Any person who is suddenly withdrawing from alcohol must experience unpleasant reactions that accompany the process. The abrupt withdrawal brings about certain signs and symptoms that characterize the sudden discontinuation of taking drugs or alcohol. Some of the symptoms may include a rapid heartbeat, profuse sweating, temporary memory loss, insomnia, headaches, anxiety and even social isolation (Miller & Gold 1998). Most people who experience similar reactions as a result of sudden withdrawal from alcohol suffer from delirium tremens (DT) (Koob 2006).
It is one of the most prevalent risk factors in this case. The patient often experiences DT after 48-96 hours of the last alcohol intake, and since the patient stopped drinking four days ago, he might be undergoing this condition. Severe or sudden withdrawal and DT is often characterized by hallucinations, tachycardia, and diaphoresis all of which the patient is exhibiting. Alcohol typically affects the central nervous system hence; the sudden withdrawal distorts the system leading to auditory hallucinations and tremors.
Another risk factor, in this case, can be the age of the patient. Patients who are 30 years and above are more likely to suffer from severe withdrawal effects as the patient in this case. Others may include concurrent illnesses like hypertension and depression that the patient has been diagnosed. The current diseases are also accelerators to the effects of sudden cessation of drinking alcohol.
Long-term alcohol use causes chemical imbalances in the brain hence leading to other illnesses such as hypertension, diabetes, blood pressure and even arthritis (Ries 1996). Tachycardia, which is a heart rate of more than 100 heartbeats, may have occurred as a result of anxiety which is one of the symptoms of sudden withdrawal from alcohol. The electrical signal from the heart’s upper chamber fire abnormally and early beats in the atria consequently speeds up the heart rate and this in turn leads to diaphoresis.
During the chemistry tests on the patient, most of the parameters were found to be way beyond or too low from the standard levels that are recommended. High alcohol intake over extended periods of time disrupts the chemical makeup of the body. In this case, the patient has been found to have abnormal levels of body chemicals like blood urea nitrogen, sodium, chloride, potassium and sodium. His sodium that was found to be 130 mmol/L is below the average levels of 136-146 mmol/L but after rehydration, it was stabilized to a reasonable level of 139 mmol/L.
A low BUN value in generally expected in alcoholics, his blood urea nitrogen was also taken to monitor the kidney functions and it a standard test among people who are suffering from withdrawal symptoms. A very high level of BUN was registered in the patient that is also greater than the average recommended level of 7-8 mg/dL, but after hydration, the level was contained to a level of 16 mg/dL which is not dangerous. Most of the elements in his body were not normal but after he underwent hydration they were stabilized.
The administration of benzodiazepine was useful in reducing anxiety in the patient and also acted as a muscle relaxant. The drugs typically work in the central nervous system, and since the patient was exhibiting signs of agitation, the drugs could be effective in preventing seizures and panic disorders. Rehydration was done on the patient to restore lost water or fluids in the patient. Loss of water comes about because alcohol reduces the production of the antidiuretic hormone which is used by the body to reabsorb water. Increased urination due to excessive consumption of alcohol depletes the body fluids. Because the patient was losing fluids from his body, then rehydration was necessary.
Detoxification is also an important way of managing withdrawal patients by the progressive reduction of the dependence-producing substance or by replacing it with a cross-tolerant pharmacological agent which will minimize the symptoms. Offering general supportive care is also crucial by placing the patients in a quiet place with minimal stimulation and low lighting. If the patient is experiencing seizures, he should have instant intravenous access for easy administration of fluids and drugs (Kaim, Klett & Rothfeld 1969).
References
Kaim, S., Klett, C. & Rothfeld, B. (1969). Treatment of the Acute Alcohol Withdrawal State: A Comparison of Four Drugs. American Journal of Psychiatry, 125(1), 1640–1646.
Koob, G. (2006).The Neurobiology of Addiction: A Neuroadaptational View Relevant for Diagnosis. Addiction, 101 (Supp 1), 23–30.
Miller, N., Gold, M. (1998). Management of Withdrawal Syndromes and Relapse Prevention in Drug and Alcohol Dependence. American Family Physician, 58, 139–46.
Ries, R. (1996). Assessment and Treatment of Patients with Coexisting Mental Illness and Alcohol and Other Drug Abuse. Rockville: Diane Publishing.
