Treatment of alcohol withdrawal syndrome with medicines is a proven method of rapid medical care to an alcoholic during a period of critical exacerbation of alcohol dependence. Of course a huge role is played by the qualification and experience of a doctor-narcologist who conducts such treatment. At the very beginning of anti-alcohol therapy, a thorough examination of the patient plays a crucial role. All detected abnormalities should be weighed and taken into account when determining the medical tactics - in many respects from the correctness of its choice depends the effectiveness of withdrawal from the binge and the success of overcoming the consequences of the withdrawal syndrome.
How to treat an abstinence syndrome is best in a hospital setting, but proper treatment is possible at home, if conducted by a professional - the doctor is a narcologist. Symptoms of alcohol withdrawal syndrome are already a direct reason for seeking professional drug treatment. In the conditions of the narcological clinic, the examination of the patient is the most complete, so it is based, including on the results of the analyzes, in such conditions a complex treatment of the withdrawal syndrome is possible. The withdrawal from the withdrawal syndrome under stationary conditions is performed in complicated and severe cases, because for this there are all the conditions necessary for the highest quality narcological treatment.
The doctor who prescribes the appropriate drug for alcohol withdrawal is based on the survey data and after interviewing relatives and close people about the details of what happened to the patient during the alcohol withdrawal syndrome, such as the period of drinking-bout, the type of drinking, the presence of chronic diseases and pathologies in the patient, Not tolerability of certain medications, etc.
The duration of alcohol withdrawal syndrome is determined in general by the same criteria as the withdrawal syndrome from other psychoactive substances. The duration of the syndrome depends first of all:
Thus, there are many factors to determine the exact value. How long does the abstinence syndrome take is easier to notice to the person, based on the experience of getting out of the binge. Of course, the narcologist calculating the duration of treatment for alcohol withdrawal should take into account the sex, age, and general health of the patient who came to him for treatment. Abstinence in alcoholism, in its acute phase in need of treatment, usually last no more than 3 weeks. For comparison, when smoking tobacco - a string of the month, and when smoking marijuana - 2 weeks. Of course, if we take into account also the psychological aspect, the duration of the duration will be increased. With addiction from stronger drugs, the timing depends more on the type of substance taken than on other criteria. It is important to realize that the desire to be treated by the patient, the urge to recover, and the accurate and accurate adherence to the prescriptions of the doctor reduces the overall duration of the withdrawal syndrome and quickly leads to recovery.
In the presence of alcohol withdrawal syndrome (AAS) and postintoxication disorders and signs, the appointment of tranquilizers for 3-5 days of the benzodiazepine group (diazepam, tazepam, phenazepam, etc.) is indicated at the beginning of treatment, as tablets or intramuscular injections. These tranquilizers, by binding to GABA-benzodiazepine receptors, increase the positive effects of GABA, which is the main inhibitory neurotransmitter. In addition, they operate other regulatory systems: hypothalamic-pituitary-adrenal and noradrenergic systems, reducing the risk of fatal overexcitation of neurons. It is necessary to individually select the dose of the drug depending on the severity of the patient's condition, the difference in doses can reach 10-fold size. Once again, it should be noted that the dose and duration of use of tranquilizers in the treatment of alcoholism are selected by the narcologist individually in each case, depending on the patient's condition and other important factors.
The manifestation in the aggregate of the signs of alcohol withdrawal syndrome of pronounced hyperactivation of the sympathetic system serves as an indicator for the use of b-adrenoblockers (propranolol, etc.). Together with tranquilizers, b-adrenoblockers boost treatment, normalizing blood pressure (BP), heart rate (heart rate) and body temperature. Also, agitation, anxiety level is lowered, craving for drinking is suppressed, which has a beneficial effect on the patient and stabilizes the course of treatment.
For the compensatory response to inhibitory effects of large doses of alcohol in the neurons of the brain, additional calcium channels are formed; Because of what when the consumption of alcohol ceases inside the neurons receives an excessive amount of calcium ions, leading to overexcitation and death of neurons. This is the basis for use in the treatment of calcium channel antagonists (nifedipine, amlodipine, etc.) in the treatment of abstinence. Calcium antagonists quite effectively manifest themselves clinically in this position. In the modern world, a lack of calcium is often made up only by a specially selected diet.
Dependents on alcohol often have a severe deficiency of magnesium ions in tissues, especially in erythrocytes, resulting from a decrease in magnesium absorption in the small intestine and an increase in magnesium excretion in the urine due to alcohol, leading to myoclonic twitching, autonomic dystonia, ataxia, tremor, insomnia, Dizziness, tension, anxiety, irritability. Therefore, in severe abstinence, especially with his cerebral variant, magnesia therapy is prescribed - intramuscular injection of magnesium salts 1-2 times a day at the rate of 2 mg of magnesium ion per 1 kg of body weight of the patient, necessarily under the control of arterial pressure. Without the use of magnesia therapy, alcoholism treatment in the phase of cupping alcohol withdrawal syndrome can be unreasonably prolonged due to the complexity of the normalization of metabolism.
If there is anamnestic suspicions of convulsive seizures or information about their presence during previous abstinent conditions in this patient, it is advisable to prescribe carbamazepine up to 1200 mg per day or sodium valproate up to 900 mg per day. At the same time, the use of group B vitamins is shown, which is beneficial for all During the treatment of alcohol dependence.
For the treatment of severe cases of alcohol withdrawal syndrome, rehydration drugs are used under the control of hemodynamics, blood coagulability and hematocrit. Intravenously injected saline, polyionic mixtures, etc. In normal cases, the listed funds are enough to radically improve the patient's condition for 3-5 days of treatment.
There are, in addition, other ways that can speed up overcoming the drunken state and improving the patient's condition. Use, for example, once freshly prepared solution from a mixture of 30 ml of a 20% solution of sodium oxybutyrate, 2 ml of a 0.5% solution of diazepam, 1 ml of a 1% solution of diphenhydramine and 1 ml of a 1% solution of propoxane. The medicine is used inside, then in the course of the next time there comes a calm and a dream, and in the morning there are only minor residual manifestations of the withdrawal syndrome. In general, the duration of the course of abstinence is reduced with such treatment of drinking-bout being reduced by 4-5 times (AM Danilenko, 1988).
The use of proroxane (0.5% solution) can be performed by the method of transcerebral electrophoresis with the aid of the Electroson apparatus (ophthalmic-mastoidal arrangement of the electrodes, pyrroxane at the anode, 2 to 10 mA, 4 to 150 Hz, pulse duration 0.3 -0.5 ms, duration of the session is 20 minutes). It is noted that with this method only two treatment sessions are sufficient, and the duration of treatment of alcohol withdrawal syndrome in most cases is reduced by half.
To medicamental methods of treatment of alcohol intoxication adjoins oxygenophytotherapy, developed by NG. Pshuk (1991). This method consists in the appointment of patients inward with fractional doses of 1.5-2 liters per day of a special oxygen-protein phytocockte, which is specially prepared by blowing oxygen through a mixture of egg protein, syrup, water, infusions of herbs - tansy, chamomile, dog rose, St. John's wort, Motherwort in a calibrated proportion, causes a quick positive result: after a few hours psychophysical discomfort disappears, calmness, relaxation, drowsiness, normal blood pressure and heart activity elnost.
It should be noted in conclusion that the rate of achievement of a positive therapeutic result in the treatment of alcohol withdrawal syndrome, as well as a reduction in the patient's stay in this state is very important, since during alcohol intoxication, especially during prolonged drinking, poisoned alcohol is exposed to the most severe toxic effects leaving negative persistent Consequences in all systems and bodies. The expediency of prescribing and using medicines in the treatment of a drinking state depends on the professionalism and experience of the narcologist, self-medication is unacceptable.