alcohol symposium

Question 1

What is hazardous drinking

Answer 1

Pattern of alcohol consumption that increases the risk of harmful consequences

Question 2

How many units is in the hazardous drinking category for men and women

Answer 2

14-34 in women

14-50 in men

Question 3

What is alcohol dependence

Answer 3

Cluster of behavioural, cognitive and physiological factors that include strong desire to drink alcohol and difficulties controlling it

Question 4

What is impaired control of alcohol

Answer 4

• Taken in larger amounts
• desire or unsuccessful attempts to cut down
• Great deal of time spent towards alcohol
• cravings

Question 5

What is alcohol tolerance

Answer 5

• Need for increased amounts of alcohol to achieve the desired effect

Question 7

What is withdrawal of alcohol

Answer 7

Alcohol is taken to reduce withdrawal symptoms

Question 8

What is the pharmaceutical treatment for medical assisted detoxification

Answer 8

Chlordiazepoxide - well tolerated drug of choice

Question 9

What are the symptoms of alcohol withdrawal syndrome

Answer 9

• Tremor
• Sweating
• nausea
• retching
• HR, BP, Temp increased
• insomnia
• anxiety
• agitation
• hallucinations
• seizures
• delirium tremens

Question 11

What are the relapse prevention medications

Answer 11

Acamprosate
Naltrexone
Disulfiram
Baclofen (France)
Gamma-Hydroxybutyric acid (Italy, Austria)
Gabapentin (unlicensed)
Topiramate (unlicensed)

Question 12

Who is acamprosate good for

Answer 12

People who are completely stopping alcohol

Question 13

What does acamprosate do

Answer 13

Reduces alcohol cravings

Question 15

How does Naltrexone work

Answer 15

Naltrexone – blocks opioid receptors – makes the body react differently to alcohol – less dopamine so less enjoyment from the alcohol

Question 16

How does disulfiram work

Answer 16

Unpleasant reaction with alcohol which causes a psychological deterrance

Question 17

What are the side effects of disulfiram

Answer 17

Heoatotoxicity
Neuropathy
Psychosis

Question 18

What is the triad of refeeding syndrome

Answer 18

Low magnesium
Low phosphate
Low potassium

Question 19

What are the physical effects of low magnesium

Answer 19

• Confusion
• Delirium
• tremors
• seizures
• tachyarrhythmias

Question 20

How is hyperkalaemia treated

Answer 20

Insulin is given which drives potassium into cells

Question 21

What are the physical symptoms of hypokalaemia

Answer 21

Weakness and decreased muscle tone

Question 22

What are the physical symptoms of hypophosphataemia

Answer 22

• Seizure
• coma
• delerium
• Cardiomyopthy
• Weakness
• Ileus

Question 23

What is the treatment of alcholcic keto-acidosis

Answer 23

fluids
Dextrose
Thiamine

Question 24

What is the presentation of Wernicke’s or korsakoffs

Answer 24

Triad:
Gate ataxia or impalanc e
opthalmoplegia
confusion

Question 25

Can alcoholic fatty liver become normal

Answer 25

Yes if the patient abstains from alcohol

Question 26

Why are alcoholics normally manourished

Answer 26

A lot of their calories come from alcohol and the alcohol doesn’t provide proteins or vitamins

Alcohol is a laxative so it can reduce energy intake further

Question 27

What is checked to see if the alcohol is compensating

Answer 27

If ABC is normal the liver is compensating;
Albumin
Bilirubin
Clotting

Question 28

What is delirium tremens and what are the symptoms

Answer 28

Delirium tremens occurs when a person who has been drinking heavily suddenly stops or significantly reduces alcohol consumption. Chronic alcohol use suppresses the central nervous system, and abrupt cessation can lead to overactivity of the brain, causing severe symptoms.
Symptoms:
Severe confusion and disorientation
Tremors (shaking)
Hallucinations (often visual, but can be tactile or auditory)
Agitation and restlessness
Fever and sweating
Rapid heartbeat (tachycardia)
High blood pressure
Seizures (can occur before DT onset)

Question 29

What is the most common symptom of alcohol withdrawal

Answer 29

Tremor which can start up to 10 hours after the last drink and can last 1-2 days

Question 30

What causes Wernicke’s encephalopathy

Answer 30

Lack of thiamine - usually due to alcohol which prevents the absorption of Thiamine

Question 31

What is used to attenuate alcohol withdrawal symptoms

Answer 31

Long acting benzodiazepine - e.g chlordiazepoxide

Patients with significant liver disease should be given a short acting benzodiazepine due to the shorter half life