Positive Romberg Sign - (r/t etoh) loss of balance that occurs when closing the eyes
ETOH withdrawal delirium may result in? - Seizures or death
DSM Severity for ETOH - Mild = 2-3 sx
Moderate = 4-5 sx
Severe = >= 6 sx
DSM ETOH Remission Criteria - Early = >3 mos & <12 mos
Substantial...
When to Start & Stop CIWA - ✔✔Start: Last ETOH w/i past 12 hours
Hx of: w/d sx, large amt of etoh over long time
Stop: When score is <10 after 3 consecutive assessments
CIWA Measurement Guideline - ✔✔N/V
Tremors
Paroxysmal Sweats
Anxiety
Agitation
Tactile, Auditory, Visual Disturbances
H/As or "fullness in head"
Orientation/Sensorium
Neurological Factors of Addiction - ✔✔"Feel good" rewards by Dopamine Pathways
Ele. Dopamine
Ele. Glutamate
Dec. GABA
Neurobiological Factor of Addiction Withdrawl - ✔✔Significant decrease in dopamine levels
Precautions w/Antabuse (disulfiram) - ✔✔May use >12 hours after last drink
NO mouthwash/perfume
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