Alcohol Missuse Flashcards
How much alcohol is 1 unit?
10ml
How do you calculate number of units?
%Xvolume/10
e.g. 40% 750ml vodka
0.4X750/10
300/10 = 30 units
What does alcohol inhibit?
The action of excitatory NMDA-glutamate controlled ion channels
What does alcohol potentiate?
The actions of inhibitory GABA type A controlled ion channels
What does alcohol withdrawal lead to?
Excess glutamate activity and reduced GABA activity
What is excess glutamate toxic to?
The nerve cell
How long do symptoms of alcohol withdrawal take to present?
Within first hours
Peak at 24-48 hours
What are symptoms of alcohol withdrawal symptoms?
Restlessness Tremor Sweating Anxiety N+V loss of appetite insomnia Tachycardia Systolic hypertension Seizures Delirium tremens
How long do alcohol withdrawal symptoms take to resolve?
5-7 days
How does delirium tremens present?
Peak at 2 days
Insidious presentation often with night time confusion
Confusion, disorientation, agitation, hypertension, fever, visual and auditory hallucinations, paranoid ideation
What is the management of alcohol withdrawal?
Benzodiazepines
Vitamins
Support
What can be used as prophylaxis against Wernicke’s Encepalopathy?
Thiamine
What are other additional features to the management of alcohol withdrawal?
Adequate hydration Analgesia Antiemetics Treat infections and other physical conditions Environmental factors
What is Disulfiram? (Antabuse)
Inhibits acetaldehyde dehydrogenase leading to accumulation of acetaldehyde if alcohol is ingested
What does Disulfiram lead to?
Flushed skin Tachycardia N+V arrhythmias hypotension
