Alcohol Flashcards
What steps helped to reduce the amount of alcoho, consumed in Scotland (precovid)?
Minimum pricing- 2018 it was inplemented.
Regulation of the market
Reduction in avalibility
Who was most harmed by the excess drinking in Scotland?
Older men who drank at home
What are the possible effects of alcohol?
Low doses- euphoria, reduced anxiety, relaxation, sociability
Higher doses- intoxicaton, imparied judgement and attention, unsteadiness, flushing, nystamus, mood instability, disinhibition, slurring, stupor and unconsiousness.
What are the potential alcohol diagnosis?
Acute intoxication
Harmful used
Dependance
Withdrawal state.
Define harful use
Harmful Use – pattern of use causing damage to physical or mental health. Use >1 month or repeatedly over 12 months
Define Dependance
3 or more of the following for >1month or repeatedly over 12 months:
Cravings/compulsions to take
Difficulty controlling use
Primacy- neglecting other things/interests
Increased tolerance- need to increase amount of alcohol comsumed to maintain effect
Physiological withdrawal on reduction/cessation
Persistence despite harmful consequences
Define withdrawal state
Withdrawal State – Group of symptoms of variable clustering and severity on complete/relative withdrawal of a psychoactive substance, after persistent use of that substance
Symptoms: Tremor Weakness nausea vomiting anxiety seizures confusion agitation death Delirium tremens
What is deliruim tremens?
Profound confusuion, tremor, hallucinations, delusions, sleeplessness, autonomic over-activity
Mortatility in 5% of cases
Death can be caused by cardiovascular collapse, infection, hyperthermia, seizures or self injury
Usually occurs 48-72hrs after alcohol stops
What is Wernicke’s Encephalopathy?
Caused by vit B1 deficiency caused by alcohol abuse
Symptoms:
Confusion
Ataxia- disorder of coordination, speech and balance
Opthalmoplegia-a paralysis or weakness of one or more of the muscles that control eye movement.
Nystagmus
What is Korsakoff’s Psychosis?
Caused by thiamine deficiency, due to the poor intake and absorption, poor hepatic function, increased requirement for alcohol metabolism
Prominent impairment of recent and remote memory Preservation of immediate recall No general cognitive impairment Retrograde (events that occurred or information that was learned in the past) and anterograde (ability to learn and remember new information, events and facts) memory impaired learning disorientation nystagmus ataxia
What are the screening tools used for an alcohol problem?
CAGE
AUDIT- alcohol use disorders identification test
FAST
PAT- Paddington alcohol test used in A&E’s
TWEAK screening test is the best one for pregnant women
What are the questions in the CAGE screening tool?
Have you tried to Cut down?
Have you felt Annoyed by people criticising your drinking?
Have you felt Guilty about drinking?
Have you felt the need to have an Eye-opener?
How do you manage an alcohol problem non-pharmalogically?
Education Support patient and family CBT, group therapy Social work input for benefits, housing, child protection if needed skills training community/third sector support e.g. AA Inpatient or residential treatment
WHat are the pharamacolgical treaments for alcohol problem?
Thiamine- to prevent Wernicke- Korsakoff
Benzodiazepines- e.g. Chlordiazepoxide for withdrawal
DIsulfiram - aversion/deterent, interacts with any alcohol in food, drink, perfume ect to cause the patient unplesent reactions e.g. vomiting, whole body flushing ect
Anti-craving medication
- acamprostate
- naltrexone
- Nalmefene
- Baclofen
What are benzodiazepines used for?
Usually chlordiazepoxide, used to manage/reduce withdrawal symptoms
