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lunes, 5 de septiembre de 2016

Phenobarbital monotherapy for alcohol withdrawal

PulmCrit (EM Crit)
EM Crit - October 18, 2015 - By Josh Farkas
  • "Although benzodiazepines are regarded as the mainstay of treatment for alcohol withdrawal, there has never been an adequately powered RCT comparing benzodiazepines vs. phenobarbital.
  • Benzodiazepines occasionally fail to control alcohol withdrawal, and may promote agitated delirium. In contrast, phenobarbital is more effective and doesn’t cause paradoxical agitation.
  • Some countries have extensive experience treating alcohol withdrawal with phenobarbital monotherapy. Available evidence supports the safety and efficacy of this approach.
  • Phenobarbital monotherapy consists of a gradual dose titration as shown below. Once a therapeutic phenobarbital level is reached, this will gradually auto-taper and provide ongoing protection from seizures or recurrent withdrawal."