Alcohol Withdrawal Delirium

Manifestation

Interprofessional Care

• Disorientation
• Visual, tactile, or auditory hallucinations
• Seizures

• Continued use of benzodiazepines
• Carbamazepine (Tegretol) or valproate (Depakote) to treat seizures
• Antipsychotic agents e.g. chlorpromazine (Thorazine), haloperidol (Haldol)
• Chlordiazepoxide (Librium) if psychosis persists after benzodiazepine administration

Body System

Effects of Alcohol

Cardiac

Hypertension, atrial fibrillation, cardiomyopathy, stroke, coronary artery disease, sudden cardiac death

Neurologic

Alcoholic dementia, Wernicke-Korsakoff syndrome.

Impaired cognitive function, psychomotor skills, abstract thinking, and memory.

Depression, anxiety, attention deficit, labile moods, seizures, insomnia, peripheral neuropathy, chronic headache

Immunologic

Increased susceptibility to infections, depressed immune function

Hematologic

Bone marrow depression, anemia, leukopenia,  thrombocytopenia, blood clotting abnormalities

Hepatic

Alcoholic hepatitis, cirrhosis, liver cancer

Musculoskeletal

Myopathy, osteoporosis, gout

Gastrointestinal

Gastritis, gastroesophageal reflux disease (GERD), peptic ulcer, esophagitis, esophageal varices, gastrointestinal bleeding, pancreatitis, oropharyngeal cancer, colorectal cancer

Urinary

Diuretic effect from inhibition of antidiuretic

hormone

Nutrition

Diabetes mellitus, anorexia, malnutrition, vitamin deficiencies (especially thiamine)

Reproductive

Breast cancer, testicular atrophy, decreased beard growth, decreased libido, decreased sperm count, gynecomastia

Integumentary

Palmar erythema, spider angiomas, rosacea, rhinophyma