Phenobarbital treatment in a patient with resistant alcohol withdrawal syndrome

Pharmacotherapy

Volumn 29, Issue 7, 2009, Pages 875-878

  Hayner, Christopher E ^a,b   Wuestefeld, Nancy L ^a   Bolton, Pamela J ^a  

^a GOOD SAMARITAN HOSPITAL   (United States)

^b Group Health Associates   (United States)

Author keywords

Alcohol resistance; Alcohol withdrawal syndrome; AWS; Benzodiazepine; Delirium tremens; Phenobarbital

Indexed keywords

ADRENERGIC RECEPTOR BLOCKING AGENT; BARBITURIC ACID DERIVATIVE; BENZODIAZEPINE; CLONIDINE; HALOPERIDOL; LORAZEPAM; METOPROLOL; PHENOBARBITAL; PROPYLENE GLYCOL;

ADULT; AGITATED DEPRESSION; ALCOHOL ABUSE; ALCOHOL WITHDRAWAL; ARTICLE; ARTIFICIAL VENTILATION; CASE REPORT; CLINICAL ASSESSMENT; CLINICAL FEATURE; CLINICAL PROTOCOL; COMPUTER ASSISTED TOMOGRAPHY; CONSCIOUSNESS; CONTINUOUS INFUSION; DELIRIUM TREMENS; DISEASE CONTROL; DISEASE COURSE; DISEASE SEVERITY; DRUG BLOOD LEVEL; DRUG DOSE ESCALATION; DRUG DOSE REDUCTION; DRUG DOSE TITRATION; DRUG WITHDRAWAL; ELECTROENCEPHALOGRAPHY; EMERGENCY WARD; ENDOTRACHEAL INTUBATION; HOSPITAL DISCHARGE; HOSPITALIZATION; HUMAN; INTENSIVE CARE UNIT; MALE; RESPIRATION DEPRESSION; SEIZURE; SYMPTOM; TREATMENT DURATION; TREATMENT RESPONSE;

ADULT; ALCOHOL WITHDRAWAL DELIRIUM; DOSE-RESPONSE RELATIONSHIP, DRUG; DRUG RESISTANCE; HUMANS; HYPNOTICS AND SEDATIVES; LORAZEPAM; MALE; PHENOBARBITAL; PROPYLENE GLYCOL; TREATMENT OUTCOME; VEHICLES;

EID: 67650834958     PISSN: 02770008     EISSN: None     Source Type: Journal    
DOI: 10.1592/phco.29.7.875     Document Type: Article

References (20)

1. Hoffman RS, Weinhouse GL. Management of moderate and severe alcohol withdrawal syndromes. In: Traub SJ, ed. UptoDate. Waltham, MA: UpToDate, Inc., 2008.
2. Cagetti E, Liang J, Spigelman I, Olsen RW. Withdrawal of chronic intermittent ethanol treatment changes subunit composition, reduces synaptic function, and decreases behavioral responses to positive allosteric modulators of GABAA receptors. Mol Pharmacol 2003;63:53-64. (Pubitemid 36043808)
3. Gold JA, Rimal B, Nolan A, Nelson LS. A strategy of escalating doses of benzodiazepines and phenobarbital administration reduces the need for mechanical ventilation in delirium tremens. Crit Care Med 2007;35:724-730 (Pubitemid 46407784)
4. Ives TJ, Mooney J, Gwyther RE. Pharmacokinetic dosing of phenobarbital in the treatment of alcohol withdrawal syndrome. South Med J 1991;84:18-21.
5. Young GP, Rores C, Murphy C, Dailey RH. Intravenous phenobarbital for alcohol withdrawal and convulsions. Ann Emerg Med 1987;16:847-850 (Pubitemid 17105031)
6. Ely EW, Margolin R, Francis J, et al. Evaluation of delirium in critically ill patients: validation of the confusion assessment method for the intensive care unit (CAM-ICU). Crit Care Med 2001;29:1370-1379 (Pubitemid 32641799)
7. Sullivan JT, Sykora K, Schneiderman J, Naranjo CA, Sellers EM. Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). Br J Addict 1989;84:1353-1357 (Pubitemid 19281139)
8. Sessler CN, Gosnell M, Grap MJ, et al. The Richmond agitation-sedation scale: validity and reliability in adult intensive care patients. Am J Respir Crit Care Med 2002;166:1338-1344 (Pubitemid 35292699)
9. Mayo-Smith MF, Beecher LH, Fischer TL, et al. Management of alcohol withdrawal delirium. Arch Intern Med 2004;164:1405-1412
10. Kosten TR, O'Connor PG. Management of drug and alcohol withdrawal. N Engl J Med 2003;348:1786-1795
11. Institute for Safe Medication Practices. ADR prevent-ERR: IV lorazepam infusion and propylene glycol toxicity. ISMP Med Safety Alert 2006;11(3):2.
12. World Health Organization. Toxicological evaluation of certain food additives with a review of general principles and of specifications: 17th report of the Joint FAO/WHO expert committee on food additives. Technical report series no. 539. Geneva: World Health Organization, 1974.
13. Barnes BJ, Gerst C, Smith JR, Terrell AR, Mullins ME. Osmol gap as a surrogate marker for serum propylene glycol concentrations in patients receiving lorazepam for sedation. Pharmacotherapy 2006;26:23-33. (Pubitemid 43082924)
14. Neale BW, Mesler EL, Young M, Rebuck JA, Weise WJ. Propylene glycol-induced lactic acidosis in a patient with normal renal function: a proposed mechanism and monitoring recommendations. Ann Pharmacother 2005;39:1732-1736 (Pubitemid 41393135)
15. Hobbs WR, Rall TW, Verdoorn TA. Hypnotics and sedatives: ethanol. In: Hardman JG, Limbird LE, ed. Goodman & Gilman's the pharmacological basis of therapeutics, 9th ed. New York: McGraw Hill, 1996:361-396
16. Bledsoe KA, Kramer AH. Propylene glycol toxicity complicating use of barbiturate coma. Neurocrit Care 2008;9:122-124
17. Yorgin PD, Theodorou AA, Al-Uzri A, Davenport K, Boyer- Hassen LV, Johnson MI. Propylene glycol-induced proximal renal tubular cell injury. Am J Kidney Dis 1997;30:134-139 (Pubitemid 27284387)
18. Miller MA, Forni A, Yogaratnam D. Propylene glycol-induced lactic acidosis in a patient receiving continuous infusion pentobarbital. Ann Pharmacother 2008;42:1502-1506
19. Devetag F, Mandich G, Zaiotti G, Toffolo GG. Alcoholic epilepsy: review of a series and proposed classification and etiopathogenesis. Ital J Neurol Sci 1983;3:275-284 (Pubitemid 14238729)
20. Kramp P, Rafaelsen OJ. Delirium tremens: a double-blind comparison of diazepam and barbital treatment. Acta Psychiatr Scand 1987;58:174-190