addiction Flashcards
problems from heroin
N&V, constipation, respiratory depression, LOC. injections- local abscess, cellulitis, osteomyelitis, septicaemia
acute problems from benzos
forgetful, drowsy, impaired concentration. IV- limb ischaemia
what does cocaine potentiate (neurotransmitters)
dopamine, serotonin and NA and blocks their reuptake
long term effects of stimulants
dependence, anxiety, irritability and restlessness, mood disturbances, psychosis
medical side effects stimulants
cardiac arrhythmias, MI, chest pain, resp arrest, CVAs, headache, epileptic seizure
what does MDMA do to neurotransmitters
increase serotonin
how long can urine tests stay +ve after cannabis
1 month
side effects of cannabis
paranoia, panic attacks, delayed reaction times, chronic- dysthmic, anxiety, amotivational syndrome
side effects anabolic steroids
hypertension, hypogonadism, gynaecomastia, amenorrhoea, liver damage, impotence, aggressive, fatigue
opiate detox what drugs can be used
methadone 50-100mg a day. buprenorphine 16mg a day
symptomatic medication used in detox
lofexidine, loperamide
what medication is used post detox once opiate free
naltrexone
what drug is used in opiate overdose
naloxone
what happens to tolerance in detox
decreased tolerance so more chance of OD
withdrawal symptoms benzos
anxiety, insomnia, tremor, agitation, headache, nausea, sweating, depersonalisation, delirium
what can you use to treat benzo withdrawal
diazepam
how does methadone work
saturates the opiate receptors in the brain
harm reduction drugs
needle exchange, information about infections, infection testing and vaccination
how much alcohol can be metabolised per hour
1 unit (8g)
where is 98% alcohol metabolised
liver
how is alcohol measured
blood alcohol concentration
if you have alcohol tolerance what is the relationship between blood alcohol conc and intoxication
high BAC not intoxicated
what happens with alcohol and asian people
metabolically inactive form alcohol dehydrogenase, get a flushing reaction
complications alcohol misuse
acute toxicity, coma, risk aspiration, hypoglycaemia, acute renal failure. psych- delirium, amnesia, Wernicke Korsakoffs
what markers are there in the blood for excess alcohol consumption
incr MCV, Y-GT, CDT
assessment patient alcohol misuse
life time pattern, current pattern, signs de[endence, problems related to alcohol, prev treatment attempts, pt goals, FHx
advised units for men and women
21 units a week men, 14 women. at least 2 days non drinking
withdrawal alcohol
malaise, nausea, autonomic hyperactivity, tremulousness, labile, insomnia, hallucinations, illusions, seizures. delirium tremens in 5%
signs of alcohol dependence
CANT SSTOP . compulsion, aware of harms, neglect of other activities, tolerance to alcohol, stopping causes withdrawal, stereotyped pattern of drinking, time preoccupied with alcohol, out of control use, persistent wish to cut down
what questionnaire can be used to detect alcohol dependence
CAGE questionnaire- have you tried to Cut down your drinking; have people Annoyed you by suggesting you do so; have you felt Guilty about drinking; have you needed an Eye opener
what is foetal alcohol syndrome characterised by
decreased muscle tone, poor coordination, developmental delay, heart defects, a range of facial abnormalities
management alcohol addiction
acute detox- in hospital if risk of delirium tremens or seizures, benzo- chlordiazepoxide or diazepam, rehhydration correction of electrolytes, oral or parenteral thiamine
how can delirium tremens be treated
lorazepam or antipsychotics- haloperidol, olanzapine
what is delirium tremens
psychotic- delirium, tremors, hallucinations, anxiety
medication which may help maintain abstinence after detox
disulfiram- blocks alcohol metabolism, acamprosate- works on GABA, naltrexone
