Treatment of alcohol production

Article by Dr. Tran Truong Giang – Department of Active Resuscitation – Share99 Times City International Health Hub

In order to be able to treat alcohol, in addition to the responsibility of the resuscitation doctor, the remaining medical staff and relatives of the patient also need to be fully equipped with detailed knowledge about the disease.

Alcohol production is difficult to treat, the disease is not directly life-threatening but indirect and causes many serious impacts on patients, relatives, environment and society. In order to be able to treat alcohol, in addition to the responsibility of the resuscitation doctor, the remaining medical staff and relatives of the patient also need to be fully equipped with detailed knowledge about the disease.

Alcohol withdrawal syndrome (AWS) can occur when an individual stops or significantly reduces alcohol consumption after a long period of use.

The complex, controversial, mechanism is now explained through neurolymous conductive agents: Alcohol has the function of inhibiting nerves through the GABA and NMDA systems. When sudden alcohol discontinuation -> sudden decrease in GABA system activity (TKTW inhibitory system). The body reacts by increasing NMDA system activity through glutamate conduction, which leads to increased release of noradrenalin, increased sympathetic stimulation: Rapid pulse, sweating, hand tremors,…

Endocular mechanism: Sudden stopping of alcohol -> Disorders of the functioning of the axis under the sythalamus – atopic glands – > increase cortisol secretion.

On average, about 6 – 48 hours will appear clinical signs if not treated -> gradually in 4 stages of the disease

Bouts of alcohol can also suddenly appear constant seizures.

• Phase 1

Usually in the early morning (6-12 hours after the last cup of wine): The patient feels tremors, moist hands, restless anxiety.

Phase 2: 24 – 48 hours after stopping drinking:

• Sweating a lot
• Tremor: Hands, lips, eyelids – Muscle vibration
• Nausea, vomiting
• Ache of the upper abdomen, diarrhea
• Stimulates insomnia, nightmares

Phase 3: Pre-production

• Symptoms such as stage 1.2 but more severe
• Trembling a lot
• Excessive sweating (into drops)
• Very anxious, anorexia, insomnia
• Appearance of neurological symptoms: Increased muscle edict, loss of sysy orientation, time, hallucinations, total body breakdown

Phase 4: Delirum – Tremens

Clearly manifested with 2 severe signs of shaking and tremor

• Full-body tremor, continuous
• Risk of seizures
• Confusion, hallucinations
• Continuous stimulation
• Difficulty speaking, loss of things, swallowing disorders
• High fever, sweating, loss of water

• be infected
• Trauma, surgery
• Cerebral vascular accidents
• Digestive bleeding
• Forced not to drink alcohol, quit alcohol

• Traumatic brain injury
• Acute meningitis
• Hypothymemia, hyponatremia
• Patients taking stimulant drugs in coordination

5.2 Diagnosis of severeness

Based on CIWA (Clinical Institute Withdrawal assessment)

• 8 points: Very light (Target when treating)
• 8 – 15 points: Average
• 15 – 26 points: Heavy
• > 26 points: Very heavy

Related to thiamine deficiency

• Wernicke's syndrome with triads: Confusion, TK wire disorders, difficulty in coordinating muscles
• Korsakoff's Syndrome: A Late Complications of Wernicke's, Dementia Dementia

7.1 Sedative treatment

The Benzodiazepin group is the first group of drugs selected because of antagonistic effects, the drug has an effect on many TK transmission systems, preventing complications. The following drugs:

• Diazepam: Severe dose may be 500 mg/ 24h ( 50 tubes )
• Chlordiazepoxide
• Lorazepam: Commonly used with BN which has a lot of liver damage

coordinate:

• Phenobarbital
• Haldoperidol:

Coordinate when there are symptoms of debilitative thought disorders such as schizophrenia. When coordinating pay attention to the prolonged effect of QT and td reduce the seizure threshold:

• Alpha 2 er er erm: Dexmedetomidine, clonidine
• Beta blocker

7.2 Treatment of convulsions in alcohol production

• Taking anti-seizure drugs maintains no role
• It's self-limiting convulsions.

7.3 Supportive nutritional treatment:

Vitamin deficiency, especially Vitamin B1:

• Vitamin B1 needs a lot for alcohol conversion through 2 enzymes Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase.
• Vitamin B1 participates in G-conversion through pentose phosphate cycle
• Therefore, when taking Vitamin B1 supplements should be before or at the same time of infusion of G
• Electrolye supplements: Magne, potassium, phosphorus, other micro-factors,..

This is a very practical attention to everyday life, since most alcoholics eat very little, especially rice, and do not pay attention to vitamins.

Share99 International Health Hub with a system of modern facilities, medical equipment and a team of experts and doctors with many years of experience in neurological examination and treatment, patients can be assured of examination and treatment at the Health Hub.

To register for examination and treatment at Share99 International Health Hub, you can contact Share99 Health System nationwide, or register for an online examination HERE.

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