Alcohol withdrawal syndrome - a case study

Symptoms that occur when someone stops using alcohol after a period of heavy drinking.
Symptoms of alcohol withdrawal can vary widely in severity. In severe cases, the condition can be life-threatening.
Symptoms may occur from two hours to four days after stopping alcohol. They may include headaches, nausea, tremors, anxiety, hallucinations and seizures.
In many cases, alcohol withdrawal requires medical treatment and hospital admission. Medication may also be used to treat physical symptoms while counselling and support groups help with controlling drinking behavior.

i have already done a case study on alcohol withdrawal syndrome ... giving link below
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1. Alcohol withdrawal syndrome – a case study PRESENTED BY MARTIN SHAJI PHARM D

2. DEMOGRAPHIC DATA NAME OF THE PATIENT : Mr . Hari AGE / GENDER: 32 years/male AD.NO: 5544. WARD : Psychiatric ward DOA:1/9/2017 DOD.: 9/9/2017 Provisional diagnosis : alcohol with DRAWAL syndrome

3. CHIEF COMPLIENTS C/O of tremor , palpitation , headache,fever , PERSONAL HISTORY: weight:54 kgs . Bowel and bladder: normal Diet: mixed Appetite: decreased Sleep: disturbed Alcohol: since 10 years

4. Family history : nothing significant Past medication history: nothing significant ALERGIES: nill

5. GENERAL EXAMINATION On general examination the patient is counscious and coherent PHYSICAL EXAMINATION TEMP:102' F PR:16 beats/ minutes Rs:22cycles/ min Bp: 120/80 mmhg

6. SYSTEMIC EXAMINATION CVS : S1S2 + RS : Clear Abdomen : abnormal

7. CONFORMATORY DIAGNOSIS Based on the lab investigations.the doctor confirmed as alcoholic withdrawal syndrome

8. LAB INVESTIGATIONS 4.2MGS/DL UP TO 1.0 MGS/ DL DIRECT BILIRUBIN 1.7 MGS/ DL U P TO 0.2 MGS/ DO INDIRECT BILIRUBIN 2.5 MGS/DL 0.2TO 0.8 MGS/DL ALBUMIN PHOSPHATE 92 I U/L 92 TO 128 IU/ L BILIRUBIN.

9. LAB INVESTIGATIONS SGPT 81IU/L 0 TO 95 IU/ L SGOT 84 IU/L 0 TO 95 IU/ L

10. SOAP NOTES SUBJECTIVE A male patient of 32 yrs old was admitted in Psychiatric ward with c/o of fever.tremor, palpitation and head ache. His past medical history and family history was nothing significant. Allergies also nothing significant.in his personal history bowel and bladder is normal .He is not using alcohol since 2 years His appetite and sleep is normal

11. OBJECTIVE EVALUATION On lab examination his bilirubin range is increased ..it is 4.3mgd/dl. On his physical examination vitals are normal. His indirect bilirubin is 2.5 mgs/ dl . SGOT AND SGPT is normal. Albumin phosphate is in normal range.

12. ASSESMENT Based on the subjective and objective evaluation the patient was found to be diagnosed as Alcohol Withdrawal Syndrome

13. PLAN ON THE DAY OF ADMISSION 1 and 2 Vitals Tp .102 ' f. PS.: 80 beats/ mint. Rs : 16 cycles/ mint. Treatment T Ativan - 2mg- p/o -BD T.valpicate - 200mg-p/o BD T.hepato protectant - 250 mg -p/o- BD T.rantac - 150 mg-p/o - BD

14. T Ativan - 2mg- p/o -BD T.valpicate - 200mg-p/o _ BD T.hepato protectant - 250 mg -p/o- BD T.rantac - 150 mg-p/o - BD T.BC._ 66.7 mg_ p/o- BD T.Rheoheptin - 250 mg-p/o- bd On the day of 4,5,6,7,8, days

15. DRUG CHART S.no Brand name Generic name Indication s Dose ROS Frequency Duration 1 T.ativan Lorazepam Anti anxiety 2mg P/o BD 5 days 2 T.valpicate Sodium valpicate Anti convulsant 200 mg p/o BD 5days 3 T.repheptin - Hepato protectant 250 mg P/o BD 3days 4 Inj.MVT Multivitamin Vitamin supplement 355 mg IV BD 2 days

16. DRUG CHART 5 Rantac Ranitidine Antacid,and lb receptor antagi nist 150 mg P/o BD 4 days 6 T.BC B comblex Vitamin supplement 664 mg P/o BD 4 days

17. PHARMACEUTICAL INTERVENTION The given prescription was rational ... No DDI & ADR was found

18. PATIENT COUNSELLING Regarding disease. Alcoholic withdrawal syndrome is the discontinuation or reduction of prolonged heavy alcohol use that result in minor or major withdrawal symptoms. It is characterized by central nervous system hyperactivity that occur where an alcohol is dependent in withdrawal abruptly stops

19. REGARDING MEDICATION T.Ativan . It is an anti anxiety drug take 2 mg twice daily orally for 4 days T.VALPICATE it is an anti convulsant drug take 200 mg twice in a day trough orally/ parentally for 5 days T REOHEPTIN it a hepato protectant take 200 mgt twice in a day trough orally/ parentally route for 3 days

20. T MVT It is a vitamin supplement. Take 300 mg twice in a day trough iv route T HEPALIAL it is a hepatic protectant.take200 mg twice in a day trough orally ,/parentally T RANTAC it an antacid take 150 mg through the oral route/ pa renteral route

21. DISCUSSION Alcoholic withdrawal syndrome is the discontinuation or reduction of prolonged heavy alcohol use. That results in minor and major withdrawal syndrome . SIGHNS AND SYMPTOMS Tachycardia Loss of appetite Shaking Sweating Convulsions Hypertension

22. Pathophysiology Not well understand Alcohol causes CNS depression Inhibit dopaminergic and adrenergic receptor GABA Like effects Cessation results in brain hyper excitability

23. NON PHARMACOLOGICAL TREATMENT Encourage healthy life style Reduction of weight Diatary sodium reduction Moderate alcohol consumption Strict adhere to medication Take exercises Drink plenty of water Avoid OTC medication Healthy diet

24. Thank you ... https://www.slideshare.net/martinshaji/a-case-study-on-alcohol-withdrawal-syndrome