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Created by Megan Kerr
about 8 years ago
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| Question | Answer |
| Features of dependance | Salience Continued use despite harm Compulsion Withdrawal Return to use after abstinence Tolerance Narrowing of repotoire Problems controlling use |
| Alcohol intake limits (in units) | Safe = 2-3 units/day, 14 units/week Harmful = >6units/day, >35 units/week 1 unit = 1/2 pint ordinary strength beer, 25ml spirit or 50ml wine |
| Alcohol History | TRAP T= type R = route A = amount P=pattern Also look for s&s of dependancy Past use Future use - see it as a problem? |
| Management of Acute EtOH intoxication | Hypoglycaemia (Glucagon resistant) :. 50ml of 50% dextrose Thiamine U&E's to guide fluids Haemodyalisis if EtOH lvls v.high |
| S&S of chronic alcohol | Liver- steatohepatitis, hepatomegaly, cirrhosis, hepatic encapalopathy GI- pancratitis, varices, gastritis, PUD Neuro-Wernickes, Karsakoffs, peripheral neuropathy, seizures, dementia Ca - Bowel, breast, oesophageal, liver CVS - HTN, cardiomyopathy, Trauma/ TBI - Due to falling in acute intoxication |
| Psychological risks associated with chronic alcoholism | Increased risk of depression, anxiety and DSH. Amnesia Dementia and wernickes/korsakoffs Alcoholic hallucinosis Jealous dellusions Social decline |
| Triad of Wernickes | Confusion/dementia Ataxia Opthalmoplegia |
| Management of Wernickes | Immediate Thiamine (Pabrinex). MEDICAL EMERGENCY |
| Korsakoffs | Irreversible retrograde amnesia. Confabulates to fill gaps in memory. Registers events as they happen but cannot remember later. |
| Managing chronic alcoholism | Change behaviour - CBT. Pre-contemplation-> contemplation->preperation->action->maintancence. Detox - Chlorodiazepoxide Thiamine Disulfram and Acamprostate |
| S&S of alcohol withdrawal | Headache Nausea, vomiting and retching tremor Sweating Insomina Anxiety and aggitation Tachy and hypotension |
| MoA of EtOH withdrawal | Supresses CNS though potentiation of GABA receptors. EtOH removal leads to hyper-excitation of neurons leading to (fatal) seizures. |
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