Scientific Poster Session III: Resident and Fellows Research-in-Progress

Residents and Fellows Research in Progress
  Monday, November 13, 2023
  01:00 PM–02:30 PM

Abstract

Introduction:

Alcohol use disorder affects approximately 14.8 million Americans. Alcohol use potentiates GABA and inhibits glutamate activity. Chronic alcoholism leads to the downregulation of GABA receptors and upregulation of excitatory glutaminergic receptors. This change in receptors can cause alcohol withdrawal syndrome (AWS) which may lead to hallucinations, seizures, delirium tremens, and even death when alcohol is stopped abruptly.

Preferred treatment for moderate to severe AWS has been symptom-triggered benzodiazepines with CIWA-Ar (Clinical Institute Withdrawal Assessment of Alcohol scale) and supportive care for many years. Due to issues with repeated and high doses of benzodiazepines, there has been interest in alternative treatment options. Phenobarbital is an alternative option with a prolonged half-life, proactive dosing regimen, and dual mechanism of action against AWS.

At Nebraska Medicine, a phenobarbital protocol for severe AWS was initiated in critical and progressive care settings in June 2021, and the protocol was extended for use on medical and surgical floor in July 2022.

Research Question or Hypothesis:

Has the phenobarbital protocol for AWS been used appropriately since its implementation on medical and surgical floors?

Study Design:

Retrospective, observational chart review.

Methods:

A retrospective chart review was conducted to assess adherence to the phenobarbital protocol for AWS for hospitalized patients on medical and surgical floors from July 25, 2022 to March 31, 2023. Data was pulled from the electronic health record for adult patients admitted to the medical-surgical floor who received phenobarbital for the treatment of AWS. Every fifth patient was chart reviewed for a target sample of 50 patients. Patients started on the phenobarbital protocol while in the intensive care unit were excluded. Patient demographics, medication use, laboratory values, symptom management, and outcomes were collected. Assessment of appropriate medication usage was determined using the phenobarbital protocol inclusion and exclusion criteria. Descriptive statistics will be utilized to assess data.

Results:

In-progress.

Conclusion:

In-progress.

Presenting Author

Cora Svoboda PharmD Candidate
University of Nebraska Medical Center College of Pharmacy

Authors

Sara Kjerengtroen PharmD, BCPS
Nebraska Medicine

Shannon Powers PharmD
University of Nebraska Medical Center

Brandon Reynolds PharmD, BCPS
University of Nebraska Medical Center

Michele Rooney PharmD, BCPS
University of Nebraska Medical Center