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33 Cards in this Set

  • Front
  • Back
third leading cause of death in U.S.
alcoholism
who are likely drinkers?
young, well educated, prosperous, urban

boys 4x girls (alcoholic) girls worsen quicker
differentiate type I
and
type II alcoholics
type I: adult onset, guilt, worry, little or no family history, men=women , good out come (75%) of pop.

type II: early onset, impulsive, distractable, male, family history,poor outcome (25%)
what is CAGE?
Cut down on drinking
Annoyed by criticism of drinking
Guilty about drinking
Eye-opener in the morning
strong indication of alcoholism is ?(mg/dL)
150 mg/dL
rough correlation of blood alcohol levels and symptoms
0-100 sedate tranquil
100-150 incoordinated, irritable
150-250 slurred speech, ataxia
>250 passing-out, unconsciosness
>350 coma, possible death
common laboratory and clinical findings implying alcoholism
fractured rib (30%)
elevated mean corpuscle volume
abnormal liver enzymes
increased GGT**
transaminase elevation
most common age range of diagnosis of alcoholism?

common co-morbid condition?
16-30

psychiatric problem
% motor vehicle acidents involving alcohol?

continued alcoholism shortens lifespan by?
50%

15 years
why is alcohol tolerance so important?
dianosis of alcoholism
increases likelihood of cirrhosis
increased tolerance= increased likelihood of dev. alcoholism
red palms a sign of ?

what is Dupuytren's contracture?
liver dysfunction

thickening and shortening of tissue beneath the skin of the palm
best specificity and sensitivity of alcohol abuser test?

alcoholics show tolerance for?
carbohydrate deficient transferrin (CDT)

other abuse substances, sedatives, marijuana etc...
correllation of alcohol and suicide
alcoholic 15x more likely to commit suicide

25%-50% of suicides have alcohol abuse or dependence present
mild to moderate withdrawal symptoms seen in % of alcoholics

severe withdrawal?
95%

5%
onset of uncomplicated ETOH withdrawal?
peak?
lasts how long?
6-8 hr onset
24-48 hr peak
lasts 5-7 days
symptoms of uncomplicated ETOH withdrawal?
anxiety, tremor, nausea, increased heart rate and blood pressure
alcohol seizures type?
onset?
peak?
percent of patients?
usually who?
grand mal
7-38 hrs
24-48 hrs
5%-15%
long-term alcoholics
alcoholic hallucinosis type?
onset?
lasts?
percent of patients?
vivid and unpleasant auditory hall.(maybe visual or tactile)
48 hrs after cessation
lasts 1 week
3%-10% w/severe alcohol withdrawal
alcohol wthdrawal delerium (delerium tremens) is characterized by?
agitation, tremors, autonomic instability, fevers, auditory and visual hallucinations, dissorientation
percent of alcoholics with delerium tremens?
onset?
peak?
duration?
5%
2-3 day onset
4-5 day peak
lasts 3 days
can be fatal
possible mortality rate of delerium tremens if untreated?

may require which additional cares?
20%

restraints, seclusion
etiology of Wernicke-Karsakoff syndrome?
alcoholics have thiamine (B1) deficiency due to poor nutrition.
causes brain damage w/ possible short-term memory loss or even death
symptoms of Wernicke's encephalopathy?

80%-90% develop?
opthalmoplegia, nystagmus, diploplia, ataxia, memory impairment, apathy

Karsakoff's psychosis
symptoms of Karsakoff's psychosis?

if you suspect give them what?

if yo give them glucose what happens?
loss of short-term memory
reduced initiative
confabulation

thiamine injection, then glucose

glucose alone can induce W-K syndrome
risk of becoming alcoholic if parents are?
morelikely male or female
4x regardless of who raises them


male
molecular testing of ? for alcoholism may signify genetic predisposition
ADH2-2
higher rates of alcoholism among?

depression occurs in?

drug dependence/ anti soc. dis.?
1st degree relatives

women

men
what increases alcohol cravings?
mu-opiate receptor increases in ventral striatum
Tx for ETOH withdrawal?
Benzos (diazepam) 20 mg/hr x3
12-steps
address psychiatric prob.
three benzos adequately metabolized in liver disease, elderly?
LOT
Lorazepam
Oxazepam
temazepam
only benzo with predictable absorption IM?
lorazepam
alcoholic adjunct therapies
disulfiram (hangover inducing)

craving: naltrexone (blocks opiod rec.) acamprosate(GABA), topiramate
injectable for of naltrexone?
how long does it last?
vivitrol

1 month