Alcohol and Drug Abuse - University of North Dakota：酒精和药物滥用-北达科他大学.pptVIP

Associated Medical Problems Nutritional deficiencies Korsakoff’s psychosis Memory loss Confusion, confabulation Associated Medical Problems Nutritional deficiencies Beriberi Paresthesias, burning of feet Cardiovascular failure Peripheral vasodilation Biventricular myocardial failure Na+ and water retention Associated Medical Problems Nutritional deficiencies Respond to administration of thiamine (Vitamin B1) Associated Medical Problems Cancer Colon Breast Abstinence Syndrome Abstinence Syndrome Results from EtOH intake reduction NOT necessarily result of complete withdrawal Abstinence Syndrome Stages Tremulousness Shakes, jitters Fine tremors GI upset Restlessness Peaks at 24 hours Patient may feel “shaky” for up to 2 weeks Abstinence Syndrome Stages Hallucinations Distorted vision Misinterpretation of visual stimuli (snakes, vermin) Auditory hallucinations Seizures (“rum fits”) Usually in first 24 hours Major motor seizures in bursts of 2 to 6 May progress to status epilepticus Abstinence Syndrome Stages Delirium tremens 24 to 72 hours after reducing intake Restlessness, tremors, hallucinations, seizures Dilated pupils, flushed face, tachycardia, nausea, vomiting 15% mortality from dehydration, electrolyte imbalance, aspiration Abstinence Syndrome Management Oxygen, monitor, IV (LR or NS) Check blood sugar Consider D50W and thiamine Minimum stimulation Sedation Phenobarbital Benzodiazepines Antabuse (disulfiram) Used in aversion therapy Blocks EtOH metabolism Causes buildup of acetaldehyde Antabuse (disulfiram) Exposure to EtOH while taking causes sudden, severe vasodilation: Hot, flushed face Dizziness Pounding heart, hypotension Nausea, vomiting Headache Antabuse (disulfiram) DANGER! Contact with other alcohol sources Foods Shaving lotion Mouthwash Alcohol and Alcoholism Ethanol Mechanism of Toxicity CNS depressant Teratogen Carcinogen Ethanol Lite Beer 2.5 - 3.5% Beer 4.0 - 6.0% Wine 10 - 18 % Flavored Liquors 15 - 25% Distilled