2.Neurologic Examination
3.Initial Lab Finding
4.Summuary
5.Problem List
6.Initial Impression
7.Plan
8.Chest X-ray
9.Summary
largely due to central nervous system being in a hyper-excitable state
can be fatal
direct glutamate excitotoxcity
elevated heart rate and blood pressure
electrolyte imbalance
malnutrition.
May includes seizure, delirium tremens
occurs as a result of neuro-adaptation from chronic exposure
neuropsychiatric excitability and autonomic disturbances
occurs upon declining blood levels of alcohol
can be alleviated by reintroduction of alcohol or cross-tolerant agent
Dependence on other sedative-hypnotics increases the severity
Exposure to substance causes counter-regulatory mechanism
When the substance is removed
residual counter-regulatory mechanisms withdrawal symptoms
Ethanol interacts with GABA, glutamate (NMDA), and opiates
binds to postsynaptic GABAA receptors
chloride influx, hyperpolarization of cell
Ultimately producing sedation
Long-term use of ethanol: downregulation of GABAA receptors

분야