Alcohol and Health Flashcards
What are the effects of alcohol in both low doses and high doses?
Low Doses
- euphoria
- reduced anxiety
- relaxation
- sociability
High Doses
- Intoxication - pathological state produced by a drug, serum, alcohol, or any toxic substance; poisoning
- impaired attention and judgement
- unsteadiness
- flushing
- nystagmus
- mood instability
- disinhibition
- slurring
- stupor
- unconsciousness
What are some of the diagnostic criteria of alcohol dependence according to the ICD 10?
- Increased tolerance
- Physical withdrawal
- Neglect of other interests
- Difficulty controlling use
What are the various ways in which alcohol dependence can be seen?
- Acute intoxication
- Harmful use
- Dependence
- Withdrawal State
What is “harmful use” of alcohol?
- Pattern of alcohol use causing damage to physical or mental health
- Use >1 month or repeatedly over 12 months.
What is “alcohol dependence”?
3 or more of the following for >1 month or repeatedly over 12 months:
- Cravings/compulsions to take
- Difficulty controlling use
- Primacy
- Increased tolerance
- Physiological withdrawal on reduction/cessation
- Persistence despite harmful consequences.
What is the “withdrawal state”?
Group of symptoms of variable clustering and severity on complete/relative of a psychoactive substance, after persistent use of that substance.
What impact does alcohol have on the neurochemistry within the brain?
- Alcohol is a depressant
- Alcohol enhances inhibitory GABA, glycine and adenosine.
- Alcohol reduces excitatory NMDA glutamate and aspartate.
- Alcohol promotes endogenous opioid release and endocannabinoid release.
What S/S occur during the alcohol withdrawal state?
- Tremor
- Weakness
- Nausea
- Vomiting
- Anxiety
- Seizures
- Confusion
- Agitation
- Death
What is a type of withdrawal that occurs 48-72hrs after last bevvy?
Delirium tremens
What is delirium tremens?
- Profound confusion, tremor, agitation, hallucinations, delusions, sleeplessness, autonomic over-activity.
- Mortality - 5%
- Death: CVS collapse, infection. hyperthermia, seizures and self-injury.
- Usually 48-72 hours after alcohol stopped.
[what that geezer in india had]
^aw what im george ive been to india
aw what im marty from londonderry
What are “the 4 Ls of alcohol abuse”?
Liver
Lover
Life
Law
Slide 12 about pathological jealousy???
…
What mental health issues are liked with alcohol use?
- Anxiety
- Depression
- Sleep disruption
- Morbid Jealousy
- Alcoholic hallucinosis
- Deliberate self-injury
- Suicidal thoughts/acts
What implications can alcohol have on physical health?
See pic.
Also
- Accident injury/violence
- cancer (mouth, oesophagus, liver)
- neurological (fits, confusional state, Korsakoff’s/Wernickes)
What is Wernicke’s Encephalopathy?
Presence of neurological symptoms caused by biochemical lesions of the central nervous system after exhaustion of B-vitamin reserves, in particula,r thiamine (vitamin B1).
- Confusion
- Ataxia
- Opthalmoplegia
- Nystagmus
Caused by thiamine deficiency
- Poor intake and absorption, poor hepatic function, increased requirement for alcohol metabolism
WHat is Korasakoff’s Psycosis?
- Prominent impairment of recent and remote memory, preservation of immediate recall, no general cognitive impairment, retrograde and anterograde memory, impaired learning and disorientation, may exhibit nystagmus and ataxia.
- Related to alcohol abuse.
Caused by thiamine deficiency
- Poor intake and absorption, poor hepatic function, increased requirement for alcohol metabolism
What impact can alcohol have on relationships?
What other aspects of life does it impact?
- Aggression
- Verbal
- Physical
- Marital difficulties
- Morbid jealousy
- Poor parenting/neglect +/- loss of parenting rights
- Loss of friendships and social supports
Employment, Financial and Legal
What screening tools are used in alcohol abuse?
- CAGE (2 or more = likely alcohol problem)
- Have you tried to Cut down?
- Have you felt Annoyed by people criticising your drinking?
- Have you felt Guilty about drinking?
- Have you felt the need to have an Eye-opener?
- AUDIT (Alcohol Use Disorders Identification Test)
- FAST (4 questions)
- PAT (Paddington Alcohol Test; used in A&Es)
How can those with alcohol problems be managed?
- Practical advice, education, harm reduction
- Holistic/bio-psycho-social approach
- Support for patient and family
- Psychological help (e.g. CBT, group therapy)
- Social work input (benefits, housing, child protection)
- Skills training
- Community Support (eg AA, ADA)
- Inpatient or residential treatment
- Medication
What medication is given to those for prevention of wenicke-korsakoff syndrome?
- Prevention of Wernicke-Korsakoff Syndrome
- Thiamine
What meds for alcohol withdrawal?
Management of alcohol withdrawal
- Benzodiazepines , commonly Chlordiazepoxide
What meds are used for aversion/deterrent?
Aversion/deterrent medication
- Disulfiram (Antabuse)
What anti-craving medications can be given?
Anti-craving medication
- Acamprosate (Campral)
- Naltrexone
- Nalmefene
- (Baclofen)
