Alcohol and Alcoholism - PowerPoint PPT Presentation

Loading...

PPT – Alcohol and Alcoholism PowerPoint presentation | free to view - id: 3b2be-MTBkN



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Alcohol and Alcoholism

Description:

Cough/Cold Preparations 3 - 25% Mouthwashes 14 - 27% Ethanol Metabolism. One drink equals: ... 70 kg person metabolizes approximately one drink/hour ... – PowerPoint PPT presentation

Number of Views:475
Avg rating:3.0/5.0
Slides: 44
Provided by: NeilC8
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Alcohol and Alcoholism


1
Alcohol and Alcoholism
2
Ethanol
  • Mechanism of Toxicity
  • CNS depressant
  • Teratogen
  • Carcinogen

3
Ethanol
  • Lite Beer 2.5 - 3.5
  • Beer 4.0 - 6.0
  • Wine 10 - 18
  • Flavored Liquors 15 - 25
  • Distilled Liquors 22 - 50
  • Everclear 95
  • Proof is double

4
Ethanol
  • Colognes/Perfumes 40 - 60
  • Glass Cleaners 10
  • Paint Stripper 25
  • Cough/Cold Preparations 3 - 25
  • Mouthwashes 14 - 27

5
Ethanol Metabolism
  • One drink equals
  • 12 ounces beer
  • 5 ounces wine
  • 1.5 ounces distilled liquor
  • 70 kg person metabolizes approximately one
    drink/hour
  • 7 calories per gram vs. fat _at_ 9 calories/gm

6
Ethanol
  • Highest serum level recorded with full recovery
    in an adult - 1510 mg/dL
  • Legal limit for intoxication - 80mg/dL or 0.08
  • Odor threshold - 10 ppm

7
Alcohol and Alcoholism
  • Ethyl alcohol
  • Most commonly abused drug in U.S.
  • 6,000,000 to 10,000,000 alcoholics
  • 50 of fatal motor vehicle crashes
  • 50 of violent deaths
  • Contributes to pathology in 25-35 of all
    hospital patients

8
Alcohol and Alcoholism
  • Alcoholism
  • Addiction to alcohol or abuse of alcohol to a
    degree that produces problems in one or more of
    these areas
  • Health
  • Social relationships
  • Economic status
  • Interpersonal relationships

9
Alcohol and Alcoholism
  • Phases
  • Problem drinking
  • Drinks to relieve stress
  • Abstinence does not cause physical symptoms
  • Alcohol addiction
  • Abstinence produces physical symptoms

10
Alcohol and alcoholism
  • Alcohol does NOT depend on type of EtOH
  • Alcoholism occurs in ALL social classes and age
    groups
  • Skid row bums 3 to 5 of alcoholics

11
Alcohol and alcoholism
  • Typical alcoholic
  • Employed male
  • Social drinker
  • Drinks early in day
  • Drinks alone or secretly
  • Binges accompanied by memory loss
  • Unexplained GI upset, bleeding
  • Green-tongue syndrome
  • Cigarette burns on clothing
  • Chronically flushed face, palms
  • Tremulousness, anxiety with reduced intake
  • Problems with family, work, law enforcement
    related to EtOH

12
  • Acute Alcohol Effects

13
Acute Alcohol Effects
  • Hangover
  • Mild withdrawal with volume depletion
  • Treatment
  • Fluids
  • Tylenol for headache
  • Not aspirin or ibuprofen

14
Acute Alcohol Effects
  • Stupor-Coma
  • Acute overdose
  • Coma
  • Depressed respirations
  • Hypotension
  • Hypothermia

15
Acute Overdose Treatment
  • ABCs
  • Oxygen, assisted ventilations
  • Intubate
  • IV, infuse fluid to support perfusion
  • Lavage if within 2 hours

16
Acute Overdose Treatment
  • DONT
  • Dextrose, Oxygen, Narcan, Thiamine
  • Glucose, thiamine (50-100mg)
  • Narcan may reduce respiratory depression but not
    CNS depression (? Use)
  • Dialysis - removes 280mg/minute

17
Acute Alcohol Effects
  • Stupor-Coma
  • Hypoglycemia
  • Inhibition of protein to sugar conversion in
    liver (gluconeogenesis)
  • D-stick all patients with altered LOC

18
Acute Alcohol Effects
  • Stupor-Coma
  • Trauma
  • Drunks fall down and hit their heads.
  • Concussion
  • Subdural hematoma

19
Acute Alcohol Effects
  • Stupor-Coma
  • Mixed drug overdose
  • Tranquilizers
  • Barbiturates
  • Anti-depressants

20
Acute Alcohol Effects
  • Acute alcoholic paranoia
  • Mean drunk
  • Violence
  • Motor vehicle crashes (50-60 of fatalities)
  • Fights

21
Acute Alcohol Effects
  • Drug Interactions
  • Potentiation of CNS depressant drugs
  • Decreased anticonvulsant effectiveness
  • Potentiation of antihypertensive effects
  • Orthostatic hypotension

22
Acute Alcohol Effects
  • Worsening of other problems
  • Peptic ulcer disease
  • Liver disease
  • Pancreatic disease
  • Heart disease (decreased pump strength)

23
  • Associated Medical Problems

24
Associated Medical Problems
  • Head injury/subdural hematoma
  • Impaired clotting mechanisms
  • Frequent falls

25
Associated Medical Problems
  • Hepatic cirrhosis
  • Causes
  • Alcohol toxicity
  • Poor nutrition

26
Associated Medical Problems
  • Hepatic cirrhosis
  • Symptoms
  • Ascites
  • Jaundice
  • Palmar erythema
  • Spider angiomata, Caput medusa
  • Gynecomastia (males)

Lemon on toothpicks
27
Associated Medical Problems
  • Hepatic Cirrhosis
  • Effects
  • Impaired glucose metabolism, hypoglycemia
  • Portal hypertension, esophageal varices
  • Coagulopathies
  • Hepatic encephalopathy

28
Associated Medical Problems
  • Pancreatitis
  • Nausea, vomiting
  • Severe upper abdominal pain radiating to back
  • Hypovolemic shock
  • Secondary diabetes
  • Pancreatic necrosis and hemorrhage

29
Associated Medical Problems
  • Methanol/ethylene glycol poisoning
  • Sterno, antifreeze ingestion
  • Serve as EtOH substitutes
  • Produce
  • profound metabolic acidosis
  • hypocalcemia in ethylene glycol poisoning

30
Associated Medical Problems
  • Nutritional deficiencies
  • Wernickes syndrome
  • Dizziness
  • Confusion
  • Apathy
  • Ophthalmoplegia
  • Ataxia

31
Associated Medical Problems
  • Nutritional deficiencies
  • Korsakoffs psychosis
  • Memory loss
  • Confusion, confabulation

32
Associated Medical Problems
  • Nutritional deficiencies
  • Beriberi
  • Paresthesias, burning of feet
  • Cardiovascular failure
  • Peripheral vasodilation
  • Biventricular myocardial failure
  • Na and water retention

33
Associated Medical Problems
  • Nutritional deficiencies
  • Respond to administration of thiamine (Vitamin B1)

34
Associated Medical Problems
  • Cancer
  • Colon
  • Breast

35
  • Abstinence Syndrome

36
Abstinence Syndrome
  • Results from EtOH intake reduction
  • NOT necessarily result of complete withdrawal

37
Abstinence Syndrome
  • Stages
  • Tremulousness
  • Shakes, jitters
  • Fine tremors
  • GI upset
  • Restlessness
  • Peaks at 24 hours
  • Patient may feel shaky for up to 2 weeks

38
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

39
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

40
Abstinence Syndrome
  • Management
  • Oxygen, monitor, IV (LR or NS)
  • Check blood sugar
  • Consider D50W and thiamine
  • Minimum stimulation
  • Sedation
  • Phenobarbital
  • Benzodiazepines

41
Antabuse (disulfiram)
  • Used in aversion therapy
  • Blocks EtOH metabolism
  • Causes buildup of acetaldehyde

42
Antabuse (disulfiram)
  • Exposure to EtOH while taking causes sudden,
    severe vasodilation
  • Hot, flushed face
  • Dizziness
  • Pounding heart, hypotension
  • Nausea, vomiting
  • Headache

43
Antabuse (disulfiram)
  • DANGER!
  • Contact with other alcohol sources
  • Foods
  • Shaving lotion
  • Mouthwash
About PowerShow.com