Alcohol Withdrawal Flashcards
S/S of mild to moderate acute withdrawal syndrome?
insomnia
tremulousness
mild anxiety
GI upset/anorexia
HA
diaphoresis/palpitations
treatment for acute alcohol withdrawal syndrome?
repletion (banana bag)
psychomotor agitations (benzodiazepines)
what are the goals of treatment for acute alcohol withdrawal syndrome?
symptoms managment (benzos, adjuncts, CIWA)
S/S of delirium tremens
common alcohol withdrawal symptoms PLUS
delirium (encephalopathy), hallucinations, tachycardia, hypertension, hyperthermia
what is the timing for delirium tremens?
onset 48-96 hrs AFTER last drink
can persist for as long as 5 days
risk factors for delirium tremens?
sustained drinking
prior DT episode
age > 30
concurrent illness
+ significant withdrawal symptoms in presence of elevated blood alcohol levels
management for DT
medical inpatient (not behavioral health unit)
aggressive administration of IV benzodiazepines
what is Wernicke Encephalopathy?
ACUTE brain disorder causing petechial hemorrhaging & necrosis in the midline brain structures
deficiency of what causes Wernicke Encephalopathy?
thiamine deficiency
what is the clinical triad of Wernicke Encephalopathy?
encephalopathy/delirium
gait ataxia (or can’t even walk)
oculomotor dysfunction (EOM not intact)
are thiamine blood levels needed to start treatment for WE?
no- normal thiamine level does not exclude WE
what is Korsakoff’s syndrome?
consequence of untreated or repeated episodes of WE
Korsakoff’s syndrome is characterized by what 3 things?
cognitive impairment
retrograde & anterograde amnesia
brain imaging shows positive atrophy
what is cerebellar degeneration?
caused nutritional deficiency & neurotoxic effects of chronic alcohol use
S/S of cerebellar degeneration
gait ataxia
poor gross motor coordination
inability to hand write
dysarthria (speech difficulty)
*cognitive capability remains intact
