Alcoholism

• Alcohol is CNS depressant!
• Stages of Alcohol Withdrawal

  Stage 1 (6-12 hours):

  P - Pain (Abdominal)

  A - Anxiety

  I - Insomnia

  N - Nausea
• Stages of Alcohol Withdrawal

  Stage 2 (12-48 hours):

  Increased vitals including hypertension
• Stages of Alcohol Withdrawal

  Stage 3 (48-72 hours):

  Delirium Tremens (seizures and hallucinations)
• The effect of alcohol in the body is sedation
• Defense mechanism alcoholics: Denial
• Aversion Therapy 


  Used to stop chronic alcoholism and maintain sobriety
• Drug used in Aversion Therapy for alcoholism: Disulfiram Antabuse
• Disulfiram Antabuse: Aversion Therapy

  Nursing Considerations:

  • The patient must be alcohol-free for 12 hours before administration. Ask "when was your last drink?"
  • When assessing a patient taking disulfiram, the nurse must ask for the time of last alcohol intake, this includes mouthwash, cough suppressants, perfume
  • Disulfiram + Alcohol = severe adverse reaction (headache, abdominal pain, vomiting)
  • A nurse must wait for 8 hours after alcohol intake before giving disulfiram and increase OFI to flush alcohol to reduce adverse reactiions
• The onset and duration of Stage 1 of Alcohol Withdrawal is 0-10 hrs.
• To decrease cravings to alcohol – Acamprosate (Campral)
• To block the effect of alcohol – Naloxone/Naltrexone
• Chronic Alcoholism can cause Wernicke - Korsakoff’s Syndrome due to B1 (Thiamine) Deficiency
• Wernicke’s vs Korsakoff’s

  Wernicke’s - acute, short-term, reversible
• Wernicke’s

  A - Ataxia

  C - Confusion

  O - Ophthalmoplegia
• Wernicke’s vs Korsakoff’s

  Korsakoff’s - chronic, long-term, irreversible
• Korsakoff’s

  C - Confabulation

  H - Hallucination

  A - Amnesia
• Wernicke - Korsakoff’s Syndrome Management: B1 (Thiamine)-rich diet e.g. lean pork chops, fish, flax seeds, navy beans, green peas, tofu, rice
• In the management of diet for Wernicke - Korsakoff’s Syndrome, the nurse must consult the dietary department 
• Group therapy for alcoholic involving 8-10 participants; must be in circular position to denote equality
• Alcoholics Anonymous (AA) 


  Support groups recovering alcoholics
• AL - Annon for the family.