Alcohol Misuse Flashcards
1 unit is the equivalent of…
10ml alcohol
increased risk drinking is drinking between _ and _ units a week
15 and 35
higher risk drinking is drinking over _ units per week
35
what tools can be used to screen for alcohol dependence?
AUDIT - alcohol user disorders identification test
CAGE - cut down, annoyed, guilty, eye opener
alcoholism has what effect on MCV?
raises it
what kind of alcohol dependent patients are managed as inpatients?
if they have comorbidities and are moderately dependent or over
how should alcohol dependent patients be managed in the community
use FRAMES Feedback to review problems experienced Responsibility for change Advise reduction Menu- provide options for change Empathy Self efficacy - give them confidence
what happens to the CNS when you withdraw alcohol?
excess glutamate activity and reduced GABA activity which is toxic to neurons which = CNS excitability and neurotoxicity
first symptoms of alcohol withdrawal occur in what timeframe
1-2 days
DT onset will be within _ hours of withdrawal
24
most symptoms of alcohol withdrawal resolve within - days
5-7
symptoms of alcohol withdrawal
restlessness tremor sweating anxiety N+V
how do benzodiazepines work in alcohol withdrawal?
act on GABA A receptors
DT peaks after how many days of withdrawal?
2
how does DT present?
insidiously with nighttime confusion
Tx of alcohol withdrawal
diazepam (benzodiazepine) reduce dose over 7 days or more hydrate analgesia antiemetics
what is the main vitamin deficiency in alcohol withdrawal and what is the consequence?
not eating so use up all their thiamine causing wernickes encephalopathy
how is prophylactic thiamine given?
parenterally
when would you manage detoxification of a patient in hospital?
secere dependence DT or recent withdrawal seizures Hx of failed detoxifications poor social support cognitive impairment
when should benzos be stopped in alcohol withdrawal?
once detoxification has been achieved
what drugs are used as prophylaxis for a relapse?
disulfiram - CANT DRINK ON IT
acamprosate
naltrexone
first line agent for relapse prevention? what kind of drug is it?
naltrexone
opioid antagonist
wernickes syndrome is due to what vitamin deficiency?
B1
