Alcohol Abuse Flashcards
Define dependence syndrome?
3 of the following
Sense of compulsion and impaired control Physiological withdrawal state Increased tolerance Persistence in taking substance despite harmful consequence Short lasting abstinence
What is the prevelance of alchol dependance in the UK, the amount of emergency and psychiatric hospital admissions related to alcohol?
M 7%
F 2%
25% emeregency
10% Psychiatric
What is the biological aetiology of alcohol dependance?
First degree relatives of alcohol-dependent persons 7x increased risk
Glutamate upregulation in alcohol dependent
Aldehyde dehydrogenase in East Asian
What is the psychological aetiology of alcohol; dependance?
Modelling drinking behaviours of peers
Positive reinforcement aka seek out positive effects of alcohol
Negative reinforcement avoids withdrawal effects
What is the social aetiology of alcohol; dependance?
Stress events
Occupation
Society
Describe the prevelance of alcohol withdrawal syndrome?
40%
What are the symptoms of AWS?
Onset 6-8hrs after last drink
Peaks at 10-30hrs
Anxiety Agitation Tacycardia Tremor Sweathing N &V
What is delirium tremens?
Occurs 1-3 days after last drink in 5% of patients with AWS
Clouding of consciousness
Visual hallucinations
Paranoid delusion
Autonomic arousal
Tremor
Agitation
Seizures
15% mortality if not treated
How do you treat delirium tremens?
Benzodiazepams
Thiamine
IV fluids
What is the triad of symptoms seen in Wernicke’s encepalopathy?
Ataxia
Confusion
Ocular Palsy
Caused by thiamine deficency
What are the potential outcomes of wernickes?
20% recovery
10% die of brainstem haemorrhage
Reamining develop Korsacov’s
What is korsacov’s encepalopathy?
Characterised by prominent short term memory deficit.
Confabulation.
Immediate recall and other cognitive functions are fine.
4 important screening questions for alcohol dependance?
CAGE
Cut down, ever felt you should?
Annoyed by criticism about your drinking.
Guilty about drinking.
Early morning drinking.
