Alcohol symposium Flashcards
- To extend students’ knowledge and understanding of the range of alcohol problems, from harmful use to dependence.
- To develop an awareness of screening tools used
- To increase knowledge of treatment options
- To recognise the broad-ranging impact that alcohol problems have on an individual’s physical and mental health and their social functioning
- To acknowledge the criminal and public health issues that can arise due to alcohol misuse
.
4 diagnoses caused by alcohol
Acute intoxication
Harmful use
Dependence
Withdrawal state
Elaborate on ‘harmful use’ of alcohol
Pattern of use causing damage to physical or mental health
Use >1 month or repeatedly over 12 months
Elaborate on ‘dependence’ on alcohol
3 or more of the following for >1month or repeatedly over 12 months
- Cravings/compulsions to take
- Difficulty controlling use
- Primacy
- Increased tolerance
- Physiological withdrawal on reduction/cessation
- Persistence despite harmful consequences
Symptoms/signs of alcohol withdrawal state
Tremor Weakness Nausea/Vomiting Anxiety Seizures Confusion Agitation
What is delirium tremens
+ symptoms (6)/signs (2) of it
Most severe form of alcohol withdrawal, manifested by altered mental status (global confusion) and sympathetic overdrive (autonomic hyperactivity), which can progress to CARDIOVASCULAR COLLAPSE
Symptoms
- profound confusion
- tremor
- agitation
- hallucinations (auditory, visual)
- delusions
- sweating
Signs
- fever
- autonomic hyperactivity (tachycardia and hypertension)
Delirium tremens usually kicks in how many days from withdrawal
2-3 days
Complications of alcohol misuse include cerebral illnesses
What are some cerebral illnesses that it can cause?
Seizures
Wernicke’s encephalopathy - ophthalmoparesis (weakness of extra ocular muscles) with nystagmus, ataxia, and confusion
Korsakoff’s psychosis - late complication of persistent Wernicke encephalopathy and results in memory deficits, confusion, and behavioral changes
Wernicke’s encephalopathy is primarily caused by
Thiamine deficiency (secondary to alcoholism as there’s increased thiamine requirement for alcohol metabolism)
Screening tools for alcoholism (4)
CAGE
AUDIT (Alcohol Use Disorders Identification Test)
FAST (4 questions)
PAT (Paddington Alcohol Test; used in A&E)
Questions asked in CAGE screening tool for alcoholism (2 or more = likely alcohol problem)
Have you tried to Cut down?
Have you felt Annoyed by people criticising your drinking?
Have you felt Guilty about drinking?
Have you felt the need to have an Eye-opener (drink in the morning)?
Basic management options for alcoholism (6)
Practical advice/ education Support for patient + family Psychological help, e.g. CBT Social work input (benefits, housing) Skills training (so they can work) Medication
Medication given for alcohol misuse
- to prevent wernicke-korsakoff syndrome (1)
- to manage withdrawal (1)
- to avert/deter from alcohol (1)
- anti-craving (3)
To prevent wernicke-korsakoff syndrome
-THIAMINE
To manage withdrawal
-BENZODIAZEPINES, usually chlordiazepoxide
To avert/deter from alcohol
-DISULFIRAM
Anti-craving
- ACAMPROSATE
- NALTREXONE
- NALMEFENE
How does the liver metabolise alcohol
ADH (alcohol dehydrogenase) breaks down alcohol into acetaldehyde, then aldehyde dehydrogenase (ALDH), rapidly breaks down acetaldehyde (CARCINOGEN) into acetate.
The acetate is further metabolised, and eventually leaves body as carbon dioxide and water.
Recommended alcohol limit for both sexes
<14 units a week
