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27 Cards in this Set
- Front
- Back
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WHat is usually sufficient for the dx of alcohol withdrawal?
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H & P
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Can most pts be treated safely and effectively as outpatients for alcohol w/drawal?
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yes
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Tx for alcohol withdrawal involves what? (very broad)
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the use of meds that are cross-tolerant w/ETOH or with ETOH itself
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What is the DOC for alcohol w/drawal?
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benzos
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What drug is an alternate to benzos for the outpatient tx of mild to moderate alcohol withdrawal?
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Carbamezepine
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What are some adjunctive meds for the tx of complications of alcohol withdrawal?
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-haloperidol
-BB -clonidine -phenytoin |
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Manifestations of acute alcohol withdrawal include what 8 things.
rediculous I know |
1-tremers
2-intoxication 3-w/draw seizures 4-tremor and transitory hallucinations 5-DTs 6-atypical delirious hallucinatory states 7-auditory hallucinations 8-others such as Wernicke-Korsokoff syndrome |
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What is the primary inhibitory neurotransmitter in the brain?
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GABA
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What is a principle excitatory neurotransmitter in the brain that deals with alcohol?
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Glutamate
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Alcohol enhaces the effect of __________, resulting in overall reduced brain excitability.
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GABA
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Because of the GABA system, abrupt cessation of alcohol results in what?
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brain hyperexcitablity
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Brain hyperexcitability manifests clinically as what things?
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-anxiety
-irritability -agitation -tremors |
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Severe manifestation of alcohol withdraw includes what?
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seizures and DTs
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Look at dx criteria for alcohol in book.
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didn't know how to make it into questions
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What are some other conditions that can mimic alcohol withdrawal?
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-Thyrotoxicosis
-Anticholinergic drug poisoning -Amphetamien or cocaine use -CNS infection or hemorrhage -w/drawal from other sedative-hypnotic agents |
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What are some basic lab tests you should run in alcohol withdrawal?
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-CBC
-LFTs -urine drug screen -BAL -E-lytes |
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Minor alcohol withdrawal may be tx with parentral or oral what?
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benzos
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Besides correcting lyte and fluid imbalances, what do you also have to give someone going through alcohol withdrawal?
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multi-vitamin and thiamine
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Before IV fluids are started for alcohol withdrawal what has to be given and why?
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Thiamine (100mg/day) to prevent Wernicke's encephalopathy
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What do you want to monitor twice hourly for an alcohol withdrawal pt and why?
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Temp, pulse, and BP to monitor for hyperthermia and hypotension
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Will sedatives terminate established DTs?
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NO but they may prevent one from progressing
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Why is Haloperidol used in alcohol withdrawal?
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to tx agitation and hallucinations but it can lower seizure threshold
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When would you use a BB in alcohol withdrawal?
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in any pt with CAD, who may not tolerate the stain that withdrawal can put on cardiovascular system
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Why is clonidine/Catapress used in alcohol withdrawal?
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because it has shown ability to improve the auto-nomic symptoms of w/drawal
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When in Phenytoin used in alcohol withdrawal?
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for a pt with an underlying seizure disorder ONLY
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What is the definition of Wernicke's Encephalopathy?
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a medical emercency characterized by opthalmoplegia, ataxia, and confusion, associated with acute thiamine deficiency, due to alcoholism and or malnutrion
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What does the tx of Wernicke's Encephalopathy consist of?
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-bed rest
-cardiac monitoring -thiamine and multi-vitamins -Mg replacement when needed |
