Alcohol
History
C ever felt the need to Cut down on drinking?
A ever felt Annoyed at criticism of your drinking?
G ever feel Guilty about your drinking?
E ever need a drink first thing in morning (Eye opener)?
Clinical Features
Withdrawal
Treatment
Non-Pharmacological
Pharmacological
Source
Toronto Notes 2012
C ever felt the need to Cut down on drinking?
A ever felt Annoyed at criticism of your drinking?
G ever feel Guilty about your drinking?
E ever need a drink first thing in morning (Eye opener)?
- Men: ≥ 2 = positive screen; Women, ≥ 1 = positive screen
Clinical Features
- Nausea and vomiting
- Headache
- Agitation
- Tremor
- Anxiety
- Paroxysmal sweats
- Tactile disturbances
- Visual disturbances
- Auditory disturbances
- Disorientation and clouding of sensorium
Withdrawal
- Occurs within 12 to 48 h after prolonged heavy drinking and can be life-threatening
- Alcohol withdrawal can be described as having 4 stages, however not all stages may be experienced
- Stage 1 (onset 6-12 h after last drink): tremor, sweating, agitation, anorexia, cramps, diarrhea, sleep disturbance
- Stage 2 (onset 1-7 d): visual, auditory, olfactory or tactile hallucinations
- Stage 3 (onset 12-72 hand up to 7 d): seizures, usually tonic-clonic, nonfocal and brief
- Stage 4 (onset 3-5 d): delirium tremens, confusion, delusions, hallucinations, agitation, tremors, autonomic hyperactivity (fever, tachycardia, hypertension)
- Course: in young almost completely reversible; elderly often left with cognitive deficits
- Mortality rate 20% if untreated
Treatment
Non-Pharmacological
- AA
- CBT
Pharmacological
- Naltrexone (prevents experience of "high")
- Disulfiram (prevents metabolism of EtOH, cause toxic sx, can cause death)
Source
Toronto Notes 2012