Patients in alcohol withdrawal may need less medication for less time with the use of a symptom-based standing order set.

Management of alcohol withdrawal in acutely ill hospitalized patients with a critical illness is challenging for pharmacists, nurses, and practicing physicians. Alcohol withdrawal is often a diagnosis considered in patients admitted with trauma; however, it can be confused with other conditions in the list of differential diagnoses of patients admitted with nontrauma diagnoses.1,3 Investigators estimate that up to 1 in 4 patients admitted to general hospitals meet diagnostic criteria for alcohol dependence.4 

Alcohol-dependent patients have a risk of withdrawal, with symptoms including altered concentration, tremulousness, autonomic hyperarousal, psychosis, seizures, and delirium tremens.5 Alcohol withdrawal delirium, commonly known as delirium tremens or “DTs,” is the most serious manifestation of alcohol withdrawal syndrome (AWS) and is characterized by hallucinations, disorientation, tachycardia, hypertension, low-grade fever, agitation, and...

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