Download e-book for kindle: Alcoholism: A Guide for the Primary Care Physician by Henrietta N. Barnes, Mark D. Aronson, Thomas L. Delbanco,

By Henrietta N. Barnes, Mark D. Aronson, Thomas L. Delbanco, Julius B. Richmond, A. Abrams, M.D. Aronson, H.N. Barnes, R.D. Bayog, M. Bean-Bayog, J. Bigby, B. Bush, M.G. Cyr, J. Daley, T.L. Delbanco, J. Ende, A.W. Fox, P.A. Friedman, M.E. Griner, P.F. Griner

ISBN-10: 1461247861

ISBN-13: 9781461247869

ISBN-10: 1461291550

ISBN-13: 9781461291558

Based at the Commonwealth Harvard Alcohol examine and instructing application, this clinically orientated paintings is designed to provide internists and first care practitioners the data and talents essential to realize and take care of sufferers with alcoholism.

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Additional info for Alcoholism: A Guide for the Primary Care Physician

Example text

Is there a typical prealcoholic personality? How does a person develop alcoholism? What is the course of the disease and its prognosis? Does treatment affect the course of the disease? The answers depend on where one looks. The breadth of alcoholism, affecting some 3% to 6% of adult Americans, and its depth, extending over decades, make it impossible for anyone observer to encompass the problem. The reviewer must acknowledge the unique advantages and limitations of different perspectives. The literature in sociology provides a background picture of normal drinking practices, cultural differences, and predisposing factors, such as heredity, but it does not address the development of the disease.

Individuals vary significantly with regard to euphoriant and hallucinogenic effects of alcohol, and the responses change according to the type and strength of the alcoholic beverage, the environment in which it is drunk, and the person's previous history of alcohol intake. 8 In even moderate doses, ethanol is an analgesic in many people. 9 The analgesia produced is similar to that of opiates rather than local anesthetics. It involves distraction from and disinterest in the source of pain rather than reducing awareness of pain or severity of a painful stimulus.

38 AW. J. A. Friedman The Pharmacology of Acetaldehyde and of Congeners Acetaldehyde is the principal first metabolite of ethanol. The first step is rate limiting for the whole metabolic pathway, so the concentration of acetaldehyde in the plasma is constant for any plasma ethanol concentration above 20 mg/dL. Brien and Loomis published a very good review of the pharmacologic effects of acetaldehyde. 24 At moderate plasma concentrations, acetaldehyde has sympathomimetic effects on the CVS, including both positive chronotropic and inotropic effects on the heart, peripheral vasoconstriction, and activation of the baroreceptor reflexes.

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Alcoholism: A Guide for the Primary Care Physician by Henrietta N. Barnes, Mark D. Aronson, Thomas L. Delbanco, Julius B. Richmond, A. Abrams, M.D. Aronson, H.N. Barnes, R.D. Bayog, M. Bean-Bayog, J. Bigby, B. Bush, M.G. Cyr, J. Daley, T.L. Delbanco, J. Ende, A.W. Fox, P.A. Friedman, M.E. Griner, P.F. Griner


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