Alcohol dependence Flashcards
What is the presentation of alcohol dependence?
Cravings/compulsions Difficulty controlling use Primacy Increased tolerance Physiological withdrawal on reduction or cessation Persistence despite harmful consequences
What are the features of withdrawal?
Tremor, weakness N&V Anxiety Seizures- peak at 36 hours Confusionm agitation Delirium tremens- peak at 48-72 hours
How is dependence diagnosed?
CAGE screening
At least 3 symptoms for >1 month or repeatedly for 12 months
What is the screening tool used for alcohol dependence?
CAGE
What is the CAGE screening tool?
Get the need to Cut down
Felt Annoyed about being criticised
Felt Guilty about drinking
Felt the need for an Eye opener
How is alcohol dependence managed?
Bio-psycho-social support
Medications
What medications are used to manage alcohol dependence?
Benzodiazepines= chlordiazepoxide Thiamine= prevention of Wernicke-Korsakoff's Deterrent= disulfiram Anticraving= naltrexone, acamprosate, nalmefene
Why are benzodiazepines given in alcohol withdrawal?
Control psychomotor agitation and prevent more severe symptoms
Can treat seizures and delirium tremens
What are some complications of alcohol dependence?
Cancer- mouth, oesophagus, stomach, liver Cerebral atrophy Alcoholic liver disease Mental health Wernick-Korsakoff's
What are the features of Wernicke encephalopathy?
Nystagmus Opthalmoplegia Ataxia Confusion, altered GCS peripheral sensory neuropathy
What are the features of Korsakoff syndrome?
Anterograde and retrograde amnesia
Confabulation
What is Wernicke-Korsakoff’s?
Acute Wernicke encephalopathy phase, followed by chronic Korsakoff syndrome
What are the features of delirium tremens?
Profound confusion Tremor Agitation Hallucinations Delusions Insomnia Autonomic overactivity
What causes death in delirium tremens?
5-10% mortality CV collapse Infection Hyperthermia Seizures Self injury
