Alcohol Withdrawal Flashcards
1
Q
Define alcohol withdrawal
A
decrease or cessation of alcohol drinking -> lower BAC than the
patient is habituated to
2
Q
What are the causes/risk factors of alcohol withdrawal?
A
Chronic alcohol use -> upregulation of postsynaptic excitatory glutamate NMDA receptors
and downregulation of postsynaptic inhibitory GABA receptors
Abrupt alcohol cessation -> overactivation of the excitatory glutamate system relative to the
inhibitory GABA system
3
Q
What are the signs and symptoms of alcohol withdrawal?
A
Minor (6-24h) • Tremor • Anxiety • Nausea • Vomiting • Insomnia
Major (10-72h) • Hallucinations (visual and auditory) • Whole body tremor • Sweating • Hypertension
Withdrawal seizures (6-48h)
• Seizures (tonic clonic) – frequently
the first sign of withdrawal
Delirium tremens (3-10 days) • Agitation • Profound global confusion • Amnesia • Delusions • Disorientation • Hallucinations e.g. formication • Fever • Sweating • Hypertension • Tachycardia
4
Q
What investigations are carried out for alcohol withdrawal?
A
• Bloods - U&Es – urea, Cr, metabolic acidosis - LFTs – alcoholic hepatitis - Toxicology screen – other drugs • CT head – exclude other causes
5
Q
What is the management for alcohol withdrawal?
A
- Ascitic tap for SBP
- B vitamins – IV Pabrinex
- Chlordiazepoxide
- Dietary monitoring/Dehydration
- Electrolyte monitoring/Enemas and lactulose for encephalopathy
