Episode 71. Pushing P! Phenobarbital for Alcohol Withdrawal Syndrome

[@smotoole17]

This was a great chat, especially as I’m gearing up to provide a small education piece to my IM residency later this week at a noon conference. It’s an exciting time to be bringing this to my co-learners as there is still so much up in the air as to how best to approach this topic and it’s management, and I think like you both said there isn’t necessarily a slam-dunk method yet but a lot of success stories no matter how you slice it. Thanks guys!

[@coupmd]

Great talk. Agree, no clear dosing strategy has shown superior. For me: high risk pt -> 10 mg/kg -> triggered dosing with Pb (65 or 130 or 260) q30 min if going to ICU or bzd if going to floors so I don't confuse our house staff. Concur, HARD pass for people with drug interactions. Also care to be taken in hepatic dysfunction (personally, I dose reduce). High risk = prior seizure, intubation, ICU admission, looks terrible, prior ativan/versed gtt for AWS Would like to hear more about timing and interpretation of drug levels.