• Abstinace time for return to normal
  • GGT 2-6 weeks
  • AST 7 days
  • Chronic use ⇒ high MCV and hypertension (resistant to therapy)
• Alcohol poisoning → resp poisoning
  • Mangmenet is mainly supportive
• Management
  • Benzodiazepines
    • Functional liver: diazepam or chlordiazeppoxide
    • Cirrhosis or alcoholic hepatitis: lorazepam
  • Improve agitation and prevent progression
• Alcohol use disorder (recurrent drinking causing)
  • Gastrointestinal: gastritis, hepatitis, cirrhosis, pancreatitis
  • Cardiac: dilated cardiomyopathy, refractory hypertension
  • Malignancy: oesophageal and oropharyngeal cancers
  • Management
    • Banana bag: IV infusion to alcohol users, contains: thiamine, folate and magnesium
      • Wernicke precipitated by glucose without thiamine
    • Disulfiram
    • Naltrexone
    • Acamprosate
      • Modulates NMDA receptors
• Wernicke-Korsakoff
  • Wernicke: acute encephalopathy
    • visual distrubances, gait ataxia and confusion
  • Korsakoff: chronic neurologic condition
    • recent memory lost more than remote
    • can’t form new memories
      • Confabulate
    • Lack of interest or concern (apathy)
    • usually permanent
  • Both associated with:
    • Thiamine (B1) deficiency as well
  • Atrophy of mammilary bodies (80% for both conditions)
  • Associated with damage to thalamic nuclei
• Associated with deficiencies:
  • Thiamine B1
  • Pyridoxine B6
  • Folate B9
  • Magnesium
  • Clacium
  • Phosphorus