Alcohol Withdrawal Flashcards
what is alcohol withdrawal
when a chronic alcoholic suddenly stops drinking
what occurs with alcohol withdrawal
‘the shakes’ initially
seizures, hallucinations, coma + death later
aetiology
chronic alcohol use inhibits glutamate (excitatory) and so causes an up-regulation of post-synaptic glutamate receptors
chronic alcohol use increases GABA (inhibitory) and so causes a down-regulation of post-synaptic GABA receptors
what causes the addiction in alcohol
alcohol causes release of dopamine and serotonin
pathophysiology
alcohol withdrawal reverses effects of chronic alcohol and causes increase in excitatory glutamate and decrease in inhibitory GABA
this can lead to seizures
features of alcohol withdrawal
sudden cessation of alcohol in a chronic user
changed mental state (memory disturbances, disoreintated)
seizures, hallucinations, delusions
what hallucinations might someone with alcohol withdrawal experience
visual hallucinations - seeing crawling insects
tactile hallucinations - pins and needles
what are delusions associated with
delirium tremens
what symptoms are associated with minor withdrawal
N+V
tremor + anxiety
HTN
what symptoms are associated with major withdrawal
change in mental status
seizures
investigations
LFTs (all elevated)
serum urea and creatinine
what is the first line treatment for alcohol withdrawal
benzodiazepines (chlordiazepoxide)
what is the first line treatment for alcohol withdrawal and liver failure
lorazepam
what vitamin supplementation may be given in alcohol withdrawal
thiamine (wernickes)
folic acid
magnesium sulphate (low Mg)
what are complications of alcohol withdrawal
alcohol withdrawal seizures
status epilepticus
