Alcohol & Addiction medicine

Question 1

Define tolerance.

Answer 1

more of the same substance needed to reach the desired effect.

Question 2

Other than tolerance, what other important questions should you ask when thinking about an alcohol or any other drug dependence?

Answer 2

• primacy - come before everything else
• effecting relationships?
• physical or mental withdrawal Sx
• continued use after harmful events?
• feel out of control?

Question 3

Sx of acute alcohol withdrawal?

Answer 3

-sweating
-tremors
-anxiety
-insomnia
-GI upset
+/- hallucinations

Question 4

What is the severe form of alcohol withdrawal called? What are it’s symptoms?

Answer 4

• Delirium Tremens
• altered consciousness
• visual + tactile hallucinations of little moving tings
• sympathetic instability - tachy, HTN, anxiety, nausea
• GTC seizures

Question 5

What medications can be used to aid with alcohol abstinence?

Answer 5

• naltrexone - decreases craving

- disulfiram - negative conditioning increases -ve SE of hangover

Question 6

How do you manage an acute withdrawal?

Answer 6

• oral chlordiazepoxide
• IV fluids
• IV Thiamine - pabrinex

Question 7

What vitamin deficiency can be caused chronic alcohol abuse?

Answer 7

-Wernicke’s or Korsakoffs

Question 8

What are the symptoms of wernickes?

Answer 8

COAT 
confusion 
ophthalmoplegia
Ataxia
TREAT THIAMINE

Question 9

What are the symptoms of korsakoffs?

Answer 9

CART 
Confabulation 
Anterograde amnesia 
Retrograde amnesia 
personaliTy changes (Temper)

Question 10

What’s the difference between wernicke’s and korsakoffs?

Answer 10

wernicke’s is reverisible

Korsakoff’s is not