Alcohol misuse disorders Flashcards
Low dose alcohol effects?
Low doses – euphoria, reduced anxiety, relaxation, sociability
High dose alcohol effects?
Higher doses – intoxication (the 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
Alcohol dependence features?
Dependence – 3 or more of the following for >1month or repeatedly over 12 months:
Cravings/compulsions to take
Difficulty controlling use
Increased tolerance
Physiological withdrawal on reduction/cessation
Persistence despite harmful consequences
What is alcohol withdrawal?
Withdrawal State – Group of symptoms of variable clustering and severity on complete/relative withdrawal of a psychoactive substance, after persistent use of that substance
Alcohol withdrawal symptoms?
Tremor, weakness, nausea, vomiting, anxiety, seizures, confusion, agitation, death
First symptoms which mainly include restlessness, tremor, anxiety, sweating and vomiting occur within hours and peak at 24-48 hours.
What is delirium tremens and it’s features?
most severe form of ethanol withdrawal
Usually 48-72 hours after alcohol stopped
Profound confusion, tremor, agitation, hallucinations, delusions, sleeplessness, autonomic over-activity
Mortality in DTs = 2-5% (with medical support - higher without)
Death: cardiovascular collapse, infection, hyperthermia, seizures or self injury
What % of alcohol withdrawal cases progress to delirium tremens?
5%
Management of alcohol withdrawal?
General support - reassurance, advice etc.
Benzodiazepines - long acting agents, reduce gradually over 7 days
Vitamin supplementation including thiamine (vitamin B1) as prophylaxis (prevention) against Wenicke’s encephalopathy.
Relapse prevention
Dose of vitamin supplementation (including vitamin B1) must be increased in suspected wenicke’s encephalopathy. true/false?
True
