Addictions

Question 1

What are the aims of motivational enhancement therapy?

Answer 1

Express empathy/reflective listening
Support self efficacy by building confidence that change is possible
Sidestep resistance

Question 2

What is SADQ?

Answer 2

Severity of alcohol dependence questionnaire

Question 3

What are the features of alcohol dependence?

Answer 3

Tolerance
Withdrawl state if reduced or ceased intake
Neglect of other activities
Compulsion to drink
Persistent substance use

Question 4

What are the features of alcohol withdrawl symptoms?

Answer 4

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)

Question 5

What are the features of delirium tremens?

Answer 5

Coarse tremor
Confusion
Delusions
Hallucinations

Question 6

What would warrant a patient being admitted for inpatient assisted withdrawal?

Answer 6

Severe SADQ score

Moderate SADQ score with comorbidity

Question 7

What comorbidities would warrant someone being admitted for inpatient withdrawal?

Answer 7

Epilepsy
Benzodiazepine dependence
Significant psychiatric or physical comorbidity
Homelessness
History of seizures on previous withdrawal
Significant learning disability
Over 65

Question 8

What drug is used in medically assisted withdrawal?

Answer 8

Chlordiazepoxide

Question 9

What physical comordibities can thiamine deficiency cause??

Answer 9

Korsakoff syndrome
Wernickes encephalopathy
Peripheral neuropathy
Cerebellar degeneration

Question 10

What are the features of Wernicke’s encephalopathy?

Answer 10

Opthalmoplegia
Staggering gait
Confusional state

Question 11

What are the features of Korsakoff syndrome?

Answer 11

Short term memory problems

Confabulation

Question 12

How is Wernicke’s encephalopathy managed?

Answer 12

IV pabrinex

Thiamine

Question 13

How does acamprosate work?

Answer 13

Reduces glutaminergic activity to help maintain abstinence

Question 14

How does naltrexone work?

Answer 14

Reduces reward/pleasure associated with alcohol intake to prevent a relapse - opioid antagonist

Question 15

How does nalfemene work?

Answer 15

Opioid antagonist to reduce alcohol consumption

Question 16

How does disulphiram work?

Answer 16

Unpleasant reaction to alcohol to maintain abstinence

Question 17

What three drugs are used in opioid overdose?

Answer 17

Naloxone
Nalfememe
Naltrexone

Question 18

What are the symptoms of opioid withdrawal?

Answer 18

Dilated pupils
Runny nose
Runny eyes
Yawning
Cold/shivering/goosebumps
Diarrheoa
Tachycardia
Sweating
Tremor
Anxiety

Question 19

What is the cause of Wernicke’s encephalopathy?

Answer 19

Thiamine deficiency - B1

Question 20

How is Wernicke’s encephalopathy treated?

Answer 20

Pabrinex - IV B1

Question 21

What is the triad of symptoms in Wernicke’s encephalopathy?

Answer 21

Opthalmoplegia
Ataxia
Confusion

Question 22

What are the four questions in CAGE?

Answer 22

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?