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Alcohol  Withdrawal  Syndrome
Dr.Balan Stephen

Clinical features
Minor symptoms:
(less than 12 hours)
-    apprehension, anxiety
-    irritability, restlessness
-    weakness
-    tachycardia,
-    sweating
-    anorexia
-    insomnia

Intermediate symptoms:
(24-48 hours)
-    minor withdrawal symptoms mentioned above plus
-    hypertension
-    illusion
-    confusion ,agitation, fear
Major Symptoms
(Delirium tremons)
(48-72 hours)
-    clinical features of intermediate withdrawal plus
-    hallucinations-visual, auditory (may prove self- harm)
-    delusions
-    seizures
-    cardiac arrhythmias
-    circulatory collapse

Medical Management
Early instigation of an oral benzodiazepine, diazepam or lorazepam in sufficient dose along with oral thiamine 100 mg daily will prevent the full blown syndrome.
The patient may be reluctant to conform to the restrictions normally expected during hospitalization.
Staff should be encouraged to talk to them,adopting a quiet ,non-judgemental attitude,to orient them to the environment
Reassure them that the symptoms are temporary.

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