Answers
Neurotransmitters affected by alcohol - ✅✅ GABA is down regulated
Glutamate is Upregulated
Benzodiazepines - ✅✅ First line treatment to prevent severe withdrawals
Treats psychomotor agitation with alcohol withdrawal
Diazepam - ✅✅ Benzo with fastest onset
Lorazapam - ✅✅ Benzo used for pt with liver issues because it does not
metabolize in liver
Side effects of Benzos - ✅✅ Confusion
Drowsiness
Resp depression
What to monitor with Benzos - ✅✅ Liver function
Resp rate
What to monitor with IV lorazapam - ✅✅ BUN/Creat and osmol gap
Propofol side effect - ✅✅ Resp depression, hypotension, pancreatitis
May need to be on vent
Thiamine deficiency - ✅✅ Wernicke's encephalopathy
Korakoff syndrome
What happens is you give glucose before thiamine - ✅✅ Wernicke's
encephalopathy
Poor nutrition due to alcohol use - ✅✅ replacement- thiamine, calcium,
potassium, phosphorus
Multivitamins
Electrolyte replacement
, Wernicke-Korsakoff syndrome - ✅✅ Organic brain syndrome resulting from
prolonged heavy alcohol use, involving confusion, unintelligible speech, and loss
of motor coordination. It may be caused by a deficiency of thiamine, a vitamin
metabolized poorly by heavy drinkers.
Wenicke's encephalopathy - ✅✅ most serious form of thiamine deficiency in
alcoholic pts
Causes vomiting, dysfunction of the extraocular muscles, fever, ataxia and mental
deterioration.
Korsakoff's syndrome - ✅✅ an alcohol related disorder marked by extreme
confusion, memory impairment, and other neurological symptoms
Alcoholic patient history - ✅✅ Last drink
Use any other substances
Amount and time been drinking
Medical and BH hx
Previous withdrawals (seizures DT etc)
Standard alcoholic drink - ✅✅ 14.5 grams of pure alcohol
12 ounces of beer
5 ounces of wine
1.5 ounces of 80 prof distilled spirits or liquor
Binge drinking - ✅✅ 5 or more drinks in one sitting
Alcohol metabolism - ✅✅ the alcohol is metabolized by the liver (about 90%)
and the other 10% is excreted in the urine or in your breath
Averages 1 oz per 3 hours
What system does alcohol depress? - ✅✅ CNS
Medication and alcohol interactions - ✅✅ Barbiturates
Benzos
General anesthetics
Solvents
Anticonvulsants
Increases sedative affect with Antihistamines
Increase change of upper GI bleed with Tylenol
Gastric irritation NSAIDS