Addictive behaviour-ILA

Question 1

How much is one unit of alcohol?

Answer 1

8g or 10ml of alcohol

Question 2

How are units calculated for alcohol?

Answer 2

strength x volume/1000

Question 3

What is dependance syndrome?

Answer 3

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

Question 4

What is tolerance?

Answer 4

need higher dose for same effect

Question 5

What is addiction?

Answer 5

increased tolerance, narrowing of drinking repertoire, failure of abstinence and alcohol becomes number one priority.

Are compulsed to drink despite consequences

Question 6

Name some screening questionaires for drinking?

Answer 6

CAGE, FAST, AUDIT

Question 7

what is it recommended to not regularly suceed in terms of units each week?

Answer 7

no more than 14 units

Question 8

What is a significant score for CAGE and what are the quesions?

Answer 8

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

Question 9

What are the short term risks of drinking alcohol?

Answer 9

injuries, violent behaviour, STIs, loss of posessions, alcohol poisoning

Question 10

What are the symptoms of alcohol withdrawal?

Answer 10

Increased pulse 
Increased heart rate 
Htn 
Shaky 
Headache 
Hallucinations 
tremor 
Seizure 
Alcoholic ketoacidosis 
Low electrolytes- heart arrythmias

Question 11

What causes the physical symptoms of alcohol withdrawal?

Answer 11

Alcohol is a depressant, without it the somatic system becomes overstimulated

Question 12

If you withdraw from alcohol suddenly what can happen?

Answer 12

delirium tremens aka alcohol withdrawal syndrome

Question 13

What is the management for acute alcohol withdrawal syndrome?

Answer 13

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

Question 14

What can be a long-term consequence of alcohol?

Answer 14

wenickes followed by korsakoffs

Question 15

What is wernicke’s encephalopathy?

Answer 15

triad of: ophthalmoplegia, ataxic, confusion
Also get memory disturbance
Peripheral neuropathy
Hypothermia

Question 16

What causes wernicke’s encephalopathy and korsakoffs?

Answer 16

low thiamine (B1 vitamin)

Question 17

What is the management for Wernicke’s?

Answer 17

IV thiamine over 1 week

Question 18

What is korsakoff’s syndrome?

Answer 18

confabulation, apathy, antegrade amnesia

Question 19

What part of the brain is affected by korsakoffs?

Answer 19

cerebral atrophy of the hypothalamus

Question 20

What do we manage korsakoffs?

Answer 20

generally irreversible

Question 21

What are the long-term physical consequences of alcohol?

Answer 21

Liver failure 
Varices 
Pancreatitis 
Arrythmia 
Cardiomyopathy 
Osteoporosis 
GI and breast cancer 
Social problems eg homelessness, breakdown of relationships

Question 22

What is the management of alcohol dependance?

Answer 22

Disulfiram (nasty reaction if have alcohol)
Naltrexone (decreases craving)
Alcoholic anonymous
Motivational counselling

Question 23

What is the cycle of change?

Answer 23

pre-contemplation –> contemplation –> preparation —> action —> maintenance —>relapse

Question 24

What are the symptoms of a heroin OD?

Answer 24

Pin prick pupils 
N+V 
Confusion 
Dry mouth 
Photophobia 
Hypothermia 
Low RR and HR 
Cyanosis 
Constipated

Question 25

What is the management for a heroin OD?

Answer 25

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

Question 26

What are the long term effects of heroin use?

Answer 26

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

Question 27

What are the effects of drug use on pregnancy?

Answer 27

Premature
Baby gets withdrawal when born
SIDS
HIV and hepatitis to baby if parent has contracted