[CypherToorima]

Alcohol withdrawal

There are several distinct but not mutually exclusive alcohol withdrawal syndromes caused by alcohol withdrawal:

* Tremulousness - "the shakes"
* Activation syndrome - characterized by tremulousness, agitation, rapid heart beat and high blood pressure.
* Seizures - acute grand mal seizures can occur in alcohol withdrawal in patients who have no history of seizure or any structural brain disease.
* Hallucinations - usually visual or tactile in alcoholics
* Delirium tremens - can be severe and often fatal.

Unlike withdrawal from opioids such as heroin, which can be unpleasant but never fatal (Lowinson), alcohol withdrawal can kill (by uncontrolled convulsions or delirium tremens) if it is not properly managed. The pharmacological management of alcohol withdrawal is based on the fact that alcohol, barbiturates, and benzodiazepines have remarkably similar effects on the brain and can be substituted for each other. Since benzodiazepines are the safest of the three classes of drugs, alcohol consumption is terminated and a long-acting benzodiazepine is substituted to block the alcohol withdrawal syndrome. The benzodiazepine dosage is then tapered slowly over a period of days or weeks.

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