/adchoices
When the diseased liver is unable to filter out neurotoxins like ammonia, we can see a spectrum of the neuropsychiatric symptoms of hepatic encephalopathy. For the final installment in our liver failure series, host Sarah Lorenzini highlights a complicated case of hepatic encephalopathy where critical thinking and interdisciplinary teamwork were key to preventing further complications.She examines the common signs and symptoms of hepatic encephalopathy, factors that trigger or exacerbate the condition, and challenges nurses face in the diagnostic process. This episode also dives into treatment strategies and how to differentiate between hepatic encephalopathy and alcohol withdrawal.Tune in to learn how cirrhosis can lead to hepatic encephalopathy, the effect of neurotoxins in the brain, and how you, as a nurse, can manage patient care!Topics discussed in this episode:Assessment of Sarah's rapid response consult patientThe team's interventions and patient outcomePathophysiology of hepatic encephalopathySigns and symptoms of hepatic encephalopathyDiagnostic challenges and aggravating factorsStrategies to manage hepatic encephalopathyHepatic encephalopathy versus alcohol withdrawalMentioned in this episode:AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!Rapid Response and Rescue Intro CourseCONNECT
Are you ready to feel confident without relying on alcohol? Join us on this eye-opening episode of The Be Better Broadcast as we dive into the journey of sobriety with Duncan Bhaskaran. After 2 DECADES of excessive drinking, Duncan turned his life around and then trained with the world's most successful stop smoking clinic. Now, he is dedicated to making alcohol-free living the norm and helping others break free from alcohol's grip.Duncan, the author of ‘Real Men Quit', brings a unique perspective to overcoming alcohol addiction with his insightful and practical advice. His mission is to show that a sober life is not only possible but profoundly fulfilling.In our conversation, Duncan will cover:
In the latest episode of "Cracking Addiction," Dr Ferghal continues the journey with Dr Richard, exploring the critical subject of alcohol withdrawal. This episode is particularly focused on the timings, the natural history of withdrawal symptoms, and the potential complications faced during alcohol detoxification. The discourse provides key insights on when symptoms typically appear, ranging from mild to severe cases, and discusses methods of intervention based on the severity of withdrawal symptoms.**Learning Outcomes:**1. **Understanding the Onset of Alcohol Withdrawal:** This episode helps listeners grasp the variable onset of alcohol withdrawal symptoms which can appear from 12 to 24 hours after the last drink. Ferghal and Richard explain the concept of 'day two' of withdrawal, enhancing understanding of the physiological changes happening in the body during this time.2. **Risk Factors and Complications:** The conversation thoroughly covers potential complications, such as seizures and delirium tremens. It emphasizes the importance of recognizing past withdrawal histories and comorbidities that heighten withdrawal complications, which proves crucial for healthcare providers in assessing risk.3. **Ethical and Effective Treatment Strategies:** Highlighting the dangers of protocol-driven approaches in detoxification settings, Richard points out the importance of tailored treatment plans. They discuss the use of diazepam to manage symptoms effectively and the strategies to mitigate risks such as 'kindling.'4. **Proper Management of Seizures and Delirium:** Key strategies for managing severe withdrawal symptoms like seizures and delirium tremens (DTs) are elaborated on, including the avoidance of certain medications and the focus on benzodiazepine regulation.**Actionable Takeaways:**1. **Recognise the Early Signs:** Listeners are encouraged to identify early withdrawal symptoms to initiate timely treatment, potentially preventing the escalation towards more severe complications such as DTs.2. **Avoid High-Protocol Rigidity:** The importance of flexibility in treatment protocols was underscored, stressing individual patient needs over rigid guidelines, which might prevent effective symptom management.3. **Prepare For Seizure Management:** Understanding that alcohol withdrawal seizures could peak around 24 hours post-last ingestion, healthcare providers should monitor and adjust benzodiazepine dosages accordingly.4. **Psychosocial Aspects of Withdrawal:** Addressing withdrawal is not just about managing physical symptoms but also involves supporting the patient's psychological well-being to enhance recovery success rates.
In this riveting episode of Cracking Addiction, Dr Ferghal Armstrong and Dr Richard Bradlow shed light on the complex issue of alcohol use and withdrawal, providing critical insights and practical guidance for individuals and healthcare professionals alike. The duo explores detailed diagnostic criteria and the implications of daily alcohol consumption and addresses the signs that might indicate a move towards severe withdrawal symptoms. Learn about the societal impacts of drinking norms and the misconceptions that might be putting individuals at risk without them even realising it. This episode uncovers the stark differences between casual drinking and potential alcohol dependence that could lead to serious health consequences.**Learning Outcomes:**1. Understand the varied patterns of alcohol withdrawal and how personal history affects its likelihood. Richard emphasizes the importance of individual patient history in predicting withdrawal symptoms such as seizures.2. Discover the guidelines for safe alcohol consumption set by different governments and how they compare, highlighting discrepancies that might affect public health advice. Particularly, the comparison between Australian, Canadian, and American standards provides a global view of alcohol consumption benchmarks.3. Recognize the clinical signs of alcohol withdrawal, applying both psychological and physiological markers, including the mnemonic PAST NIGHT (Psychomotor Agitation, Anxiety, Seizures, Terrors, etc.) proposed by Ferghal for easier recall during assessments.4. Learn about the significant risks associated with ignoring other potential diagnoses when a patient presents symptoms similar to alcohol withdrawal, underscoring the necessity of comprehensive medical evaluation.
For some of us, each time we go through withdrawal, the next withdrawal is worse. This is called kindling and in this episode I'm explaining what kindling is and how it happens. You'll learn why we get withdrawal symptoms when we quit drinking, what delirium tremens is, and how kindling makes it harder to get sober. I'll also discuss what counts as a cycle of withdrawal and what doesn't. What to listen to next: E191: Going Back and Forth Makes Your Cravings Stronger E201: Your Dysregulated Stress Response E203: Why You Still Want Alcohol Even When You Hate It (It's Dopamine!) E22: Why You Think Alcohol Helps Your Anxiety E180: Why Your Drinking Gets Worse Over Time, Not Better E196: How the Brain Recovers After Quitting Drinking E170: Here's Why Early Sobriety is So Hard (it's dopamine) E161: What to Expect Emotionally in Early Sobriety Get Support: Community & Meetings: Living a Sober Powered Life https://www.soberpowered.com/membership Anger Management Program https://www.soberpowered.com/anger Weekly emails on Thursdays https://www.soberpowered.com/email Quiz: what is causing your alcohol cravings? https://www.tryinteract.com/share/quiz/65db8de55d674c92e333e001 Free resources https://www.soberpowered.com/free Thank you for supporting this show by supporting my sponsors. Learn more: https://www.soberpowered.com/sponsors If you enjoyed this episode please consider buying me a coffee to support my work https://www.buymeacoffee.com/soberpowered Sources are posted on my website Disclaimer: all of the information described in this podcast is my interpretation of the research combined with my opinion. This is not medical advice. Learn more about your ad choices. Visit megaphone.fm/adchoices
This week, Kate, Henry and Mark discuss pharmacotherapy for alcohol use disorder, using opioids in adults with cancer pain who also use non-medical stimulants, and brexpiprazole for agitation in patients with Alzheimer's dementia.
Speaker: Dr. Abhishek Singh No Disclosures Objectives: •Outline the DSM 5 criteria for substance use disorders •Identify etiologies and pathophysiology of Alcohol use disorders and Stimulant Use disorder •Describe treatment options for Alcohol Use disorder various substance use disorders •Identify how interprofessional team strategies can improve patient outcomes in SUD •Identify and discuss new challenges in SUD
This interview on the Reshape Your Health Podcast is especially motivating, especially if you have a social drinking habit. After this interview, I committed to not drink for 30 days. Prior to this interview, I would have no more than 1 drink per week, so it wasn't a big stretch. I'd encourage you to do the same after listening to this interview. James Swanwick is CEO and founder of Swanwick Sleep, Alcohol Free Lifestyle, and host of the podcast, Alcohol Free Lifestyle. He's one of the people leading the crusade on people having a better relationship with alcohol and improving their sleep. His teachings have been featured in Forbes, Entrepreneur magazine and Psychology Today. He's also a former SportsCenter anchor on ESPN. Subscribe & ReviewSubscribing and leaving a rating and review are important factors in helping the Reshape Your Health Podcast and the YouTube Channel reach more people. If you haven't already subscribed, please do that today.We would also be grateful if you left a rating and review, too. In your listening app, scroll to the “Ratings and Reviews” section, then click “Write a Review” and let us know what you enjoy about our show. We appreciate you taking the time to show your support. Thank you!Resources From This Episode>> Join Zivli>> Book a Free Zivli Discovery Call>> Freebie: The Ultimate Food Guide>> Free Training - 5 Mistakes That Sabotage Weight Loss After 50>> 30dayalcoholfreechallenge>> Alcoholfreelifestyle.com/scorecared>> alcoholfreelifestyle.com>> Swanwick Blue Light Blockers
Trial of the Week: Phenobarbital for Acute Alcohol Withdrawal Special Guest: Joseph Lam, PharmD Joseph Lam joins me to highlight the 2013 trial published in the Journal of Emergency: Phenobarbital for acute alcohol withdrawal: a prospective, randomized, double-blind, placebo-controlled study. Joe shares his experience in the trial and all he did behind the scenes. Plus, we discuss the role of phenobarbital at that time, what this study found, what do we still need to know on this topic, and much more. Reference list: https://pharmacytodose.files.wordpress.com/2023/09/phb-in-aws-references.pdf PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices
Fear of experiencing withdrawal can stop us from taking action. Learn what to expect, common symptoms, and ways to get yourself through to the other side. ★ - Learn more about Project 90: www.alcoholfreelifestyle.com/Project90 ★ - (Accountability & Support) Speak verbally to a certified Alcohol-Free Lifestyle coach to see if, or how, we could support you having a better relationship with alcohol: https://www.alcoholfreelifestyle.com/schedule ★ - (Free Guide) The Alcohol Freedom Formula For Over 30s Entrepreneurs & High Performers: https://home.alcoholfreelifestyle.com/pod
In this episode we discuss the emerging trend of Phenobarbital for inpatient alcohol withdrawal management. We review the history, mechanism of action, dosing, side effects and medication interactions associated with Phenobarbital. Hosted by Darlene Petersen, MD and Paula Cook, MD. Check us out on facebook @Theaddictionfiles or twitter @THEADDICTIONFI1 or Instagram Theaddictionfiles or email us at theaddictionfiles@gmail.com No explicit language but this podcast discusses the abuse and treatment of legal and illegal drugs and may not be appropriate for all listeners.
Episode 16! In this episode we talk about "Phenobarbital-Based Protocol for Alcohol Withdrawal Syndrome in a Medical ICU: Pre-Post Implementation Study" published April 2023 by Alwakeel et al and then talk about the landmark study TRICC or "A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care"We also explore car donation jingles (1-877 KARS 4 KIDSPhenobarbital: https://pubmed.ncbi.nlm.nih.gov/37091477/TRICC: https://pubmed.ncbi.nlm.nih.gov/9971864/TRISS: https://pubmed.ncbi.nlm.nih.gov/23281973/Transfusion in Upper GI bleeds: https://pubmed.ncbi.nlm.nih.gov/25270275/Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!
Contributor: Travis Barlock MD Educational Pearls: Alcohol binds the GABA receptor, which produces an inhibitory response, hence the “depressive” effects of ethanol beverages. Over time, alcohol downregulates the GABA receptors, leading to unopposed glutamate activity. Given that glutamate is excitatory, this can lead to seizures. Alcohol also suppresses REM sleep; in patients with chronically suppressed REM sleep, the brain starves for dream sleep and it spills over into the wakeful state, inducing a dream-like state when someone is awake. The awake dream-like state of delirium tremens (DT) differs from alcohol hallucinosis Alcohol hallucinosis presents with visual hallucinations in a wakeful state DT presents with a generalized clouding of the sensorium and a dream-like state Treatment for DT is better achieved with phenobarbital due to predictable pharmacology Phenobarbital acts on GABA and NMDA receptors References 1. Davies M. The role of GABAA receptors in mediating the effects of alcohol in the central nervous system. J Psychiatry Neurosci. 2003;28(4):263-274. 2. Fujimoto J, Lou JJ, Pessegueiro AM. Use of Phenobarbital in Delirium Tremens. J Investig Med High Impact Case Reports. 2017;5(4):4-6. doi:10.1177/2324709617742166 3. Walker, M. Chapter 13: iPads, Factory Whistles, and Nightcaps In: Walker, M, Why We Sleep. Scribner; 2017, pg. 272. 4. Zarcone V. Alcoholism and sleep. Adv Biosci. 1978;21:29-38. Summarized & Edited by Jorge Chalit, OMSII
2023 SAEM PharmD Research 02:10 – Emergency Medicine Resident Perceptions of the Educational Impact of Emergency Medicine Clinical Pharmacists with Francisco Ibarra, PharmD, BCCCP 12:10 – Impact of Emergency Medicine Pharmacists on Anticoagulation Reversal with Jaclyn Scalgione, PharmD, BCPS 24:25 – Incidence of Postintubation Hypotension after Rapid Sequence Intubation in Full vs. Reduced Dose Induction Agent with Alicia Mattson, PharmD, BCCCP 35:12 – Phenobarbital as an Adjunct to Benzodiazepines in the Setting of Alcohol Withdrawal with Amelia Slane, PharmD, BCPS 48:19 – Single Dose Aminoglycosides for Complicated Urinary Tract Infections in the Emergency Department with Jordan Jenrette, PharmD 61:53 – Effect of Intravenous vs. Oral First Dose Antibiotics in the Emergency Department on Hospital Admission with Jessica Pham, PharmD PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices
Podcast summary of articles from the April 2023 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include cardiac arrest, non-opioid pain management, ocular ultrasound, alcohol abuse and withdrawal, a home health care model, and EMS. Guest speakers are Dr. Mitch Skinner and Dr. Jeffery Rabinowitz.
Are you using Precedex for alcohol withdrawal? Hear my take on why I don't like this idea, with evidence from a recently-published meta-analysis.Follow HERE!References:All references for Episode 94 are found on my Read by QxMD collectionSupport the showFind ER-Rx: - On Instagram: @ERRxPodcast - On the website: errxpodcast.com - On YouTube Disclaimer: The information contained within the ER-Rx podcast episodes, errxpodcast.com, and the @errxpodcast Instagram page is for informational/ educational purposes only, is not meant to replace professional medical judgement, and does not constitute a provider-patient relationship between you and the authors. Information contained herein may be accidentally inaccurate, incomplete, or outdated, and users are to use caution, seek medical advice from a licensed physician, and consult available resources prior to any medical decision making. The contributors of the ER-Rx podcast are not affiliated with, nor do they speak on behalf of, any medical institutions, educational facilities, or other healthcare programs.
Description: An immersive reading of excerpts from Treasure Island by Robert Louis Stevenson with reflection on alcohol withdrawal, bargaining and grey. Website:https://anauscultation.wordpress.com/ Work:excerpts from Treasure Island by Robert Louis Stevenson But he broke in cursing the doctor, in a feeble voice but heartily. “Doctors is all swabs,” he said; “and that doctor there, why, what do he know about seafaring men? I been in places hot as pitch, and mates dropping round with Yellow Jack, and the blessed land a- heaving like the sea with earthquakes — what to the doctor know of lands like that?— and I lived on rum, I tell you. It's been meat and drink, and man and wife, to me; and if I'm not to have my rum now I'm a poor old hulk on a lee shore, my blood'll be on you, Jim, and that doctor swab”; and he ran on again for a while with curses. “Look, Jim, how my fingers fidges,” he continued in the pleading tone. “I can't keep 'em still, not I. I haven't had a drop this blessed day. That doctor's a fool, I tell you. If I don't have a drain o' rum, Jim, I'll have the horrors; I seen some on 'em already. I seen old Flint in the corner there, behind you; as plain as print, I seen him; and if I get the horrors, I'm a man that has lived rough, and I'll raise Cain. Your doctor hisself said one glass wouldn't hurt me. I'll give you a golden guinea for a noggin, Jim.”References:Treasure Island paperback: https://www.tatteredcover.com/book/9780008514587 Treasure Island digital: https://www.gutenberg.org/files/120/120-h/120-h.htm Newman RK, Stobart Gallagher MA, Gomez AE. Alcohol Withdrawal. [Updated 2022 Aug 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.Rosenbaum M, McCarty T. Alcohol prescription by surgeons in the prevention and treatment of delirium tremens: historic and current practice. Gen Hosp Psychiatry. 2002;24(4):257-259.Schuckit MA. Recognition and management of withdrawal delirium (delirium tremens). N Engl J Med. 2014;371(22):2109-2113.NB: Tattered Cover is a local Denver bookstore
Alcohol withdrawal can send our patients into a spiral of delirium and downstream complications in the ICU. What are the risks of benzodiazepines for our patients even during alcohol withdrawal? How can we give our patients the best chance to walk away from ETOH withdrawal and critical illness? Dr. Obiajulu Anozie, MD joins us in this episode to explore the benefits of phenobarbital for alcohol withdrawal. www.daytonicuconsulting.com --- Support this podcast: https://podcasters.spotify.com/pod/show/restoringlife/support
Special Guest: Lewis S. Nelson, MD, MBA, DFASAM Article Referenced: R.J. Strayer et al., EMERGENCY DEPARTMENT MANAGEMENT OF PATIENTS WITH ALCOHOL INTOXICATION, ALCOHOL WITHDRAWAL, AND ALCOHOL USE DISORDER: A WHITE PAPER PREPARED FOR THE AMERICAN ACADEMY OF EMERGENCY MEDICINE, Journal of Emergency Medicine, https://doi.org/10.1016/j.jemermed.2023.01.010 ASAM Resources: The ASAM Clinical Practical Guideline on Alcohol Withdrawal Management Alcohol Withdrawal Management Pocket Guide Sign Up for the Q&S Newsletter Sign Up for the ASAM Weekly ASAM Membership
A huge thank you to the Nash Family and @ @KliqThis Podcast for their incredible efforts in raising awareness about the dangers of alcohol withdrawal. Despite their immense grief, they have selflessly dedicated their time to helping others. https://youtu.be/mMA4beCxR8w CHAPTERS: 0:02 Loss of son to alcohol withdrawal 2:55 Detox history 4:15 Medical clearance explained 6:32 Risk factors for alcohol seizures 8:02 Kevin Nash's story 10:10 Tristan Nash's role in @kliqthis podcast 11:25 High-risk factors for seizures 12:33 PAWSS (Predictor of Alcohol Withdrawal Severity Scale) 16:05 Alcohol seizures from reducing drinking 17:55 José R. Maldonado on withdrawal symptom severity 19:50 Tristan Nash's history with alcohol complications 21:20 Kevin Nash's decision to quit drinking 24:14 Awareness of addiction medicine 26:45 Gabapentin in alcohol withdrawal management 29:20 Kevin Nash's take on clonazepam 30:52 CIWA Scale 36:30 Kevin Nash on society's portrayal of alcohol 42:50 Dr. Wip's summary SUMMARY: In this video, we discuss the heartbreaking impact of alcohol withdrawal complications on the Nash family and explore safe, medically supervised detox methods. As we share the Nash family's story, we also cover general information about alcohol withdrawal, including risk factors, symptom timelines, treatments, and the unpredictability of symptoms for those dependent on alcohol and benzodiazepines. REFERENCES: Robert Meyers' book on helping a loved one quit drinking: https://www.smartrecovery.org/get-your-loved-one-sober-alternatives-to-nagging-pleading-and-threatening/ Clinical guide for primary care providers on alcohol use disorder: https://cep.health/clinical-products/alcohol-use-disorder/ Comprehensive clinical guide to alcohol use and withdrawal: https://www.bccsu.ca/wp-content/uploads/2021/01/AUD-Guideline.pdf, https://www.bccsu.ca/alcohol-use-disorder/ UpToDate on alcohol withdrawal management: https://www.uptodate.com/contents/management-of-moderate-and-severe-alcohol-withdrawal-syndromes PAWSS literature: https://www.psychdb.com/_media/addictions/etoh_pawss_score_maldonando_.pdf, https://academic.oup.com/alcalc/article/50/5/509/198370?login=false Alcohol withdrawal timeline article: https://onlinelibrary.wiley.com/share/CIIRKMK7DIVBFJK5PW42?target=10.1111/ane.12671 DISCLAIMER: This video is for informational purposes only and is not medical advice. Consult your healthcare provider or visit the nearest emergency department for clinical guidance. ABOUT THE CHANNEL: Join addiction psychiatrist Dr. Wiplove (Wip) Lamba, addiction case manager and former addict Jean-Paul (JP) Michael, and their guests as they explore topics related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment, and recovery. Wip and JP share their passion and curiosity for their field, with JP working daily in a renowned inner-city hospital in Canada's largest city. This work is separate from Wiplove's clinical and academic endeavours.
Background information: Alcohol has potentiating effects on the inhibitory GABA neurotransmission system and inhibitory effects on the excitatory glutamate neurotransmission system. Chronic alcohol use causes changes to preserve homeostasis, and when the stimulus is removed, alcohol withdrawal results due to decreased inhibition via the GABA system and increased excitation via the glutamate system. Treatment options ... Read more The post REBEL Cast Ep115 – Phenobarbital vs Lorazepam in Alcohol Withdrawal appeared first on REBEL EM - Emergency Medicine Blog.
In this episode, we review the high-yield topic of Acute Alcohol Withdrawal from the Psychiatry section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Happy Holidays and New Year's to our listeners! Thank you for what you do for your patients each day. We appreciate you listening. We decided to re-publish one of our most popular episodes from 2022 as a throw-back. Enjoy the talk on Alcohol Withdrawal (#relevant for New Year's). Cite this podcast as: Briggs, Blake; Husain, Iltifat. Episode 157. Alcohol Withdrawal: What are you doing New Year's Eve? December 26th, 2022. https://www.emboardbombs.com/podcasts/157-alcohol-withdrawal-what-are-you-doing-new-years-eve. Accessed [date]
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode759. In this episode, I'll discuss whether phenobarbital offers a clinically meaningful advantage over benzodiazepines for alcohol withdrawal in the ED. The post 759: Does phenobarbital offer a clinically meaningful advantage over benzodiazepines for alcohol withdrawal in the ED? appeared first on Pharmacy Joe.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode759. In this episode, I ll discuss whether phenobarbital offers a clinically meaningful advantage over benzodiazepines for alcohol withdrawal in the ED. The post 759: Does phenobarbital offer a clinically meaningful advantage over benzodiazepines for alcohol withdrawal in the ED? appeared first on Pharmacy Joe.
In episode 6 we discuss a benzodiazepine-sparing alcohol withdrawal protocol.Smith JT, Sage M, Szeto H, et al. Outcomes After Implementation of a Benzodiazepine-Sparing Alcohol Withdrawal Order Set in an Integrated Health Care System. JAMA Netw Open. 2022;5(2):e220158. 2022 Feb 2. doi:10.1001/jamanetworkopen.2022.0158We also discuss long-term outcomes from a primary-care based MAT clinic, and the movement to deregulate methadone and expand access.Cope K, DeMicco J, Salib J, Michael M, Yakoub P, Daoud K, Cope R. Three-year Retention Rates With Office-based Treatment of Buprenorphine for Opioid Use Disorder in a Private Family Medicine Practice. J Addict Med. 2022 Aug 1. doi: 10.1097/ADM.0000000000001009. PMID: 35913992.This is Addiction Medicine Journal Club with Dr. Sonya Del Tredici and Dr. John Keenan. We practice addiction medicine and primary care, and we believe that addiction is a disease that can be treated. This podcast reviews current articles to help you stay up to date with research that you can use in your addiction medicine practice. The best part of any journal club is the conversation, and we want to hear what you have to say. To have your opinions about the articles included in a future episode, send us your comments. Email: addictionmedicinejournalclub@gmail.comTwitter: @AddictionMedJC Facebook: @AddictionMedJCCredits:We got help for this episode from the St. Max's medical librarians. Original theme music: composed and performed by Benjamin KennedyAudio production: Angela OhlfestAddiction Medicine Journal Club is intended for educational purposes only, and should not be considered medical advice. The views expressed here are our own, and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities.
In this episode, we review the high-yield topic of Alcohol Withdrawal from the Psychiatry section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbulletsIn this episode --- Send in a voice message: https://anchor.fm/medbulletsstep1/message
Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Abstract abdominal pain complaint, no good diagnostic test, unreliable presentation. Sounds like the perfect storm for a tricky diagnosis. Let's talk presentation, diagnosis, pitfalls, and management of PID.
In the final part of this "Mini Grand Rounds" series, the author of a recently-published study discusses his experience with phenobarbitalClick HERE to leave a review of the podcast!Subscribe HERE!References:All references for Episode 73 are found on my Read by QxMD collectionDisclaimer: The information contained within the ER-Rx podcast episodes, errxpodcast.com, and the @errxpodcast Instagram page is for informational/ educational purposes only, is not meant to replace professional medical judgement, and does not constitute a provider-patient relationship between you and the authors. Information contained herein may be accidentally inaccurate, incomplete, or outdated, and users are to use caution, seek medical advice from a licensed physician, and consult available resources prior to any medical decision making. The contributors of the ER-Rx podcast are not affiliated with, nor do they speak on behalf of, any medical institutions, educational facilities, or other healthcare programs.To celebrate the 2-year anniversary of the ER-Rx Podcast, we're giving away another medically-related prize bundle. All you have to do to enter is subscribe to the podcast newsletter found on errxpodcast.com—and don't worry- if you've already done that in the past you will still be entered into the drawing. The deadline to enter is May 15th and the winner will be announced on May 19th- the 75th episode. Support the show (https://www.buymeacoffee.com/errxpodcast)
In Part 2 of this "Mini Grand Rounds" series, we discuss the data behind phenobarb and how to dose and monitor itClick HERE to leave a review of the podcast!Subscribe HERE!References:All references for Episode 72 are found on my Read by QxMD collectionDisclaimer: The information contained within the ER-Rx podcast episodes, errxpodcast.com, and the @errxpodcast Instagram page is for informational/ educational purposes only, is not meant to replace professional medical judgement, and does not constitute a provider-patient relationship between you and the authors. Information contained herein may be accidentally inaccurate, incomplete, or outdated, and users are to use caution, seek medical advice from a licensed physician, and consult available resources prior to any medical decision making. The contributors of the ER-Rx podcast are not affiliated with, nor do they speak on behalf of, any medical institutions, educational facilities, or other healthcare programs.Support the show (https://www.buymeacoffee.com/errxpodcast)
The Pharm So Hard Podcast: An Emergency Medicine and Hospital Pharmacy Podcast
Alcohol withdrawal syndrome (AWS) is a disease commonly treated in the emergency department, with~5% of cases leading to delirium tremens. In patients with a history of AWS, decreased GABA-A receptor sensitivity to GABA agonists may causebenzodiazepine (BZD) monotherapy to be ineffective. Patients may experience increase in morbidity and mortality due to escalated doses of benzodiazepines. […] The post Episode 71. Pushing P! Phenobarbital for Alcohol Withdrawal Syndrome appeared first on The Pharm So Hard Podcast.
Contributor: Aaron Lessen, MD Educational Pearls: Retrospective cohort study looked at return rate of discharged patients after receiving either phenobarbital or benzodiazepines or both in the ED for treatment of alcohol withdrawal Patients who received benzodiazepines had a 25% chance of returning in 3 days versus a 10% chance of returning in 3 days for those who received phenobarbital 13% of patients returned in 3 days after receiving both phenobarbital and benzodiazepines Phenobarbital may make it less likely for patients to come back to the ED after receiving treatment for alcohol withdrawal References Lebin JA, Mudan A, Murphy CE 4th, Wang RC, Smollin CG. Return Encounters in Emergency Department Patients Treated with Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal. J Med Toxicol. 2022;18(1):4-10. doi:10.1007/s13181-021-00863-2 Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account. Donate to EMM today!