Substance Misuse And Pain Flashcards

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1
Q

Describe moderate alcohol dependence

A

Degree of dependence but have not reached the stage of ‘relief drinking’ to avoid withdrawal symptoms
May be suitable for detox in the community

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2
Q

Describe severe alcohol dependence

A

May have serious and long standing problems
Often seen as ‘chronic alcoholic’
Typically have experienced significant withdrawal symptoms and habitually drink to prevent symptoms
May require in-patient detox

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3
Q

Name some alcohol screening tests

A

CAGE
AUDIT
FAST
PAT

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4
Q

What does the CAGE alcohol screening test look at?

A
C = cutting down
A = annoyed
G = guilt
E = eye opener
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5
Q

Describe some pharmacological interventions that help during withdrawal symptoms

A

Chlordiazepexide
Vitamin B complexes
Diazepam (valium)

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6
Q

Give some medications that promote abstinence

A

Acomprosate
Disulfiram
Nalmefene

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7
Q

How do you manage acute intoxication?

A

Monitor vitals, electrolytes (esp K+) and glucose
Administer thiamine (B1)
Management of withdrawal if necessary

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8
Q

What is the doctor role with regards to substance misuse?

A
Assessment 
Motivating patient 
Offering basic advice
Knowing what the different treatments do
Sign posting 
Supporting people
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9
Q

What are the cluster groups we use for drugs?

A

Depressants and dissociatives
Stimulants and empathogens
Hallucinogens and cannabis
Opiates and opioids

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10
Q

What is likely to have occurred if pain persists from more than 3 months?

A

Original physical damage may have healed but pain pathways have become over-sensitised or dysregulated

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11
Q

Does anxiety lead to increased or decreased pain tolerance?

A

Decreased pain tolerance

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12
Q

Does fear lead to increased or decreased pain tolerance?

A

Increased tolerance (released of endogenous opioids)

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13
Q

What is nocicepton?

A

The stimulation of peripheral pain receptors

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14
Q

What is pain sensation?

A

How the pain is interpreted

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15
Q

What is suffering?

A

Perceived pain, distress and disability that can arise from pain and other related factors

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16
Q

Define pain threshold

A

Point at which a stimulus becomes painful

Similar more most people

17
Q

Define pain tolerance

A

Degree to which a painful stimulus can be tolerated

Varies widely between individuals

18
Q

Describe the gate theory of pain

A

The notion of a synaptic gate between peripheral nerves and neurons in the spinal cord
Can be opened and closed by physical and psychological factor