Efficacy and Safety of Phenobarbital in Alcohol Withdrawal Syndrome Management: a Focused Literature Review
by Amanda E. Egbert, 2024 PharmD Candidate, Kathryn A. Freitag, 2024 PharmD Candidate, Sarah E. Haley, 2024 PharmD Candidate, Molly A. O’Connell, 2024 PharmD Candidate, Hope E. Schier, 2024 PharmD Candidate, Janvi Shah, 2024 PharmD Candidate, Alex Gidal, PharmD
"Alcohol withdrawal syndrome (AWS) is a potentially life-threatening clinical complication in patients who misuse alcohol.1 In the United States, clinical treatment is required for approximately 500,000 episodes of AWS annually.2 Protocols and guidelines are often utilized in hospital settings for the treatment of AWS.3 However, severe and treatment-resistant cases are more likely to rely on clinician input and professional judgment for symptom management. Currently there are multiple dosing strategies used to manage AWS, including fixed dose, loading dose, symptom-triggered, and symptom-monitored loading dose regimens.4 Benzodiazepines are commonly used in symptom-triggered therapy protocols, which are often guided by CIWA-Ar. Barbiturates, like phenobarbital (PB), may be considered an alternative therapeutic option to benzodiazepines in the management of AWS due to the differing mechanism of action."
Keywords: Withdrawal, Symptoms, Benzodiazepines, Alcohol, Receptors, AMPA, Alcohol Withdrawal, Receptors, GABA, Half-Life, Phenobarbital, Delirium, Dosing
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2023 September/October Table of Contents
"Alcohol withdrawal syndrome (AWS) is a potentially life-threatening clinical complication in patients who misuse alcohol.1 In the United States, clinical treatment is required for approximately 500,000 episodes of AWS annually.2 Protocols and guidelines are often utilized in hospital settings for the treatment of AWS.3 However, severe and treatment-resistant cases are more likely to rely on clinician input and professional judgment for symptom management. Currently there are multiple dosing strategies used to manage AWS, including fixed dose, loading dose, symptom-triggered, and symptom-monitored loading dose regimens.4 Benzodiazepines are commonly used in symptom-triggered therapy protocols, which are often guided by CIWA-Ar. Barbiturates, like phenobarbital (PB), may be considered an alternative therapeutic option to benzodiazepines in the management of AWS due to the differing mechanism of action."
Keywords: Withdrawal, Symptoms, Benzodiazepines, Alcohol, Receptors, AMPA, Alcohol Withdrawal, Receptors, GABA, Half-Life, Phenobarbital, Delirium, Dosing
Download PDF
2023 September/October Table of Contents