ALCOHOLISM Alcoholism is a chronic disease characterized by a tendency to drink more than was intended; unsuccessful attempts at stopping drinking and continued drinking despite adverse social and occupational consequence.

Alcohol interferes with ability to socialize and to work and leads to many destructive behaviors. Drunkenness may disrupt family and social relationship. married couples divorce extreme absenteeism from work can lead to unemployment If an alcoholism suddenly stop drinking withdrawal symptom are likely to set in and usually begin at 12-48 hrs

EARLY SYMPTOMS Tremor weakness Sweating Nausea Alcoholic epilepsy(rum fits) Alcoholic hallucinosis Hallucination accusatory & threatening Apprehension /fear Loss of appetite Insomnia/paranoid morbid jealousy/anger/amnesia Anxiety and suicidal thoughts

other symptoms Loss of lidibo Secondary impotence/premature ejaculation Rape Sexual deviation Reduction of sperm count reduced testis Irregular menstration/miscarriage/

SEVERE SYMPTOMS Delirium tremen Increased confusion Sleeplessness Nightmare Excessive sweating depression Raised purse rate Fever Hallucinations Disorientation Persistence tremors – sometimes extended to the head & body- becomes uncoordinated and could lead to death.

Korsakoff’s sydrome Occur to people who drink heavily & are malnourished and have deficiency of vit B ( particularly thramine) Lose of recent memory - making up stories to try to cover up the inability to remember.

WERNICKES ENCEPHALOPATHY Abnormal eye movement Confusion Uncoordinated movement Abnormal nerve function NB: two glasses of wine a day isn’t associated with these problems

Alcohol produces both psychologic and physical dependence. Alcohol interferes with ability to socialize and to work and leads to many destructive behaviors. Drunkenness may disrupt family and social relationship. m arried couples divorce; extreme absenteeism from work can lead to unemployment If an alcoholism suddenly stop drinking withdrawal symptom are likely to set in usually begin at 12-48 hrs Alcohol produces both psychologic and physical dependence. Alcohol interferes with ability to socialize and to work and leads to many destructive behaviors. Drunkenness may disrupt family and social relationship. married couples divorce; extreme absenteeism from work can lead to unemployment If an alcoholism suddenly stop drinking withdrawal symptom are likely to set in usually begin at 12-48 hrs

INTERVENTION Take comprehensive history Do physical examination Mental status assessment must be done Apply unconditional positive regard Help the patient to identify their problems Involve the patient and relatives through out this period of therapy. For minor symptoms, give psychotherapy. Have a very good referral system.

TREATMENT Large doses of vitamin C & B complex especially thiamine Intravenous fluids Magnesium and glucose are often given to prevent some of the symptom of alcoholic withdrawal and to avoid dehydration Antipsychotic are generally given to small number of people with alcoholic hallucinosis e.g. Haloperidal 5mg bd one month Benzhexol 5mg od one month Diazepam 20mg in divided doses 1st day ’’ 15mg 2nd day ‘’ 10mg 3rd day ‘’ 5mg od for 3days Anticonvulsive drugs Epanutin 100mg—200MG TID 5/7 Phenobarbitone 30mg tid 5/7

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