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CLASP: Alcohol 2017/18 > 5: Alcohol dependence disorders > Flashcards

5: Alcohol dependence disorders Flashcards

1
Q

What is harmful use of alcohol?

A

Pattern of alcohol use which causes damage to physical or mental health

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2
Q

How long does a patient need to be misusing alcohol to qualify as having harmful use disorder?

A

1 month

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3
Q

What are the criteria of alcohol dependence syndrome?

A

3 or more of:

Strong compulsion to take alcohol

Difficulties in controlling use of alcohol

Using alcohol despite evidence of harm

Preoccupation with alcohol use

Increased alcohol tolerance

Psychological withdrawal

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4
Q

What is the biopsychosocial model?

A

Focuses on the body + the mind

i.e psychology and social factors

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5
Q

international classification of diseases - f code is alcohol use disorders

A
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6
Q

What screening tests are used to determine a patient’s dependence on alcohol before and after treatment?

A

FAST screen

AUDIT screen

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7
Q

What does MAAW stand for?

A

Medically assisted alcohol withdrawal

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8
Q

Which drugs are used to help patient’s withdraw from alcohol use?

A

Chlordiazepoxide / Diazepam

Oxazepam

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9
Q

What is the Child-Pugh score?

A

Used to calculate prognosis in chronic liver disease / cirrhosis

AND to assess patient’s suitability for drugs e.g MAAW drugs like chlordiazepoxide

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10
Q

alcohol withdrawal asspit

A
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11
Q

chlordiazepoxide mechanism of action

A
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12
Q

What are supportive treatments given to patients with alcohol use disorders?

A

Oral thiamine for low risk patients

IM/IV pabrinex (variety of vitamins) for high risk patients (inpatients usually)

Nutrition

Rehydration therapy

Anti-emetics

Anti-diarrhoeals

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13
Q

B vitamins like thiamine are ___ stored in the body.

A

minimally

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14
Q

A chronic alcoholic is likely to be thiamine ___.

A

deficient

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15
Q

Thiamine is essential for which biochemical process?

What does it act as?

A

Kreb’s Cycle

Co-enzyme

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16
Q

What happens to the Kreb’s Cycle when a patient is thiamine deficient?

A

Shuts down, switch to anaerobic respiration

17
Q

Why can patients with thiamine deficiency suffer brain damage?

A

Lactic acid accumulation in the brain due to anaerobic respiration

18
Q

What should be given to any alcohol-use disorder patient who is nutritionally deficient?

A

IV pabrinex

19
Q

withdrawal complications

A
20
Q

What is withdrawal state with delirium?

A

Alcohol withdrawal + sudden mental/NS changes

21
Q

What should be the next step if you suspect a withdrawal patient is delirious?

A

Admit to hospital

IV pabrinex

22
Q

What usually occurs 2-3 days into alcohol withdrawal and is associated with hallucinations like shrunken people and the sensation of insects under the skin?

A

Delirium tremens

23
Q

clinical presentation of alcohol withdrawal

A
24
Q

Wernicke’s encepalopathy is ___.

Korsakoff’s syndrome is ___.

(irreversible / reversible)

A

Wernicke’s - reversible

Korsakoff’s - irreversible

25
Q

What causes Wernicke’s encephalopathy?

A

Lactic acidosis in the brain

26
Q

What causes Korsakoff’s syndrome?

A

Irreversible brain damage re: lactic acidosis in brain

27
Q

How does disulfiram (antabuse) work?

A

Blocks action of acetaldehyde dehydrogenase

so when the patient drinks alcohol it’s converted to acetaldehyde but no further, which makes them nauseous, flushed etc.

28
Q

Apart from disulfiram, what are some other drugs used to prevent relapse in alcohol-dependent patients?

A

Acamprosate - neuroprotective, reduces cravings

also baclofen, naltrexone

29
Q

What must be considered before giving patients drugs to prevent relapse?

A

Liver function - LFTs, history, interactions with other drugs

30
Q

What psychological condition is similar to delirium tremens, but seen in chronic drinkers and tending to have a better prognosis?

A

Alcoholic hallucinosis

31
Q

revise w-k syndrome from module

A
32
Q

What is confabulation?

A

Approximate answers to disguise memory loss

CLASP: Alcohol 2017/18 (8 decks)

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