Addictive behaviour-ILA Flashcards
How much is one unit of alcohol?
8g or 10ml of alcohol
How are units calculated for alcohol?
strength x volume/1000
What is dependance syndrome?
a strong desire or sense of compulsion to take the substance;
Difficulty in controlling substance use
Physiological withdrawal
Tolerance
Neglect of alternative hobbies or interests
Persistence in use despite knowing harmful consequences
What is tolerance?
need higher dose for same effect
What is addiction?
increased tolerance, narrowing of drinking repertoire, failure of abstinence and alcohol becomes number one priority.
Are compulsed to drink despite consequences
Name some screening questionaires for drinking?
CAGE, FAST, AUDIT
what is it recommended to not regularly suceed in terms of units each week?
no more than 14 units
What is a significant score for CAGE and what are the quesions?
have you thought you should Cut down on drinking?
Annoyed by criticisms of your drinking?
Guilty about your drinking?
Eye opener- need a drink to get you going in the morning?
2+ is significant
What are the short term risks of drinking alcohol?
injuries, violent behaviour, STIs, loss of posessions, alcohol poisoning
What are the symptoms of alcohol withdrawal?
Increased pulse Increased heart rate Htn Shaky Headache Hallucinations tremor Seizure Alcoholic ketoacidosis Low electrolytes- heart arrythmias
What causes the physical symptoms of alcohol withdrawal?
Alcohol is a depressant, without it the somatic system becomes overstimulated
If you withdraw from alcohol suddenly what can happen?
delirium tremens aka alcohol withdrawal syndrome
What is the management for acute alcohol withdrawal syndrome?
is a medical emegency
first-line: benzodiazepines e.g. chlordiazepoxide. Lorazepam may be preferable in patients with hepatic failure.
carbamazepine also effective in treatment of alcohol withdrawal
Thiamine
What can be a long-term consequence of alcohol?
wenickes followed by korsakoffs
What is wernicke’s encephalopathy?
triad of: ophthalmoplegia, ataxic, confusion
Also get memory disturbance
Peripheral neuropathy
Hypothermia
What causes wernicke’s encephalopathy and korsakoffs?
low thiamine (B1 vitamin)
What is the management for Wernicke’s?
IV thiamine over 1 week
What is korsakoff’s syndrome?
confabulation, apathy, antegrade amnesia
What part of the brain is affected by korsakoffs?
cerebral atrophy of the hypothalamus
What do we manage korsakoffs?
generally irreversible
What are the long-term physical consequences of alcohol?
Liver failure Varices Pancreatitis Arrythmia Cardiomyopathy Osteoporosis GI and breast cancer Social problems eg homelessness, breakdown of relationships
What is the management of alcohol dependance?
Disulfiram (nasty reaction if have alcohol)
Naltrexone (decreases craving)
Alcoholic anonymous
Motivational counselling
What is the cycle of change?
pre-contemplation –> contemplation –> preparation —> action —> maintenance —>relapse
What are the symptoms of a heroin OD?
Pin prick pupils N+V Confusion Dry mouth Photophobia Hypothermia Low RR and HR Cyanosis Constipated
What is the management for a heroin OD?
ABCDE
Drug screen
IV naloxone (has a short half-life- may need to regive)
Supportive care
Social support
Narcotic anonymous
Manage their pain if that’s what they’re taking it for
What are the long term effects of heroin use?
Tolerance and dependence Chronic venous insufficiency- DVT and PE Dental cavities Constipated Sweaty Infections- HIV, Hep B, IE Cognition declines Itching Resp illness Social problems eg homelessness
What are the effects of drug use on pregnancy?
Premature
Baby gets withdrawal when born
SIDS
HIV and hepatitis to baby if parent has contracted
