Addictions Flashcards
What are the aims of motivational enhancement therapy?
Express empathy/reflective listening
Support self efficacy by building confidence that change is possible
Sidestep resistance
What is SADQ?
Severity of alcohol dependence questionnaire
What are the features of alcohol dependence?
Tolerance Withdrawl state if reduced or ceased intake Neglect of other activities Compulsion to drink Persistent substance use
What are the features of alcohol withdrawl symptoms?
Increased BP, HR Sweating/shivers Agitation, anxiety Insomnia Tremor Tactile, auditory or visual hallucinations (up to 6 days) Withdrawal seizures (0-48 hours) Delirium tremens (48-72 hours)
What are the features of delirium tremens?
Coarse tremor
Confusion
Delusions
Hallucinations
What would warrant a patient being admitted for inpatient assisted withdrawal?
Severe SADQ score
Moderate SADQ score with comorbidity
What comorbidities would warrant someone being admitted for inpatient withdrawal?
Epilepsy
Benzodiazepine dependence
Significant psychiatric or physical comorbidity
Homelessness
History of seizures on previous withdrawal
Significant learning disability
Over 65
What drug is used in medically assisted withdrawal?
Chlordiazepoxide
What physical comordibities can thiamine deficiency cause??
Korsakoff syndrome
Wernickes encephalopathy
Peripheral neuropathy
Cerebellar degeneration
What are the features of Wernicke’s encephalopathy?
Opthalmoplegia
Staggering gait
Confusional state
What are the features of Korsakoff syndrome?
Short term memory problems
Confabulation
How is Wernicke’s encephalopathy managed?
IV pabrinex
Thiamine
How does acamprosate work?
Reduces glutaminergic activity to help maintain abstinence
How does naltrexone work?
Reduces reward/pleasure associated with alcohol intake to prevent a relapse - opioid antagonist
How does nalfemene work?
Opioid antagonist to reduce alcohol consumption
How does disulphiram work?
Unpleasant reaction to alcohol to maintain abstinence
What three drugs are used in opioid overdose?
Naloxone
Nalfememe
Naltrexone
What are the symptoms of opioid withdrawal?
Dilated pupils Runny nose Runny eyes Yawning Cold/shivering/goosebumps Diarrheoa Tachycardia Sweating Tremor Anxiety
What is the cause of Wernicke’s encephalopathy?
Thiamine deficiency - B1
How is Wernicke’s encephalopathy treated?
Pabrinex - IV B1
What is the triad of symptoms in Wernicke’s encephalopathy?
Opthalmoplegia
Ataxia
Confusion
What are the four questions in CAGE?
Have you ever considered Cutting down on drinking?
Have people Annoyed you by criticizing your drinking?
Have you ever felt Guilty about drinking?
Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?
