Diagnosis and treatment of acute alcohol intoxication and alcohol withdrawal syndrome: position paper of the Italian Society on Alcohol

被引：53

作者：

Caputo, Fabio ^{[1
,2
]}

Agabio, Roberta ^{[3
]}

Vignoli, Teo ^{[4
]}

Patussi, Valentino ^{[5
]}

Fanucchi, Tiziana ^{[5
]}

Cimarosti, Paolo ^{[6
]}

Meneguzzi, Cristina ^{[6
]}

Greco, Giovanni ^{[7
]}

Rossin, Raffaella ^{[8
]}

Parisi, Michele ^{[9
]}

Mioni, Davide ^{[10
]}

Arico', Sarino ^{[11
]}

Palmieri, Vincenzo Ostilio ^{[12
]}

Zavan, Valeria ^{[13
]}

Allosio, Pierluigi ^{[14
]}

Balbinot, Patrizia ^{[15
]}

Amendola, Maria Francesca ^{[16
]}

Maccio, Livia ^{[17
]}

Renzetti, Doda ^{[18
]}

Scafato, Emanuele ^{[19
]}

Testino, Gianni ^{[15
]}

机构：

[1] SS Annunziata Hosp, Dept Internal Med, Unit Internal Med, Via Vicini 2, I-44042 Ferrara, Italy

[2] Univ Bologna, Dept Med & Surg Sci, G Fontana Ctr Study & Multidisciplinary Treatment, Bologna, Italy

[3] Univ Cagliari, Dept Biomed Sci, Sect Neurosci & Clin Pharmacol, Cagliari, Italy

[4] Unit Addict Treatment, Lugo, Ravenna, Italy

[5] Careggi Hosp, Reg Ctr Alcohol, Florence, Italy

[6] Alcohol Unit, Pordenone, Italy

[7] Alcohol Unit, Ravenna, Italy

[8] Alcohol Unit, Milan, Italy

[9] Alcohol Unit, Nicosia, Enna, Italy

[10] Nursing Home Parco Tigli, Padua, Italy

[11] Mauriziano Hosp, Gastroenterol Unit, Turin, Italy

[12] Univ Bari, Dept Biomed Sci & Human Oncol, Murri Clin Internal Med, Bari, Italy

[13] Alcohol Unit, Alessandria, Italy

[14] Alcohol Unit, Turin, Italy

[15] Reg Ctr Alcohol, Genoa, Italy

[16] Alcohol Unit, Cosenza, Italy

[17] Alcohol Unit, Savona, Italy

[18] Mater Dei Hosp, Dept Internal Med, Bari, Italy

[19] Natl Inst Hlth, Natl Observ Alcohol, Rome, Italy

来源：

INTERNAL AND EMERGENCY MEDICINE | 2019年 / 14卷 / 01期

关键词：

Acute alcohol intoxication; Alcohol withdrawal syndrome; Pharmacological treatment; DOUBLE-BLIND; SODIUM OXYBATE; GAMMA-HYDROXYBUTYRATE; USE DISORDERS; ACID GHB; MANAGEMENT; GUIDELINES; TIAPRIDE; QUALITY; CLOMETHIAZOLE;

D O I：

10.1007/s11739-018-1933-8

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The chronic use of alcohol can lead to the onset of an alcohol use disorder (AUD). About 50% of subjects with an AUD may develop alcohol withdrawal syndrome (AWS) when they reduce or discontinue their alcohol consumption and, in 3-5% of them, convulsions and delirium tremens (DTs), representing life-threatening complications, may occur. Unfortunately, few physicians are adequately trained in identifying and treating AWS. The Italian Society on Alcohol has, therefore, implemented a task force of specialists to draw up recommendations for the treatment of AWS with the following main results: (1) while mild AWS may not require treatment, moderate and severe AWS need to be pharmacologically treated; (2) out-patient treatment is appropriate in patients with mild or moderate AWS, while patients with severe AWS need to be treated as in-patients; (3) benzodiazepines, BDZs are the gold standard for the treatment of AWS and DTs; (4) alpha-2-agonists, beta-blockers, and neuroleptics may be used in association when BDZs do not completely resolve specific persisting symptoms of AWS; (5) in the case of a refractory form of DTs, the use of anaesthetic drugs (propofol and phenobarbital) in an intensive care unit is appropriate; (6) alternatively to BDZs, sodium oxybate, clomethiazole, and tiapride approved in some European Countries for the treatment of AWS may be employed for the treatment of moderate AWS; (7) anti-convulsants are not sufficient to suppress AWS, and they may be used only in association with BDZs for the treatment of refractory forms of convulsions in the course of AWS.

引用

页码：143 / 160

页数：18

共 88 条

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