Multiprofessional Critical Care Review: Adult 2024 (MCCRCA24ON)-3: Management of Drug Withdrawal Syndromes in the ICU (Gourang Patel, BCCCP, BCPS, PharmD)

Video Transcription

Video Summary

In this video, Dr. Saurabh Patel discusses the management of various withdrawal syndromes in the intensive care unit (ICU). He covers the management of alcohol withdrawal, opioid withdrawal, stimulant withdrawal, and THC (cannabinoid) withdrawal. <br /><br />For alcohol withdrawal, Dr. Patel explains that the mechanism of action involves GABA receptor hyperactivity. He discusses the diagnostic criteria for alcohol withdrawal and the use of supportive therapies such as patient hydration and essential electrolyte replacement. He also mentions therapeutic options including medications that act on the GABA receptor, such as barbiturates and benzodiazepines.<br /><br />Regarding opioid withdrawal, Dr. Patel discusses the importance of accurately identifying the substance involved to determine the appropriate management strategies. He mentions the use of alpha-2 agonists, gabapentinoids, and slowly titrating methadone. He also mentions the utilization of diphenoxylate for severe diarrhea.<br /><br />Dr. Patel then explains the management of stimulant withdrawal, including the use of benzodiazepines for acute and severe agitation, hydration, and the management of hypertensive episodes. He mentions adjunct therapies like methylphenidate and engaging the substance abuse and addiction teams for safe outpatient transition.<br /><br />Lastly, Dr. Patel discusses the management of THC withdrawal, including the use of noradrenergic agents, serotonergic agents, and the possibility of using CB1 receptor agonists like dronabinol. He emphasizes the importance of tapering and monitoring the patient during treatment and discontinuing therapy as deemed safe.<br /><br />Overall, the video provides an overview of the management approaches for various withdrawal syndromes in the ICU, highlighting important considerations and therapies for each.

Keywords

Dr. Saurabh Patel

Withdrawal syndromes

Intensive care unit

Alcohol withdrawal

Opioid withdrawal

Stimulant withdrawal

THC withdrawal

	Society of Critical Care Medicine 500 Midway Drive Mount Prospect, IL 60056 USA Phone: +1 847 827-6888 Fax: +1 847 439-7226 Email: support@sccm.org	Contact Us About SCCM Newsroom Advertising & Sponsorship DONATE	MySCCM LearnICU Patients & Families Surviving Sepsis Campaign Critical Care Societies Collaborative	GET OUR NEWSLETTER
© Society of Critical Care Medicine. All rights reserved. \| Privacy Statement \| Terms & Conditions The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.