Drinking Hx (EtOH, Alcohol)

 

Index

 

HPI

-  Type

-  Spirits

-  Beer: heavy, light

-  Wine: cask, bottles, fortified

-  Mixed drinks, shots

-  Other: petrol, methanol..

-  Amount

-  Standard drinks

-  Bottles, cans, glasses

-  NHMRC guidelines

-  Frequency

-  Days/week

-  Binges vs regular consumption

-  NHMRC guidelines

-  Environment

-  Who with: work colleagues, sport, partner

-  Where: pub, home, street, work

-  Underlying reasons

-  Men: ? depression/psych issues

-  CAGE Questions

-  Used to assess if pt at risk of EtOH harms &/or dependance

-  Do you think you should Cut down?

-  Do you get Annoyed when people tell you to stop?

-  Do you feel Guilty about drinking?

-  Do you need an Eye opener in the morning?

-  Level of current function

-  ? Quit attempts

-  +/- Drug Hx, Smoking Hx

 

Standard Drinks

-  1 standard drink = 10g EtOH (In Aus)

-  Beer

 

285ml

375ml

2.7%

0.5

0.8

3.5%

0.7

1.0

4.9%

1.0

1.5

 

-  Glasses of wine (12%)

-  100ml standard = 1

-  180ml average = 1.8

 

-  750 ml Bottles

-  Wine 12% = 7

-  Spirits 40% = 24

 

NHMRC Guidelines (2009)

-  2 days EtOH free per week

-  Not >2 per day

-  Not >4 on any occassion

-  Male = Female

-  Children

-  <15yrs at greatest risk of harm

-  15-17yrs delay initiation as long as possible

 

PMH/Associated Conditions

-  Chronic Liver Disease

-  Cirrhosis

-  Wernickes Encephalopathy

-  Korsakovs Psychosis

-  Depression

-  Beri Beri

-  Malnutrition

-  Gastritis

-  Mallory Weis Tears

-  Pancreatitis

-  Aspiration pneumonia

-  Cardiomyopathy

 

Social/Personal

-  Smoking

-  Drugs

-  Effect on life

-  Relationships

-  Work

-  Driving

-  Children

-  Risky behaviour: rape, violence..

-  Depression/stress

 

Family Hx

-  Alcohol dependance

-  Depression

 

Ex

-  Examine for evidence of associated conditions

-  Gastro Exam

-  Hepatosplenomegaly: portal hypertension, alcoholic hepatitis

-  Shrunken liver: cirrhosis

-  Gynaecomastia

-  Spide naevi

 

Mx

-  Brief Intervention

-  Alcohol Withdrawal Scale (AWS)

-  Mx of EtOH Dependance

 

 

 

 

References

 

NHMRC – Australian Guidelines To Reduce Health Risks from Drinking Alcohol 2009