Médico psiquiatra, Universidad de Costa Rica, subespecialistas en Psiquiatría de Enlace, Pontifica Universidad Javeriana.
Médico Psiquiatra, subespecialista en Psiquiatría de Enlace, coordinador académico Especialidad en Psiquiatría de Enlace, candidato a Magíster en Psicofarmacología Clínica, Pontificia Universidad Javeriana, Departamento de Psiquiatría y Salud Mental, Hospital Universitario San Ignacio, Bogotá, Colombia.
Rev Colomb Psiquiatr (Engl Ed). 2021 Jan-Mar;50(1):52-56. doi: 10.1016/j.rcp.2019.10.002. Epub 2020 Jan 22.
Alcohol use disorder is one of the main causes of morbidity and mortality in the world. Alcoholic liver disease is a common complication of this disorder, and hepatic encephalopathy is a serious complication of alcoholic cirrhosis. Precipitating factors may be related to infection, gastrointestinal bleeding, dehydration or the effects of psychotropic drugs (e.g. benzodiazepines and non-benzodiazepine hypnotics). We present a case of the hospital management of a patient with a severe alcohol use disorder, cirrhosis and hepatic encephalopathy who developed alcohol withdrawal symptoms while in hospital, and discuss the complexity of the antagonistic management of a GABAergic delirium characteristic of hepatic encephalopathy in the context of a glutamatergic-noradrenergic delirium due to alcohol withdrawal.
酒精使用障碍是世界范围内发病率和死亡率的主要原因之一。酒精性肝病是这种疾病的常见并发症，而肝性脑病是酒精性肝硬化的严重并发症。诱发因素可能与感染、胃肠道出血、脱水或精神药物（如苯二氮䓬类和非苯二氮䓬类催眠药）的作用有关。我们报告了一例严重酒精使用障碍、肝硬化和肝性脑病患者的住院管理案例，该患者在住院期间出现酒精戒断症状，并讨论了在酒精戒断引起的谷氨酸能-去甲肾上腺素能性谵妄的背景下，对抗性治疗肝性脑病特征性 GABA 能性谵妄的复杂性。
