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Symtomes and management of Alcoholism 
Alcoholism is a medical condition where the patient is on chronic Alcohol abuse to develop a state of dependence on alcohol consumption, the abstenence of  alcohol is a challenging process that could involve multiple relapses. Alcoholism will be associated with lots of medical conditions involving liver cirrhosis, pancreatitits, anemia and congestive heart failure. The medical treatment of Alcoholism should be combined with multi-approach treatment of Psychological support and isolation if needed in a motivated patient. Disulfiram 500 mg tab once daily for 2 weeks then 250 mg tab once daily is administerd till the patient acheive self control. of note that the patient should be take the drug 12 hrs after the last drink of alcohol and consult your treating psychiatrist to acheive the appropriate control.
Required investigations 
After the proper physical exam, You should do cbc to detect any signs of anemia, liver functions AST, ALT ,ALP ,Total protein ,Albumin and LDH. Amylase should be done in addition to lipase to detect Signs of pancreatitis. Abdomen US to detect any signs of Liver cirrhosis. serum ethelene level should be done to monitor alcohol abstinance.
 Disulfiram warnings 

• Disulfiram should never be administerd to a patient with alcohol intoxication 
• Never admisinter without patient knoweldge 
• Contraindicated in patients with severe cardiac disease 
• Contraindicated in patient with Psychosis 

Our advice 
The patient should be fully concious and alert of his management plan to acheive the goal of abstinance, should be monitored for signs of relapses and have healthy diet and consult the treating psychiatrist
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