5.1. Alcohol Symposium - Alcohol Dependency Flashcards
What is the effect of Low Doses of Alcohol?
- Euphoria
- Reduced Anxiety
- Relaxation
- Sociability
What is the effect of High Doses of Alcohol?
- Intoxication - Pathological State produced by a Drug / Serum / Alcohol / Toxic Substance - Poisoning
- Impaired Attention / Judgement / Disinhibition
- Unsteadiness / Slurring / Stupor / Unconsciousness
- Flushing
- Nystagmus
- Mood Instability
What are the Different Diagnoses, with regards to Alcohol Intoxication?
- Acute Intoxication
- Harmful Use - Patter of causing damage to Health
- Dependence
- Withdrawal State - Symptoms on complete Withdrawal or a Psychoactive Substance
What is Alcohol Dependence?
3+ of the following for > 1 month:
- Cravings / Compulsion to Take
- Difficulty Controlling use
- Primacy
- Increased Tollerance
- Physiological Withdrawal on Reduction / Cessation
- Persistence depsite Harmful Consequences
What are the Symptoms of an Alcohol Withdrawal State?
- Tremor / Weakness
- Nausea / Vomiting
- Anxiety / Agitation
- Seizures
- Confusion
- Death
- Delirium Tremens
What are the “4 L’s” associated with Alcohol Problems?
Liver - Physical / Mental Health
Lover - Relationships
Livelihood - Employment / Financial
Legal - The Law
What Mental Health changes are there with Alcohol Dependence?
- Anxiety / Depression
- Sleep Disruption
- Morbid Jealousy
- Alcoholic Hallucinosis
- Deliberate Self-Injury
- Suicidal Thoughts / Acts
What are the Major Alcohol Problems?
- Wernicke’s Encephalopathy
2. Korsakoff’s Psychosis
How does Wernicke’s Encephalopathy present?
- Confusion
- Ataxia
- Opthalmoplegia
- Nystagmus
What can Wenicke’s Encephalopathy go on to form?
Korsakoff’s Psychosis
What is the Cause of Korsakoff’s Psychosis?
Thiamine Deficiency:
- Poor Intake / Absorption
- Poor Hepatic Function
- Increased Requirement for Alcohol Metabolism
How does Korsakoff’s Psychosis present?
- Impairment of Recent / Remote Memory
- Preservation of Immediate Recall
- No General Cognitive Impairment
- Retrograde and Anterograde Memory
- Impaired Learning and Disorientation
- Nystagmus and Ataxia
How can Alcohol Dependency affect Relationships?
- Aggression - Verbal / Physical
- Marital Difficulties - Morbid Jealousy
- Poor Parenting / Neglect +/- Loss of Parenting Rights
- Loss of Friendships and Social Supports
What are the Screening Tools for Alcoholism?
- CAGE
- AUDIT - Alcohol Use Disorders Identification Test
- FAST - 4 Questions
- PAT - Paddington Alcohol Test (used in A&E)
What does the CAGE Screening tool involve?
C - Cut - “Have you tried to CUT down?”
A - Annoyed - “Have you felt ANNOYED by people criticizing your drinking?”
G - Guilty - “Have you felt GUILTY about drinking?”
E - Eye-Opener - “Have you felt the need to have an EYE-OPENER?”
What is the Management of Alcohol Dependency?
- Practical Advice / Education / Harm Reduction
- Holistic / Bio-Social Approach:
- a) Support for Patient and their Family
- b) Psychological Help
- c) Social Worl Input
- d) Skills Training
- e) Community Support (e.g. A.A. / A.D.A)
- f) Inpatient / Residential Treatment
- g) Medication
What Medication can be provided to Prevent Wenicke-Korsakoff Syndrome?
Thiamine
How is Alcohol Withdrawal Managed?
- Benzodiazepines - Diazepam
2. (Commonly) Chlordiazepoxide
What Aversion / Deterrent Medication is available for Alcohol Dependence Treatment?
Disulfiram
What Anti-Craving Medication is available for Alcohol Dependence Treatment?
- Acamprosate
- Naltrexone
- Nalmefene
