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Transtornos decorrentes do uso de bebidas alcoólicas

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 20 Aug 2025
Última atualização: 18 Sep 2024

Resumo

Definição

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • abstinência
  • tolerância
  • aumento/diminuição do tamanho do fígado, icterícia, ascite
Full details

Other diagnostic factors

  • insônia
  • disfunção erétil
  • transtorno decorrente do uso de nicotina
  • distúrbios gastrointestinais
  • cãibras musculares, dor, sensibilidade, percepção sensorial alterada
  • hipertensão e taquicardia
  • estado nutricional comprometido
  • marcha de base ampla
Full details

Risk factors

  • história familiar de transtorno decorrente do uso de bebidas alcoólicas
  • comportamento antissocial (pré-mórbido)
  • alto nível de ansiedade-traço
  • ausência de rubor facial mediante exposição a bebidas alcoólicas
  • baixa responsividade aos efeitos das bebidas alcoólicas
  • história de bypass gástrico
Full details

Diagnostic investigations

1st investigations to order

  • entrevista diagnóstica
  • nível de álcool (hálito e sangue)
  • Clinical Institute Withdrawal Assessment for Alcohol, revisada (CIWA-Ar)
Full details

Investigations to consider

  • transferrina deficiente em carboidratos (CDT)
  • gama-glutamiltranspeptidase, alanina aminotransferase (ALT), aspartato aminotransferase (AST)
  • Hemograma completo
  • etilglicuronídeo urinário
Full details

Treatment algorithm

ONGOING

consumo de bebidas alcoólicas de risco

transtorno decorrente do uso de bebidas alcoólicas: adulta não gestante sem uso concomitante de opioides ou diagnóstico de saúde mental

transtorno decorrente do uso de bebidas alcoólicas: adulto não gestante com uso concomitante de opioides

transtorno decorrente do uso de bebidas alcoólicas: adulto não gestante com diagnóstico de saúde mental concomitante

transtornos decorrentes do uso de bebidas alcoólicas: adolescente não gestante

transtornos decorrentes do uso de bebidas alcoólicas: gestante

Contributors

Authors

Elisabeth Poorman, MD, MPH

​Assistant Professor of Medicine

Department of Medicine

University of Illinois Chicago

Chicago

IL

Disclosures

EP declares that she has no conflicting interests.

Marlene Martin, MD

Associate Professor of Clinical Medicine

Director, Addiction Care Team

San Francisco General Hospital

University of California, San Francisco

San Francisco

CA

Disclosures

MM is a board member for the National Harm Reduction Coalition and has done consultancy work for the Society of Hospital Medicine.

Sarah Messmer, MD

​Assistant Professor of Clinical Medicine and Pediatrics

University of Illinois Chicago

Chicago

IL

Disclosures

SM declares that she has no conflicting interests.

Acknowledgements

Dr Elisabeth Poorman, Dr Marlene Martin, and Dr Sarah Messmer would like to gratefully acknowledge Dr Colin Drummond, Dr Julie R. Pittman, Dr Philip H. Chung, Dr Robert M. Swift, and Dr Lorenzo Leggio, previous contributors to this topic.

Disclosures

CD, JRP, PHC, and RMS declare that they have no competing interests. LL is an author of a reference cited in this topic.

Peer reviewers

Paul S. Haber, MD

Royal Prince Alfred Hospital and Discipline of Medicine

University of Sydney

Sydney

Australia

Disclosures

PSH is an author of a reference cited in this topic.

Roberta Agabio, MD

Bernard B. Brodie Department of Neuroscience

University of Cagliari

Cagliari

Italy

Disclosures

RA is an author of a number of references cited in this topic.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.

Reus VI, Fochtmann LJ, Bukstein O, et al. The American Psychiatric Association practice guideline for the pharmacological treatment of patients with alcohol use disorder. Am J Psychiatry. 2018 Jan 1;175(1):86-90.Full text  Abstract

Lingford-Hughes AR, Welch S, Peter L, et al. BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction, and comorbidity: recommendations from BAP. J Psychopharmacol. 2012 Jul;26(7):899-952. Abstract

Anton RF, O'Malley SS, Ciraulo DA, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA. 2006 May 3;295(17):2003-17.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • Differentials

    • Outros transtornos psiquiátricos
    • Outros transtornos relacionados ao uso de substâncias (especialmente sedativos)
    More Differentials

  • Guidelines

    • International statistical classification of diseases and related health problems, 11th ed. (ICD-11)
    • Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR)
    More Guidelines

  • Patient information

    Transtornos decorrentes do uso de bebidas alcoólicas

    More Patient information

  • Calculators

    Questionário AUDIT para rastreamento do consumo de álcool

    More Calculators
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