重症患者のアルコールの乱用
Marc Moss1, Ellen Lyda Burnham
1Divison of Pulmonary Sciences and Critical Care Medicine, University of Colorado at Denver and Health Sciences Center, Denver, CO 80262, USA. Marc.Moss@uchsc.edu
Lancet (London, England)
|December 26, 2006
まとめ
アルコールの乱用は,集中治療室 (ICU) の患者で一般的ですが,しばしば診断されません. アルコール使用障害を早期に認識することは,重症患者の効果的な治療と改善された結果にとって極めて重要です.
科学分野:
- クリティカルケア・メディシン
- 依存症の精神医学 依存症の精神医学
- 内科内科は,内科の内科である.
背景:
- アルコール乱用および依存症障害は,重症病棟 (ICU) の入院中に多く見られ,患者の約10%に影響します.
- これらの疾患は,ICU環境ではしばしば診断されない.
- 過剰なアルコール摂取による全身的影響は,重篤な病気に対する脆弱性を高め,または直接原因となる.
研究 の 目的:
- 重症患者のアルコール乱用および依存症の早期発見の必要性を強調する.
- アルコール特有の診断の予後および治療的意義を強調する.
- アルコール関連疾患のスクリーニング方法,疫学,病原性,臨床表現,ICUにおけるアルコール関連疾患の治療法をレビューする.
主な方法:
- 重症患者のアルコールの乱用と依存症に焦点を当てた文献レビュー.
- 診断を改善するためのスクリーニングツールの議論.
- アルコール関連疾患の流行病学,病原性,ICUでの臨床的症状の分析.
主要な成果:
- アルコール関連の障害は一般的ですが,ICU患者ではしばしば見過ごされています.
- 診断されていないアルコール使用は,重篤な病気への感受性を高め,管理を複雑にする.
- アルコール関連の特定の診断は,患者の予後と治療戦略に大きな影響を及ぼします.
結論:
- アルコール乱用および依存症の早期スクリーニングと診断は,集中治療室の患者にとって不可欠です.
- アルコールに特異的な症状を認識することで,適応型の治療介入が可能になります.
- アルコール関連障害の治療は,重症患者のケアと治療結果を最適化するために不可欠です.
関連する概念動画
CNS Depressants: Alcohol and Nicotine
Ethanol, a clear colorless alcohol, has been consumed by humans for millennia, but its effects on the body are far from benign. At lower doses, it induces decreased inhibitions and loquaciousness, leading to its social appeal. However, it can cause severe consequences at higher doses, such as coma and respiratory depression, due to its zero-order elimination kinetics. Chronic ethanol abuse wreaks havoc on multiple organ systems, particularly the CNS and the liver. Abrupt cessation of ethanol...
CNS Depressants: Barbiturates and Benzodiazepines
CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
Drug Toxicity: Risk factors
Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
Substance Use Disorders Affecting Sleep
Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
Understanding the concepts of physical dependence,...
Understanding the concepts of physical dependence,...
Depressants
Depressant drugs, including alcohol and sedative-hypnotics, diminish central nervous system activity by enhancing the action of gamma-aminobutyric acid (GABA), a neurotransmitter that reduces brain activity and promotes relaxation. These substances can have various therapeutic uses but also pose significant risks, especially when misused or combined.
Alcohol is a common depressant that can induce a sense of relaxation and reduced inhibition at low doses. Contrary to its occasional...
Alcohol is a common depressant that can induce a sense of relaxation and reduced inhibition at low doses. Contrary to its occasional...
Hepatic Encephalopathy
DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...


