Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- abstinência
- tolerância
- aumento/diminuição do tamanho do fígado, icterícia, ascite
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
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
Diagnostic tests
1st tests to order
- entrevista diagnóstica
- nível de álcool (hálito e sangue)
- Clinical Institute Withdrawal Assessment for Alcohol, revisada (CIWA-Ar)
Tests to consider
- transferrina deficiente em carboidratos (CDT)
- gama-glutamiltranspeptidase, alanina aminotransferase (ALT), aspartato aminotransferase (AST)
- Hemograma completo
- etilglicuronídeo urinário
Treatment algorithm
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
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 DifferentialsGuidelines
- 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 GuidelinesPatient information
Transtornos decorrentes do uso de bebidas alcoólicas
More Patient informationCalculators
Questionário AUDIT para rastreamento do consumo de álcool
More CalculatorsLog in or subscribe to access all of BMJ Best Practice
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