Table 3: Management of the Alcoholic State 1. Assessment of: Physical functioning by means of a throughPhysical examination, followed by: a. C.B.C. and E.S.R. estimation b. Urine (Routine) examination c. Fasting blood sugar estimation d. Blood urea estimation e. Serum cholesterol estimation f. Serum creatinine estimation g. Serum amalyse estimation h. Liver function tests: i. SGOT ii. SGPT iii. Serum bilirubin iv. Serum proteins i. ECG j. X-ray chest k. EEG l. Any other investigations deemed necessary. |
Table 4: Psychological functioning by a thoroughpsychiatric examination, following if necessary by: i. The Rorschach test ii. The Bender Gestalf test iii. The Thematic Apperception Test iv. The M.M.P.I. The management of Alcohol withdrawal is as follows: 1. Tranquillisers: Diazepam - 10-20 mg orally daily. 2. Hypnotics a. Flurazepam - 15-30 mg orally at bed time, or Nitrazepam - 10-20 mg orally at bed time. b. Amitriptyline - 25-75 mg orally at bed time. 3. Antiepileptics Diphenylhydantion 100 mg orally 3 times a day. 4. Nutrients and Correctiveness: a. Dextrose (5%) - 2000 cc. I.V. b. Vitamins - B-complex group orally andintramuscularly. c. Electrolytes d. Liv.52 - 2 tablets 3 times a day. e. Inj. Vitamin K-1 Ampoule intramuscularly for 3days. f. Other medications as required. 5. Antibiotics – to prevent infection. 6. Psychotherapy – to improve motivation and explorepersonality configuration. The Management of Drug Withdrawal should be asfollows: 1. Hospitalisation in a secure institution with adequatesafeguards. 2. Complete withdrawal of the drug. 3. Tranquillisers: Tablet Trihexyphenithyl 2 mg, three times a day. |
If required – Capsule Doxepin 25-75 mg three times a day. 4. Hypnotic – Tablet Amitriptyline 50-75 mg at bedtime. Capsule Flurazepam 15-30 mg at bedtime. If the patient is severely hallucinated during thewithdrawal, give a barbiturate preparation atbedtime but for no longer than 5. Antiepileptics – Capsule Diphenylhydantion 100-200 mg three timesa day is very useful to prevent convulsion spasms,irritability, restlessness, etc. 6. Antibiotics should be given to prevent chestinfection. Any patient suffering from PulmonaryTuberculosis should be adequately treated. 7. Antacids, cough expectorants analgesics etc.,may be necessary to reduce particular symptoms. 8. Nutrients and Vitamins should be given in plentydepending on the patients, individualrequirement, about 2000 of Injection IVDextrose 5% is essential for the first ten days toassist nutri 9. Psychotherapy for the patient and his familymembers should be started early and continuedeven after the withdrawal phase. The utility of organisations like the AlcoholicsAnonymous. Al Anon, Narcotics Anonymousshould not be forgotten and efforts made to utiliseand principles of these organisations forimplementing Follow-up Therapy in an industrialunit. The Follow-up Therapy for Alcoholism in anindustrial un 1. Individual Psychotherapy with the patient, hiswife and family members. 2. Group Psychotherapy with other alcoholics andthe wives of alcoholics separately. 3. Monitoring of Disulfiram Therapy throughcareful supervision of administration andestimation of serum levels. For the persistentdrop-outs Disulfiram implants are advised. 4. Policing of the alcoholic and even alcoholicprisons are at times useful. 5. Alcoholics Anonymous programming whereavailable may be useful but this form of therapycannot be used on its own. |