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shosh114
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What happens if you give glucose to an alcoholic without thiamine?
Thiamine is a cofactor in carb metabolism. If you give glucose you trigger carb metabolism, which depletes thiamine stores. This can precipitate Wernicke's encephalopathy
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Wernicke encephalopathy
- Acute encephalopathy
- Nystagmus
- Ophthalmoplegia
- Ataxia
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Korsakoff syndrome
- Chronic psychosis seen in alcoholics
- Retrograde amnesia, confabulation
- Irreversible!!
- Caused by damage to mammary bodies and thalamic nuclei
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Stages of alcohol withdrawal:
- 1. Acute--12--48 hours--tremors, sweating, hyperreflexia, seizures
- 2. Alcoholic hallucinations--24--72 hours--auditory and visual hallucinations
- 3. DT--2--7 days--hallucinations, confusion, autonic instability (sweating, tachycardia, fever), can be fatal
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Why is peripheral neuropathy seen in alcoholics?
Thiamine deficiency
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Mechanism of Disulfiram
- Inhibits aldehyde dehydrogenase, causes nausea and vomiting with drinking
- (cephalosporins and metronidazole have a similar effect when taken with alcohol)
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Fetal alcohol syndrome
- Mental retardation
- Microcephaly
- Microphthalmia
- Short palpebral fissures
- Midfacial hypoplasia
- Cardiac defects
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Most common cause of hypoglycemia
Alcohol abuse
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Management of non-bleeding varices
Non-selective beta blockers (propranolol, nadolol, timolol)
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