Alkoholový odvykací stav a delirium - od patofyziologie k léčbě
KAŠPÁREK, Tomáš, Michal DREISIG and Richard BARTEČEK. Alkoholový odvykací stav a delirium - od patofyziologie k léčbě (Alcohol Withdrawal Syndrome and Delirium - from its Pathophysiology to Treatment). Česká a slovenská neurologie a neurochirurgie. Praha: Nakladatelské a tiskové středisko ČLS JEP, 2014, vol. 77, No 2, p. 153-157. ISSN 1210-7859. |
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Basic information | |
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Original name | Alkoholový odvykací stav a delirium - od patofyziologie k léčbě |
Name (in English) | Alcohol Withdrawal Syndrome and Delirium - from its Pathophysiology to Treatment |
Authors | KAŠPÁREK, Tomáš (203 Czech Republic, guarantor, belonging to the institution), Michal DREISIG (203 Czech Republic, belonging to the institution) and Richard BARTEČEK (203 Czech Republic, belonging to the institution). |
Edition | Česká a slovenská neurologie a neurochirurgie, Praha, Nakladatelské a tiskové středisko ČLS JEP, 2014, 1210-7859. |
Other information | |
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Original language | Czech |
Type of outcome | Article in a journal |
Field of Study | 30000 3. Medical and Health Sciences |
Country of publisher | Czech Republic |
Confidentiality degree | is not subject to a state or trade secret |
Impact factor | Impact factor: 0.165 |
RIV identification code | RIV/00216224:14110/14:00075753 |
Organization unit | Faculty of Medicine |
UT WoS | 000333662100002 |
Keywords in English | alcohol; withdrawal; syndrome; delirium; neurotoxicity |
Tags | EL OK |
Tags | International impact, Reviewed |
Changed by | Changed by: Soňa Böhmová, učo 232884. Changed: 22/7/2014 16:21. |
Abstract |
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Závislost na alkoholu se projevuje adaptací nervového systému, která vede při náhlém přerušení přísunu alkoholu k rozvoji odvykacího syndromu. Ten je charakterizován zejména excesivní glutamátergní excitační aktivitou a nedostatečnou aktivitou inhibičních mechanizmů, zprostředkovaných systémem kyseliny gama-aminomáselné. Tato nerovnováha se projevuje anxietou, neklidem, tremorem, snížením záchvatového prahu. Další změny se týkají dopaminergního, serotoninergního, noradrenergního opioidního systému, aktivity kortikotropního hormonu, které se podílejí na klinickém obrazu odvykacího stavu, jenž zahrnuje vegetativní hyperaktivitu, změny emotivity, jako jsou dysforie, hypohedonie. Komplikací odvykacího stavu je delirium. |
Abstract (in English) |
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Alcohol dependence leads to adaptations of the nervous system that leads to withdrawal syndrome manifestation when regular alcohol consumption is abruptly discontinued. Withdrawal syndrome is characterized mainly by excessive excitatory and diminished inhibitory mechanisms, mediated by glutamatergic and gaba-ergic systems. This imbalance leads to anxiety, restlessness, tremor and decreased seizure threshold. Furthermore, changes to dopaminergic, serotoninergic, noradrenergic, opioid system, or corticotropin releasing hormone-related activation of stress reaction contribute to the clinical picture that includes vegetative hyperactivity, affective changes, dysphoria, hypohedonia, etc. Delirium - a complication of severe withdrawal - is a significant clinical syndrome that complicates health care management and may lead to fatal outcomes. Treatment of alcohol withdrawal and delirium is based on gradual establishment of a new balance of excitatory and inhibitory systems without the presence of external inhibitory substance - alcohol. In clinical practice the pathophysiology is reflected in the administration of gaba-ergic compounds (benzodiazepines, clomethiazole) with gradual dose tapering. Complex effect of alcohol with a number of related somatic complications requires additional systematic somatic care. |
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