Alcohol - the clinicians perspective Flashcards
What are the symptoms of mild alcohol withdrawel?
Fine tremor Sweating Anxiety Hyperactivity Tachycardia Hypertension Anorexia Nausea Retching
What are the symptoms of moderate alcohol withdrawel?
Coarse tremor Shaking Agitation Confusion Disorientation Paranoia Seizures Hallucinations
What are the symptoms of severe alcohol withdrawl?
Severe agitation Anxiety Confusion Tactile visual hallucinations Circulatory collapse and death
What type of seizure is an alcohol withdrawal seizure?
Generalised tonic clonic seizure
Clustered over a few hours
What is peripheral neuropathy?
Sensorimotor axonal polyneuropathy
Causes burning, pain and weakness
What is compression neuropathy?
Temporary damage to myelin sheath (saturday night palsy)
Radial nerve compression at humeral head
What sort of myopathy can occur after an acute binge?
Myalgia, proximal weakness, swollen tender muscles due to a raised CK
What sort of myopathy can occur with chronic alcoholism?
Painless, proximal weakness and atrophy, normal CK, low K and PO4
What is wernikes encephalopathy?
Thiamine deficiency and cytotoxic oedema in mamillary bodies
What is the triad of wenickes encephalopathy?
Occular dysfunction (nystagmus and opthalmoparesis)
Ataxic gait
Acute confusion
What is korsakoff syndrome?
Cerebral atrophy resulting from WE
What are the symptoms of korsakoff syndrome?
Anterograde amnesia
Confabulation
Lack of insight
Abstinence and nutrition for treatment
How does chronic alcoholism cause cardiomyopathy?
Impaires ventricular function (calcium homeostasis, mitochrondrial effects, signal transduction)
Prolonged exposure leads to chronic inflammation/ fibrosis of myofibrils
What arrhythmias can occur with acute alcohol intoxication?
AF, SVT (holiday heart)
What arrhythmias can occur with chronic alcohol intoxication?
Electrolyte imbalance can lead to a long QT
Dilated cardiomyopathy can lead to atrial and ventricular arrhythmias
What is the pathogenesis for regular heavy drinking?
Fat accumulation in hepatocytes
Inflammation
Fibrosis
Cirrhosis
What is alcohol related hepatits?
Acute, lifethreatning manifestation
Parenchymal inflammation and hepatocyte damage
Jaundice, coagulopathy and liver failure
What is the pathogenesis for alcohol related cirrhosis?
Progressive fibrosis
Architectural distortion
Cirrhosis
Portal hypertension
What is compensated alcohol related cirrhosis?
Compensated - normal liver function and normal physical function
What is decompensaed alcohol related cirrhosis?
Impaired synthetic function, ascited and encephalopathy
What are the treatments for alcohol cirrhosis?
Abstinence Vitamins Nutrition Endoscopic Pharma - Bblockers, lactulose, rifaximin Radiological - TIPPS Surigcal - transplant
What is a brief intervention?
Feedback on person’s alcohol use and any related harm
Clarification as to what constitutes low risk consumption
Info on harms associated with risk alcohol use
Benefits of reducing intake
What are the pharmacological interventions that can reduce alcohol consumption?
Acamprosate - reduces cravings
Naltrexone - reduces desire for alcohol
Disulfiram - aversion therapy drug - produces a similar reaction of metrondiazole with alcohol
Nalmefene - opioid antagonist
