Alcohol withdrawal

Question 1

Define alcohol withdrawal

Answer 1

the symptoms that may occur when a person has been drinking too much alcohol on a regular basis and suddenly stops drinking.

Question 2

brief pathophysiology?

Answer 2

• Chronic alcohol consumption suppresses the activity of glutamate
• so the body compensates by increasing sensitivity to glutamate
• when alcohol consumption stops there is increased glutamate activity

Question 3

at what points do symptoms start?

Answer 3

Symptoms: 6-12 hours
Seizures: 36 hours
Delirium tremens: 72 hours

Question 4

define delirium tremens?

Answer 4

an acute confusional state often seen as withdrawal syndrome in chronic alcoholics and caused by sudden cessation of drinking alcohol. It can be precipitated by a head injury or an acute infection causing abstinence from alcohol.

Question 5

investigations ?

Answer 5

‘Clinical Institute Withdrawl Assessment for Alcohol’

Question 6

management?

Answer 6

first line: benzo to stop seizures Chlordiazepoxide

• Barbiturates may be used if refractory to benzodiazepines
• Thiamine (Pabrinex) - prevents progression to Wernicke-Korsakoff syndrome

Question 7

prognosis

Answer 7

• Delirium tremens has a mortality of 35% if untreated