Addiction Pt. II

Question 1

Alcohol Use

Answer 1

• 3rd leading preventable cause of death in the U.S.

- Alcohol misuse and abuse problems contribute to ~25% of patients admitted to the hospital

Question 2

Alcohol + Absorption

Answer 2

• Water soluble liquid
• 20% absorbed through the stomach wall immediately after consumption + enters the bloodstream
• 80% absorbed by the small intestine slower

Question 3

What helps slow absorption of alcohol?

Answer 3

Food

Question 4

What influences absorption of alcohol?

Answer 4

Food intake, body mass, liver function

Question 5

Alcohol + Distribution

Answer 5

• Based on water content

- Cerebrum + Cerebellum affected first

Question 6

Alcohol + Metabolism

Answer 6

• 95% through liver and lungs
• ~ 1 oz. / 90 minutes
• ~15 mg/dl per hour

Question 7

Alcohol Intoxication: Short-term effects

Answer 7

• Slurred speech
• Loud talking
• Poor attention
• Disinhibition
• Impaired judgement
• Fuzzy thinking
• Decreased anxiety
• Decreased tension

Question 8

Chronic effects of alcohol

Answer 8

• Cirrhosis of the liver
• Esophageal varices
• Gastric ulcers
• Myopathy
• Portal hypertension
• Pancreatitis
• Depletion of B vitamins
• Enlargement of the cerebral ventricles
• Korsakoff’s psychosis
• Wernickes’s encephalopathy

Question 9

Mild Alcohol Syndrome Side Effects

Answer 9

• Anxiety/ irritability
• Insomnia
• Mild HTN
• Tachycardia
• Mild GI upset
• Decreased appetite
• Tremulousness

Question 10

Moderate Alcohol Syndrome Side Effects

Answer 10

• Tachycardia
• Diaphoresis
• Nausea/vomiting
• Photophobia
• Marked tremor/ muscle rigidity
• Poor concentration + bad memory
• Agitation
• Insomnia
• Hallucination; delusions
• Grand Mal seizures
• Loss of consciousness
• Brief cessation of breathing

Question 11

Alcohol Withdrawal Delirium

Answer 11

• Generally starts within 2-3 days after last drink
• Progression from earlier symptoms
• Hallucinations
• Tachycardia
• Hyper/hypo tension
• Confusion + disorientation
• Extreme tremors
• Agitation
• Diaphoresis, fever
• Cardiovascular collapse/ hypothermia

Question 12

Pharmacological Management of Acute Alcohol Withdrawal

Answer 12

Benzodiazepines:

• Chlordiazepoxide
• Diazepam
• Oxazepam
• Lorazepam

Beta-Adrenergic Blockers:

• Folate
• Thiamine
• MVI