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Clinical Theory and Skills EMIs
Published in Michael Reilly, Bangaru Raju, Extended Matching Items for the MRCPsych Part 1, 2018
Each option may be used once, more than once or not at all.Choose the phrase above that best fits each of the following statements about delirium.This disturbance of sleep-wake cycle is very common in delirium.This is the most common single cause of delirium in the elderly.Alcohol withdrawal delirium is commonly associated with this neurotransmitter abnormality.In delirium of moderate severity, these are the most common memory functions affected.
Assessment
Published in David F. O'Connell, Dual Disorders, 2014
Delirium is a life-threatening alteration in mental functioning resulting from injury or metabolic insult to the central nervous system. (Delirium is discussed further in Chapter 6.) Due to the potential for irreversible consequences, the ability to identify delirium is absolutely essential in the addictions treatment setting. Benzodiazepine and alcohol withdrawal (delirium tremens) are the most frequently encountered causes of delirium.
Clinical specialties
Published in Andrew Schofield, Paul Schofield, The Complete SAQ Study Guide, 2019
Andrew Schofield, Paul Schofield
Steve, aged 39, goes to see his GP about a sore throat and during the consultation you notice he is slurring his words. On examination, he smells strongly of alcohol. What are the recommended safe alcohol limits in units per day for men and women, according to the NHS? (1)You find on further questioning that Steve drinks around 90 units per week. What is the definition of alcohol abuse? (1)List 2 factors for Steve that might imply addiction. (2)What treatments could you offer Steve in an effort to reduce drinking? (2)Two weeks later, Steve attends the emergency department following a witnessed seizure, having not had enough money to buy a drink for 2 days. What are four other symptoms of alcohol withdrawal/delirium tremens? (2)Having started Steve on chlordiazepoxide, he is also started on high-dose B and C vitamins (Pabrinex). Why has he been started on Pabrinex? (1)Concerning long-term complications of alcohol abuse, name one example for the following systems: liver, CNS, CVS, GI tract. (2)Steve is eventually started on Antabuse (disulfiram). How does this agent work in preventing relapse? (1)
An open-label pilot study of pregabalin pharmacotherapy for alcohol use disorder
Published in The American Journal of Drug and Alcohol Abuse, 2021
John J. Mariani, Martina Pavlicova, C. Jean Choi, Daniel J. Brooks, Amy L. Mahony, Zora Kosoff, Nasir Naqvi, Christina Brezing, Sean X. Luo, Frances R. Levin
Participants met DSM-5 criteria for current AUD; reported drinking a minimum of five standard drinks for men or four standard drinks for women at least 4 days per week over the past 28 days; were between the ages of 18 and 65; and were able to provide informed consent and comply with study procedures. Participants were excluded if they: had any current psychiatric disorder as defined by DSM-5, other than AUD, that in the investigator’s judgment might require intervention over the course of the study; were receiving psychotropic medication treatment; demonstrated evidence of moderate-to-severe alcohol withdrawal (CIWA-Ar ≥ 13); had a history of alcohol withdrawal seizures or alcohol withdrawal delirium; had a history of allergic reaction to pregabalin; were pregnant, lactating or failed to agree to use adequate contraceptive methods (females); had unstable physical disorders which might make participation hazardous; had a current DSM-5 diagnosis of moderate or severe substance use disorder, with the exception of alcohol, nicotine and caffeine dependence; were legally mandated to participate in alcohol use disorder treatment; or were cognitively impaired. The research psychiatrist offered participation to eligible participants and obtained informed consent.
Professional Perspectives on Supporting Those with Alcohol-Related Neurocognitive Disorders: Challenges & Effective Treatment
Published in Alcoholism Treatment Quarterly, 2021
Robert M. Heirene, Bev John, Marie O’Hanrahan, Ioannis Angelakis, Gareth Roderique-Davies
It is also important to note that some of the challenges and recommendations reported by participants may not be applicable to all of those with ARNDs, given the considerable degree of diversity within this cluster of conditions. Indeed, more short-term disorders such as alcohol-withdrawal delirium and the acute phase of Wernicke’s encephalopathy – which are sometimes classed under the ARND and ARBD umbrellas – are likely to require substantially different management strategies than someone in the chronic phase of KS, which was often the focus of participants’ experiences and suggestions for treatment.