Alcohol

Question 1

Alcohol Guidelines

How much is one unit?
Recommended units? How should this be spread throughout the week?
How do you calculate units?

Consequences of chronic heavy drinking?

Answer 1

One unit is equal to 10ml/8g
14 units a week on a regular basis is the strength (ABV) x volume (ml) ÷ 1,000 = units

Spread the drinking over 3 or more days
If trying to cut down, have drink-free days

Liver disease ,pancreatitis, cancer, ulcers and gastrointestinal problems ,immune system dysfunction, brain damage, malnourishment vitamin deficiencies especially Vitamin B, osteoporosis.
Wernicke’s encephalopathy and Korsakoff syndrome related to thiamine levels being low.

Question 2

Pregnancy and Drinking

Consequences?

Answer 2

Don’t drink, unlikely that much harm has been done to the baby if in early stages when pregnancy unknown.

Fetal Alcohol Syndrome: restricted growth, facial abnormality, learning and behavioural disorders
Risk of low birth weight, preterm birth.

Question 3

Alcohol and Medication

Sedatives
Paracetamol
NSAID's
Opioids
Antidepressants
Anticoagulants
Antihyperglycaemics 
Antihypertensives

Answer 3

If taking medication, advised to minimise how much alcohol you drink.

Sedatives - increases effects of both drugs, could slow or affect breathing fatally
Paracetamol - both metabolised by liver so harder work
NSAID’s - irritates the stomach so makes gastric bleeding more likely
Opioids - increases effects of both drugs, could slow or affect breathing fatally
Antidepressants - can make symptoms worse
Anticoagulants - may increase the risk of bleeding
Antihyperglycaemics- alcohol can make it difficult to spot signs of hyperglycaemia
Antihypertensives - regular drinking can raise BP and reduce effectiveness of the medication

Question 4

Harmful drinking
Alcohol dependence

CAGE questionnaire

Answer 4

Healthy problems directly related to alcohol including depression, RTA, acute pancreatitis.
Craving, tolerance, preoccupation with alcohol despite the harmful consequences

Screening tool - self questionnaire. >=2 should promote further exploration. This is considered more significant than GGT liver test.
Ever felt you should Cut down on drinking, have people Annoyed you by criticising your drinking, Guilty about drinking, drink in the morning or to get rid of a hangover - Eye opener

Abstinence is usually the most appropriate goal, for high-risk drinking consider a moderate level of drinking as the goal, for severe dependence, consider a harm reduction programme of care.