Alcohol Withdrawal in a 48-Year-Old Man
Write a prescription for alcohol withdrawal syndrome and have every line marked: drug choice, dose, route, frequency and duration, checked against the patient's allergies, current medicines, renal function and the interaction database, with each error explained.
medium8 scoring rules
- Patient
- 48 years, male, 75 kg
- Diagnosis
- Alcohol withdrawal syndrome
- Renal function
- eGFR 95 mL/min/1.73m²
- Allergies
- None known
The scenario
Patient B-217 is a 48-year-old man admitted to the acute medical unit with a two-day history of tremors, agitation, and poor sleep. He drinks approximately 15 units of alcohol daily and has done so for many years. On examination he is tremulous, sweaty, and restless. Heart rate is 118 bpm, blood pressure 158/94 mmHg, temperature 37.3 C. He is fully oriented. No signs of chronic liver disease are present. Investigations: haemoglobin 14.2 g/dL, white cell count 11.3 x10^9/L, platelets 210 x10^9/L, INR 1.1, ALT 65 U/L (reference 10-40), AST 58 U/L (reference 10-40), bilirubin 12 micromol/L, GGT 240 U/L (reference <60). Serum creatinine 0.9 mg/dL, eGFR 95 mL/min. Blood glucose 5.6 mmol/L. He has no known drug allergies and takes no regular medicines. He weighs 75 kg.
Your task
Presents with a two-day history of tremors, agitation, and insomnia. He consumes about 15 units of alcohol per day. No other medical history. No known allergies. Not on regular medications.
What gets marked
- Whether you chose an indicated drug, and whether you avoided the contraindicated ones.
- Dose, route, frequency and duration against the range for this patient.
- Renal and hepatic dose adjustment where this patient's numbers demand it.
- Allergy cross-reactivity and interactions with the medicines already on the chart.
- The instructions and monitoring you write, not only the drug you pick.
8 scoring rules apply to this scenario. A single critical error fails the attempt whatever the score.
Log in to prescribe for "Alcohol Withdrawal in a 48-Year-Old Man"
A free account opens the prescription pad: search the formulary, write the chart, and have it marked line by line by the safety engine.
Taught in
More like this
- Clinical case: Paracetamol Overdose in a Young Woman: A Clinical Case
- Clinical case: A 34-year-old man found unresponsive with pinpoint pupils and a respiratory rate of 6
- Clinical case: Lithium Toxicity and ACE Inhibitor Interaction
- Clinical case: Acute Kidney Injury in an Older Patient with Diarrhoea
- Anaphylaxis to Intravenous Co-amoxiclav
- Atrial fibrillation with chronic kidney disease: anticoagulation
Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.