Alcohol

Question 1

What is intoxication?

Answer 1

The pathological state produced by a drug, serum, alcohol or any toxic substance; poisoning.

Question 2

What are the symptoms of alcohol intoxication?

Answer 2

• impaired attention + judgement
• unsteadiness
• flushing
• nyastagmus
• mood instability
• disinhibition
• slurring
• stupor
• unconsciousness

Question 3

What is harmful use?

Answer 3

• pattern od use causing damage to physical or mental health
• use > 1 month or repeatedly over 12 months

Question 4

What is dependance?

Answer 4

3 or more of- for > 1 month or repeatedly over 12 months:

• cravings/compulsion to take
• difficulty controlling use
• primacy
• inc. tolerance
• psyhcological withdrawal on reduction/cessation
• persistance despite harmful consequences

Question 5

What is withdrawal state?

Answer 5

• group of symptoms of variable cluster and severity
• on complete/relative withdrawal of a psychoactive substance
• after persistant use of that substance

Question 6

What are the symptoms of alcohol withdrawal state?

Answer 6

• tremor
• weakness
• N + V
• seizures
• confusion
• agitation
• death
• delirium tremens

Question 7

What is delirium tremens?

Answer 7

• profound confusion, tremor, agitiation, hallucinations, delusion, sleeplessness, autonomic over-activity
• mortality = 5%
• death by; CV collapse, infection, hyperthermia, seizures, self-injury
• usually 48-72 hrs after alcohol stopped

Question 8

What are the effects of alcohol on mental health?

Answer 8

• anxiety
• depression
• sleep disruption
• morbid jealousy
• alcoholic hallucinations
• deliberate self-injury
• suicidal thoughts/acts

Question 9

What are the symptoms of Wernicke’s encephalopathy?

Answer 9

• confusion
• ataxia
• opthalmoplegia
• nystagmus
• caused by thiamine deficiency

Question 10

What are the symptoms of Korsakoff’s psychosis?

Answer 10

• prominantly impaired recent + remote memory
• impaired learning + disorientation
• nystagmus
• ataxia
• caused by thamine deficiency

Question 11

What are screening tools for alcohol problems?

Answer 11

• CAGE
• AUDIT (alcohol use disorders identification test)
• FAST
• PAT (Paddington alcohol test)

Question 12

What are the questions for CAGE?

Answer 12

2 or more of:

• have you tried to Cut down?
• have you ever felt Annoyed by people criticising your drinking?
• have you ever felt Guilty about drinking?
• have you ever felt the need to have an Eye-opener?

Question 13

What is the managment for alcohol problems?

Answer 13

• practical advice
• education
• harm reduction
• holistic/bio-psycho-social approach

Question 14

What medications can be used for alcohol problems?

Answer 14

• thiamine (prevent Wernicke-Korsakoff Syndrome)
• benzodiazepines e.g. chlordiazepoxide (manage alcohol withdrawal)
• disulfiram (antabuse) (deterrent)
• anti-craving medication
• acamprosate
• naltrexone
• nalmefene
• Baclofen