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The One Deck To Rule Them All > Addiction, Overdoses + Toxicology > Flashcards

Addiction, Overdoses + Toxicology Flashcards

1
Q

Effect of chronic alcohol on body

A

Chronic alcohol consumption

  • enhances GABA mediated inhibition in the CNS
  • inhibits NMDA-type glutamate receptors
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2
Q

Effect of alcohol withdrawal on body

A

Alcohol withdrawal

  • decreases GABA
  • increases NMDA-type glutamate receptors
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3
Q

Alcohol withdrawal symptoms in 6-12 hours

A

tremor
sweating
tachycardia
anxiety

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4
Q

Peak seizure time in alcohol withdrawal

A

36 hours

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5
Q

Alcohol withdrawal symptoms in 48-72 hours

A

Delirium Tremens

coarse tremor
confusion 
delusions
hallucinations (A&V)
fever
tachycardia
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6
Q 
coarse tremor
confusion 
delusions
hallucinations (A&V)
fever
tachycardia
A

Delirium Tremens

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7
Q

1st line for Alcohol withdrawal

A

Long acting benzodiazepines

  • Chlordiazepoxide
  • Diazepam
  • Lorazepam (if hepatic failure)
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8
Q

2nd line for Alcohol withdrawal

A

Carbamazepine

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9
Q

How do you assess severity of alcohol withdrawal

A

Clinical Institute Withdrawal Assessment (CIWA-Ar)

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10
Q

How do you identify alcohol withdrawal

A

CAGE Questionnaire

AUDIT Questionnaire

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11
Q

2 medications to help alcohol abstinence

A

Disulfiram (Antabuse)

Acamprostate (Campral)

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12
Q

MoA of Disulfiram

A

Acetaldehyde dehydrogenase inhibitor

  • causes nausea, vomiting & flushing if you take with alcohol
  • don’t give to frail patients
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13
Q

MoA of Acamprostate

A

Stops cravings for alcohol

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14
Q

2 medications to help opioid abstinence

A

Methadone (opioid mu receptor agonist)

Buprenorphine (mixed opioid agonist/antagonist)

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15
Q

Biochemistry seen in Paracetamol overdose

A

Increased ALT
Increased AST

PTT is an indicator of liver failure

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16
Q

Management of paracetamol overdose

A

N Acetylcysteine

Activated charcoal if < 1hr since ingestion

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17
Q 
Blue lines on gum
Abdo pain 
Peripheral neuropathy (motor)
A

Lead poisoning

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18
Q

Management of lead poisoning

A

Dimercaptosucinic acid (DMSA)

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19
Q 
dehydration 
dilated pupils
hypotension 
tachycardia 
Prolonged QT
A

Tricyclic antidepressant overdose

20
Q

Management for tricyclic antidepressant overdose

A

IV Sodium bicarbonate

21
Q

Magnesium sulphate overdose can cause

A

Respiratory depression

22
Q

Management of magnesium sulphate overdose

A

Calcium gluconate

23
Q

High pyrexia + overdose

A

MDMA overdose

24
Q

Management of benzodiazepine overdose

A

Flumenazil

25
Q

Management of opioid overdose

A

Naloxone

- lasts 45 mins

26
Q

Management of cocaine overdose

A

Diazepam

27
Q

Management of heparin overdose

A

Protamine sulphate

28
Q

Management of beta-blocker overdose

A

Atropine

Glucagon

29
Q

Management of salicylate (aspirin) overdose

A

Alkalisation (IV bicarbonate) = 7.5-8 pH

Haemodialysis

30
Q

Mixed respiratory alkalosis + metabolic acidosis
Hyperventilation
Tinnitus

A

Salicylate (aspirin) overdose

31
Q

Management of lithium overdose

A

Haemodialysis

32
Q

Management of methanol overdose

A

Ethanol (competitive inhibitor)

33
Q

Management of warfarin overdose

A

Vit K

Prothrombin

34
Q

Management of cyanide overdose

A

Hydroxycoalbumin

35
Q

Management of organophosphates (insecticide) overdose

A

Atropine

36
Q

Management of lead overdose

A

Chelating agents:

  • Dimercaprol
  • Calcium edetate
37
Q

Management of iron overdose

A

Desferrioxamine

38
Q

Management of ethylene glycol (anti-freeze) overdose

A

Fomepizole
Ethanol
Haemodialysis

39
Q

Headache
Nausea + vomiting
Vertigo
Confusion

“Lives in a caravan”

A

Carbon Monoxide poisoning

40
Q

Investigations for Carbon Monoxide poisoning

A

Carboxyhaemoglobin levels = 10-30%

Should be:
<3% normal
<10% smokers

41
Q

Management of carbon monoxide poisoning

A

O2 100%

42
Q

Confusion
Green/yellow vision
Nausea

A

Digoxin toxicity

  • predisposed by hypokalaemia
43
Q

Management of digoxin overdose

A

Digibind

44
Q

Management of LSD overdose

A

Lorazepam

45
Q

Management of local anaesthetic toxicity

A

IV 20% lipid emulsion

46
Q 
Confusion 
Myoclonic jerks
Vivid dreams
Hallucinations
Pin point pupils
Respiratory depression
A

Opiod toxicity

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