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Wernickes-Krosokoff Syndrome - #PHARMFAX

Thiamine deficiency will lead to neuronal death.

 

Thiamine deficiency will lead to neuronal death. Wernickes-Korsokoff Syndrome is attributed to thiamine deficiency. Vitamin B1, or thiamine, is more importnat than you think. Thiamine is critical for many metabolic processes and enzymatic functions. One of those important functions? Cerebral metabolism.


Alcoholism accounts for roughly half of Wernicke encephalopathy. This disease can also be caused by starvation and malabsorption issues. Wernicke’s encephalopathy is more of the acute phase; the three cardinal signs are AMS, ataxia, and oculomotor abnormalities. If not replaced, Wernicke’s encephalopathy will progress into Korsakoff syndrome, which is more of a permanent, chronic amnesia. What? We’re pulling high dose thiamine from the drug bank. Theres different dosing practices, but patients should receive thiamine 400 - 500 mg IV or PO for several doses. Consider TID for 2 days and then eventually to a maintenance of 100 mg daily. You’ll often see hypoglycemia in this patient population. It would be best to replace thiamine prior to dextrose, but those circumstances are up to the patient. The sudden influx of dextrose will cause insulin release from the pancreas, worsening your thiamine deficiency. The PHARMFAX are runnin hot, share this with a friend.



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