Alcohol Withdrawal Flashcards
True or false: Ethanol does not bind directly to GABA receptors but facilitates binding
True
What are the receptors involved in the inhibitory pathway?
GABA
What are the 2 excitatory pathway receptors?
- NMDA
- Glutamate
True or false: Ethanol binds directly to the NMDA/GLUTAMATE receptors
False (reduces binding to receptors)
What are two enzymes that metabolize ethanol?
- Alcohol dehydrogenase
- Aldehyde dehydrogenase
What are 3 complications of alcohol withdrawal?
- Uncomplicated symptoms
- Alcoholic hallucinations
- Alcohol withdrawal seizures
What is a serious complication of alcohol withdrawal that is diagnosed by the presence of delirium and tremors?
Delirium Tremens
What are 5 things that are seen with delirium tremens?
- Agitation
- Hallucinations
- Tachycardia
- Tachypnea
- Hypertension
What test is used for diagnosing alcohol withdrawal?
PAWSS
What score on PAWSS shows a low likelihood of developing moderate to severe alcohol withdrawal?
<4
What score on PAWSS shows a high likelihood of developing moderate to severe alcohol withdrawal?
> /= 4
What diagnosis tool for alcohol withdrawal is the most commonly used?
CIWA-AR
What are 7 supportive care treatments used for alcohol withdrawal?
- Fluids
- Antipyretics
- Thiamine and multivitamins
- Electrolyte replacement
- Dextrose
- Mechanical ventilation
- Restraints
What drugs increase the affinity of GABA to GABAA receptors leading to an inhibitory effect?
Benzodiazepines
What are 4 benzodiazepines that can be used for alcohol withdrawal?
- Diazepam
- Lorazepam
- Midazolam
- Chlordiazepoxide
What are 3 neurologic ADRS of benzos?
- Sedation
- Dizziness
- Delirium
What is a cardiovascular effect of benzos?
Hypotension
What is a rare side effect of benzos?
Respiratory depression
What benzodiazepine is very susceptible to 3A4 inhibitors?
Midazolam
What may occur if lorazepam is infused at high doses?
Metabolic acidosis
What drug class enhances GABA binding to the GABAA receptors and increases the duration of the Cl channel opening?
Barbiturates
What are the barbiturates place in therapy?
Adjunct therapy to benzodiazepines
What drug class treats the symptoms of alcohol withdrawal but not the underlying physiological source of the withdrawal?
Alpha 2 agonists
What are the 2 alpha 2 agonists?
- Precedex
- Propofol
