Alcohol Withdrawal Flashcards
Tolerance
The need for a larger dose of a drug to obtain the original effects. Decreased sense of pleasure from experiences that previously resulted in positive feelings.
Relief Craving
The intense desire for a substance, usually experienced after decreased use.
Reward Craving
Occurs in the presence of people, places or things associated with substance taking.
Attitudes towards people with substance-related problems
stigma and prejudice are affected by the media, misinformation and misconceptions.
positive interactions with a health care provider significantly improve health outcomes and increase the likelihood that the person will engage in reducing the harms associated with substance use.
Urgent Care Situations Precipitated by…
acute intoxication - usually last less that 24 hrs
overdose
withdrawal
Overdose
emergency! management is based on the type of substance involved. priority is ABCs. continuous monitoring is critical.
Effects of Alcohol Use
effects are related to the concentration of alcohol in the body and individual susceptibility. concentration can be determined by assessing the BAC (affected by amount consumed, drinking rate, drink concentration, body size and composition and hormones).
Alcohol Screening (CAGE)
C (cut down) - have you felt you need to cut down on your drinking/drug use?
A (annoyed) - have people annoyed you by criticizing your drinking/drug use?
G (guilt) - have you felt bad or guilty about your drinking/drug use?
E (eye opener) - have you ever had a drink or used drugs first thing in the morning to steady your nerves, get rid of a hangover or to get the day started?
Alcohol Withdrawal
sudden withdrawal may have life-threatening effects in alcohol dependent people. most experience a minor withdrawal syndrome in the first 6-12 hours after the last drink (may last 3-5 days).
Alcohol Withdrawal Symptoms
tremors, anxiety, increased HR +BP, sweating, nausea, hyperreflexia, agitation, insomnia, hallucinations.
seizures most likely to occur 24-28hrs after last drinks.
alcohol withdrawal delirium may occur between 48-96hrs after the last drink.
delirim tremens.
Delirium Tremens
anticipated within 48-72 hrs of last drink. severity depends on how much alcohol was ingested and for how long.
symptoms include anxiety, tremor, autonomic over-activity (dilated pupils, profuse perspiration)
death can result from hyperthermia, peripheral vascular collapse, or cardiac failure.
Delirium Tremens Post-op
significant mortality rate associated with cardiac dysrhythmias, cardiomyopathy, bleeding tendencies.
avoid by screening all patients for alcohol use.
Wernickle’s Encephalopathy
complication of chronic alcohol abuse. life threatening caused by chronic thiamine deficiency. affects CNS and PNS. nystagmus, ataxia, confusion.
Korsakoff Syndrome
condition that results from chronic thiamine deficiency. damage to nerve cells in the brain and spinal cord. memory issues.
Ethanol ETOH level
used to diagnose alcohol intoxication. critical level >64.8 mol/L or >300mg/dL
In canada, breathalyzer of >0.08% considered intoxicated. <0.05% considered not under influence.
