Alcohol withdrawal

Question 1

Define AW:

Answer 1

the symptoms that arise when a person has been drinking a large amount of alcohol on a regular basis and suddenly stops drinking.

Question 2

What is the aeitiology of AW?

Answer 2

When you drink there is an decrease in glutamate.

If you suddenly stop there is an increased sensitivity to the glutamate and so you get excitatory effects.

Question 3

what is the epidemiology?

Answer 3

It will affect 6% of alcoholics if it is not treated.

10% will experience hallucinations

Question 4

What are the symptoms of AW?

Answer 4

There is a history of alcoholism. 
Tremors
Mild anxiety
Palpitations
Headaches
Nausea/vomiting
Sweating
Insomnia
Fatigue 
Craving alcohol

IN more severe cases:
Hallucinations
Delirium tremens
Withdrawal seizures (tonic clonic type)

Question 5

What are the investigations of AW?

Answer 5

serum urea and creatinine
liver function tests
ethanol
electrolyte panel
FBC
CT of head
chest x-ray

Question 6

What is the management of AW?

Answer 6

Barbiturates in the refractory period to benzodizapines.

Thiamine to stop Wernicke-Korsakoff syndrome

Chlordiazepoxide - reduces symptoms of alcohol withdrawal

SUPPORT.

Question 7

What are possible complications of AW?

Answer 7

seizures which can lead to death if untreated

Question 8

what is the prognosis of AW?

Answer 8

<2% if it is treated. If not then delirium tremens have 35% mortality