Alcohol Withdrawal Flashcards
Define Alcohol Withdrawal?
The symptoms that may occur when a person has been drinking too much alcohol on a regular basis and suddenly stops drinking
What is the aetiology of Alcohol Withdrawal?
Chronic Alcohol Consumption suppresses the activity of glutamate which is an excitatory neurotransmitter, so the body compensates by increasing sensitivity to glutamate
When alcohol consuption stops, you get increased glutamate activity leading to excitatory symptoms
What is the epidemiology of alcohol withdrawal?
If untreated, 6% of alcohol-dependent patients develop clinically relevant symptoms of withdrawal
Up to 10% of them will delirium tremens
What is Delirium Tremens?
An acute confusional state often seen as withdrawal syndrome in chronic alcoholics and caused by sudden cessation of drinking alcohol
It can be precipitated by a head injury or an acute infection causing abstinence from alcohol
What are the features of Delirium Tremens?
Anxiety
Tremor
Sweating
Vivid and Terrifying visual and sensory hallucinations
Can be Fatal
What are the mild symptoms of Alcohol Withdrawal?
Insomnia and Fatigue
Tremor
Mild Anxiety/feeling nervous
Mild Restlessness/agitation
Nausea and Vomiting
Headache
Sweating
Palpitations
Anorexia
Depression
Craving Alcohol
What are the more severe symptoms of Alcohol Withdrawal?
Hallucinations
Withdrawal Seizures
What are the appropriate investigations for alcohol withdrawal?
NO investigations
What is a management plan for alcohol withdrawal?
Chlorodiazepoxide - reduces symptoms of alcohol withdrawal
Barbiturates may be used if refractory to benzodiazepines
Thiamine (Pabrinex) - prevents progression to Wernicke-Korsakoff Syndrome
What is a possible complications of alcohol withdrawal?
Patients can have seizures and die if it is left untreated
What is the prognosis for patients with alcohol withdrawal?
Delirum Tremens has a mortality of 35% if untreated
Mortality is <2% with early detection and treatment
