CIWA
What is Clinical Institute Withdrawal Assessment for Alcohol Scale?
Why give IV infusion of fluids?
What is to speed up body's removal of substances?
Motivational therapy and cognitive behavioral therapy are examples of which type of treatment for alcohol addiction?
What is individual, non-pharmacologic treatment?
What are common differential diagnoses for Jan (or other patients with alcohol withdrawal)?
Infection, acute coronary syndrome, pulmonary embolus, hypothyroidism, anxiety, intoxication
Babinski sign/reflex
What is when the big toe remains extended while the other tans are fanned out when the sole of the foot is stimulated?
CIWA measures?
What is withdrawal severity?
Activated Charcoal
What is to help bind drugs and keep them in the stomach/intestines so drugs are not absorbed in the blood?
What symptoms of Jan's suggest severe withdrawal, as opposed to mild or moderate?
Hallucinations, seizures
List common physical exam findings for patients with alcohol/opioid/benzodiazepine use.
- Reduced reflexes
- Pinpoint pupils
- Apathy
- Euphoria
- Decreased HR
- Decreased BP
- Decreased body temperature
- Slurred Speech
Deep Tendon Reflexes
What is
0= no response, abnormal
+1= slight but present response
+2= normal
Examinations
What is
Evaluate every 10 to 15 minutes if severe patient, then hourly assessments
Evaluate every 4-6 hours for stable patients
Exact IV infusion for alcohol withdrawal patients
What is IV infusion of thiamine, folate, multivitamin in isotonic saline with 5% dextrose?
List common risk factors for withdrawal.
- More drinks per occasion
- Presence of more alcohol related problems
- Older age
- Low potassium and platelet levels
- Genetic factors
- Recent use of agents that depress the nervous system such as benzodiazepines
What are common barriers to receiving care for substance abuse and withdrawal?
- Social stigma
- Physician bias
- Believing that success hinges on abstinence
- Perceiving relapse as failure
- Ignoring the risk of prescription medication interactions
- Under treated pain due to addiction concerns
Tremulous
Diaphoretic
What is shaking or quivering? What is perspiration?
Acute Withdrawal Score
>= 8
Mechanism of Alprazolam and Lorazepam
Activate GABAa receptors as a positive allosteric regulator to open chloride channels, hyper-polarizing the cell and inhibit action potential.
What percentage of patients with addiction experience some sort of withdrawal symptoms when they reduce or stop drinking?
50%
This medication can be administered immediately following acute alcohol withdrawal and works to reestablish disrupted GABA and Glutamate pathways.
What is Acamprosate?
MMSE
What is mini mental state examination that tests for orientation, attention, memory, language, and visual-spatial skills?