Alcoholism

Question 1

Screening for alcoholism

Answer 1

CAGE
Ever thought you should Cut down?
Annoyed by criticism of drinking?
Guilty about drinking?
Eye-opener in the morning?

Question 2

Alcohol withdrawal signs

Answer 2

Starts 10-72hrs after last drink
Tachycardia, hypotensive
Confusion, fits, hallucinations

Question 3

Alcohol withdrawal management

Answer 3

Chlordiazepoxide 10-50mg/6h for first 3d, additional as needed
Lorazepam shorter acting if needed, in more serious liver failure so blood levels can be monitored
Advice on stopping

Question 4

Alcoholism relapse treatment

Answer 4

Acamprosate for cravings, contraindicated in pregnancy, liver failure, renal failure
Disulfiram as aversion therapy

Question 5

Managing alcoholic hepatitis

Answer 5

IV vitamin K 10mg/d
IV Thiamine 100mg/d
Optimise nutrition
Treat hepatitis complications e.g. ascites SBP

Pred 40mg/d for 4 wks if severe