11/9/2022 0 Comments Give thiamine before glucose![]() ![]() These regions require adequate availability of ATP for energy and NADPH for In addition, these regions are likely toīe more sensitive to the availability of thiamine for cellular function. The brain is, in part, likely due to the direct toxic effects of alcohol (and The brain damage is known to vary but typically involves theįormation of hemorrhagic and necrotic lesions in the mammillary bodies of theīrain, hypothalamus, thalamus, the periaqueductal region, and floor of theįourth ventricle, and cerebellar vermis.7 The damage to these areas of Type of brain damage is seen in thiamine deficient alcoholic patients? Not appropriate for a number of reasons (see past newsletter 2010 volume 3 Oral replacement in the setting of acute alcohol intoxication is Wernicke-Korsakoff Syndrome and result in irreversible damage to theīrain. Failing to do so has been known to worsen the Theįocus of this publication is explain why the thiamine should be given be prior Give them thiamine 100 mg intravenously (IV) before administering glucoseĬontaining IV fluids and then to continue this dose for several days. The current standard of treatment for such patients is to Should alcoholic patients with Wernicke-Korsakoff Syndrome receive thiamine Increased risk for Wernicke-Korsakoff Syndrome, cerebellar degeneration, andĬardiovascular dysfunction.3-5 In fact, reports have shown thatĪpproximately 13-42% of alcoholics had evidence of Wernicke-Korsakoff SyndromeĪnd cerebellar degeneration on autopsy.6,7 If the thiamineĭeficiency is left untreated, these complications can result in irreversibleĭamage to several parts of the central nervous system (CNS). Vitamin B1 (thiamine).1,2 This is clinically relevant, as thiamineĭeficiency in this patient population is known to put the patient at an Is well known that chronic alcoholics are at high risk for being deficient in Results in either cell death or activation of apoptosis. Phosphate pathway to protect the cell from reactive oxygen species thatĭamage cellular structures and the mounting stress on the cell overall, This development of acidosis, the inability of the pentose.Only increase the amount of lactic acid produced. Therefore, if you feed theĬell more glucose without giving the needed thiamine to allow for theįorward movement of cellular reactions for complete ATP generation, you ![]() To maintain glycolysis at a minimum rate. To convert the pyruvate to lactate (or lactic acid) in order to be able The inability of pyruvate to enter the TCA cycle causes the cell.Them thiamine 100 mg intravenously (IV) before administering glucoseĬontaining IV fluids and then to continue this dose for several days. ![]()
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