Substance Abuse Flashcards
A 56-year-old male is admitted in stable condition to the hospitalist service in your suburban hospital with a diagnosis of community-acquired pneumonia. He has been given antibiotics, oral steroids and oxygen by nasal prongs. On review of systems, you learn that he regularly drinks about 14 standard alcoholic beverages a day. His last drink was 18 hours ago.
List five symptoms of alcohol withdrawal he may already have experienced in the first six to 12 hours after his last drink.
Insomnia Tremulousness Mild anxiety Gastrointestinal upset Headache Diaphoresis Palpitations Anorexia
CFPC Self Learning Module: Vol 32.2
A 56-year-old male is admitted in stable condition to the hospitalist service in your suburban hospital with a diagnosis of community-acquired pneumonia. He has been given antibiotics, oral steroids and oxygen by nasal prongs. On review of systems, you learn that he regularly drinks about 14 standard alcoholic beverages a day. His last drink was 18 hours ago.
What three types of hallucinations may begin within 12-24 hours after his last drink?
Visual, auditory and tactile hallucinations
A 56-year-old male is admitted in stable condition to the hospitalist service in your suburban hospital with a diagnosis of community-acquired pneumonia. He has been given antibiotics, oral steroids and oxygen by nasal prongs. On review of systems, you learn that he regularly drinks about 14 standard alcoholic beverages a day. His last drink was 18 hours ago.
If unmanaged, for what two potentially serious complications of alcohol withdrawal is he at risk?
Seizures
Alcohol withdrawal delirium (delirium tremens)
A 56-year-old male is admitted in stable condition to the hospitalist service in your suburban hospital with a diagnosis of community-acquired pneumonia. He has been given antibiotics, oral steroids and oxygen by nasal prongs. On review of systems, you learn that he regularly drinks about 14 standard alcoholic beverages a day. His last drink was 18 hours ago.
You order basic laboratory investigations including electrolytes, because severe electrolyte abnormalities may lead to which serious cardiac complication?
Cardiac arrhythmias
A 56-year-old male is admitted in stable condition to the hospitalist service in your suburban hospital with a diagnosis of community-acquired pneumonia. He has been given antibiotics, oral steroids and oxygen by nasal prongs. On review of systems, you learn that he regularly drinks about 14 standard alcoholic beverages a day. His last drink was 18 hours ago.
When might you consider using adjunctive clonidine?
Some patients may require additional antihypertensive therapy for cardiac adrenergic symptoms (hypertension, tachycardia) if symptoms do not resolve by treating other medical problems such as dehydration and electrolyte imbalances. The authors suggest that use of clonidine should be restricted to patients who have a substantial increase in blood pressure over baseline or are nearing hypertensive urgency or emergency (pressures >180/120 mm Hg).
