{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:16:31Z","timestamp":1777680991696,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,4,13]],"date-time":"2018-04-13T00:00:00Z","timestamp":1523577600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hosp Pharm"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>Background: Alcohol withdrawal occurs commonly but diagnosis and therapies have not been described. Objective: To characterize practices regarding the assessment and treatment of acute severe alcohol withdrawal and describe perceived barriers to therapies. Methods: A random sample of 500 US-based critical care pharmacists received the pretested, electronically distributed questionnaire. Results: 94 (20%) of 471 eligible recipients responded with diverse representation. Manifestations of alcohol withdrawal that were commonly rated as severe were seizures (91.3%), not oriented to person\/place\/date (84.1%), delusions (73.8%), diastolic blood pressure &gt;110 mmHg (51.7%), inconsolable agitation (50.7%), and tachycardia (50.7%). Scoring tools were considered highly effective for assessing severity by 43 respondents (45.8%). Management protocols existed in 86 (90.5%) institutions. Sixty-eight (72.3%) respondents indicated protocols were used often\/routinely for initial management but only 23 (24.5%) for adjunctive therapies (p&lt;0.0001). Agents employed for initial and adjunctive management were benzodiazepines (92.6% and 61.7%, respectively, p&lt;0.0001), clonidine (29.8% and 34%, respectively), haloperidol (26.6% and 33%, respectively), and barbiturates (20.2% and 24.5%, respectively). Adjunctive agents were most commonly added to reduce dosages of benzodiazepines (antipsychotics, barbiturates, alpha-2 agonists), prevent respiratory depression (alpha-2 agonists), prevent or treat autonomic symptoms (alpha-2 agonists), and prevent or treat agitation\/delusions (antipsychotics, barbiturates, alpha-2 agonists). Agents with common barriers to use were dexmedetomidine (bradycardia, hypotension, cost), propofol (hypotension, tracheal intubation required), and ketamine (lack of supportive data). Conclusion: Assessment and management strategies of acute severe alcohol withdrawal vary considerably. Benzodiazepines are the mainstay of treatment. Other agents are commonly used to prevent complications from benzodiazepines or treat agitation\/delusions.<\/jats:p>","DOI":"10.1177\/0018578718769241","type":"journal-article","created":{"date-parts":[[2018,4,13]],"date-time":"2018-04-13T10:44:04Z","timestamp":1523616244000},"page":"22-31","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["The Assessment and Management Practices of Acute Alcohol Withdrawal: Results of a Nationwide Survey of Critical Care Pharmacists"],"prefix":"10.1177","volume":"54","author":[{"given":"Susanne","family":"Dyal","sequence":"first","affiliation":[{"name":"University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"MacLaren","sequence":"additional","affiliation":[{"name":"University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,4,13]]},"reference":[{"key":"bibr1-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2012.07.004"},{"key":"bibr2-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69490-7"},{"key":"bibr3-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03550020076042"},{"key":"bibr4-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-012-2758-y"},{"key":"bibr5-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1111\/acer.12002"},{"key":"bibr6-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2015.11.022"},{"key":"bibr7-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-015-0075-7"},{"key":"bibr8-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1177\/0885066614554908"},{"key":"bibr9-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000141"},{"key":"bibr10-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1P575"},{"key":"bibr11-0018578718769241","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2015.00144"},{"key":"bibr12-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1177\/1060028014555859"},{"key":"bibr13-0018578718769241","first-page":"CD005064","volume":"3","author":"Amato L","year":"2010","journal-title":"Cochrane Database of Syst Rev"},{"key":"bibr14-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/agr142"},{"key":"bibr15-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000256841.28351.80"},{"key":"bibr16-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2012.07.056"},{"key":"bibr17-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(87)80520-6"},{"key":"bibr18-0018578718769241","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2009.10.010"}],"container-title":["Hospital Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0018578718769241","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0018578718769241","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0018578718769241","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:38:24Z","timestamp":1777451904000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0018578718769241"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,13]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1177\/0018578718769241"],"URL":"https:\/\/doi.org\/10.1177\/0018578718769241","relation":{},"ISSN":["0018-5787","1945-1253"],"issn-type":[{"value":"0018-5787","type":"print"},{"value":"1945-1253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,13]]}}}