Alcohol

Question 1

psychoactive substance that causes the greatest harms of health, legal, social and economic costs and problems!

Answer 1

2. alcohol

Question 2

Alcohol-Related Harms

Answer 2

Liver disease (ascending order of severity):
1. Fatty liver
2. Alcoholic Hepatitis
3. Alcoholic Cirrhosis
Damage to heart, lungs and kidneys
Alcohol dependence
Neuropsychiatric diseases
Diabetes
Cardiovascular and gastrointestinal diseases
Cancer

Question 3

ACCUTE PHYSIOLOGICAL EFFECTS

Answer 3

Heat Loss – alcohol causes peripheral dilation
Diuretic effects – alcohol use decreases the antidiuretic hormone =swollen hands, feet
Effects on sleep – alcohol use effects REM sleep
Interactions with other drugs

Question 4

Accute behavioral effects

Answer 4

Blackouts
Driving skills
Violence and aggression
Sex and Sexual Desire
Drunk dialing/texting
Sadness/crying etc.

Question 5

Wernicke encephalopathy

Answer 5

life-threatening condition associated with thiamine deficiency. From severe malnutrition. Symptoms include: confusion, disorientation, abnormal eye movements, difficulties with coordination. Some form a type of chronic amnesia called Korsakoff syndrome

Question 6

Alcohol Withdrawal

Answer 6

• Chronic heavy drinkers who abstain from alcohol for more than a few hours can experience withdrawal symptoms:
• Early signs: tremors, palpitations & sweating
• Delirium tremens: (24-48 hours after alcohol cessation) clouding of consciousness, auditory and visual hallucinations (persecutory type), and seizures. Mortality rate = 5-15%
• Mild withdrawal symptoms
• Symptoms: Insomnia, Tremulousness, Mild anxiety, Gastrointestinal upset, anorexia, Headache, Diaphoresis, Palpitations

Question 7

withdrawal treatment

Answer 7

• Vitamin therapy
• Small doses on long-acting benzodiazepines for only a few days i.e. chlordiazepoxide (Librium) which decreases anxiety, successful for alcohol withdrawal, relaxation. Given PO 5-10mg tid-qid
• Benzodiazapines (for anxiety, seizures and DT’s)
• IV fluids/electrolytes – for dehydration
• Vitamins (B, thiamine, magnesium, folic acid)
• Anti-psychotics in low doses (for DT’s)
• Support, empathy and compassion
  Detox
• Treatment Centers
• Alcoholics Anonymous
• Counselling – rapport and connection
• Pharmacotherapy:

Question 8

Disulfiram (Antabuse)

Answer 8

It inhibits aldehyde dehydrogenase, thereby preventing the metabolism of the primary metabolite of alcohol: acetaldehyde; this leads to the production of a range of unpleasant side effects, i.e. nausea, vomiting, flushing, sympathetic overactivity & palpitations, if they drink!