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Stage 3: EJR - Mental Health > Alcohol and Drugs > Flashcards

Alcohol and Drugs Flashcards

1
Q

ICD-10 definition of substance withdrawal

A
  1. Physical and/or psychological effects
  2. From complete/partial cessation of a substance
  3. after prolonged, repeated or high level of use
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2
Q

6 signs of substance addiction

A

Drug Problems Will Continue To Harm

  1. Strong Desire to consume substance
  2. Preoccupation with substance
  3. Withdrawal if stopped
  4. Cannot control behaviour
  5. Tolerance to substance (so need to take more)
  6. Continuing use despite Harmful effects
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3
Q

ICD-10 3 general criteria for alcohol intoxication

A
  1. Clear evidence of substance use at high dose levels
  2. Change in consciousness, cognition, perception or behaviour
  3. Not accounted for by medical or mental disorder
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4
Q

ICD-10 evidence of dysfunctional behaviour in alcohol intoxication

A
  • Unsteady gait
  • Difficulty standing
  • Slurred speech
  • Nystagmus
  • Flushing, red eyes
  • Reduced Consciousness
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5
Q

ICD-10 features of alcohol withdrawal (any 3 of the following)

A
  • Tremor
  • Sweating
  • Nausea, Vomiting
  • Tachycardia/ increased BP
  • Headache
  • Psychomotor agitation
  • Insomnia
  • Malaise
  • Transient hallucinations
  • Grand mal convulsions
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6
Q

What drugs may cause drowsiness/ decreased coordination

A
  • opiates
  • cannabis
  • solvents (glue, petrol)
  • LSD
  • BZDs, barbiturates
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7
Q

What drugs may cause increased aggression

A
  • cocaine
  • ecstasy
  • amphetamines
  • solvents
  • steroids
  • BZDs, barbiturates
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8
Q

What drugs may cause paranoia/ hallucinations

A
  • LSD
  • cocaine
  • ecstasy
  • amphetamines
  • steroids
  • cannabis
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9
Q

Why do drunk people get visual hallucinations

A

Alcohol affects optic chiasma and corpus callosum

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10
Q

Signs of severe alcohol intoxication

A
  • Hypoglycaemia

- Coma

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11
Q

In alcohol withdrawal, when is the peak incidence of delirium tremens

A

72h after withdrawal

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12
Q

Features of delirium tremens

A 
o	Dehydration
o	Electrolyte disturbance
o	Cognitive impairment
o	Hallucinations/ illusions
o	Paranoid delusions
o	Tremor 
o	Autonomic arousal: tachycardia, fever, pupil dilation, sweating
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13
Q

Wernicke’s encephalopathy or Korsakoff’s psychosis

-which is permanent

A

Korsakoff’s psychosis is PERMANENT

Must treat Wernicke’s ASAP to prevent progression to this

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14
Q

What vitamin deficiency causes Wernicke’s encephalopathy

A

Thiamine deficiency (Vit B1)

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15
Q

Classic triad in Wernicke’s encephalopathy

A
  1. Ocular motor anomalies: nystagmus, opthalmoplegia
  2. Cerebellar dysfunction eg ataxia
  3. Altered mental state
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16
Q

What is the alcohol limit

A

14units for both genders

17
Q

Describe some equivalents of 1 unit

A
  • 1 shot
  • 1/3 beer or cider
  • 1/10 bottle of wine
18
Q

What 2 drugs are given in an opioid detox

A
  • Methadone

- Buprenorphine (Subutex)

19
Q

What drug is given in an opioid overdose

A

Naloxone (opioid antagonist)

20
Q

During what periods are addicts at greatest risk of overdose during a detox

A
  • 1st week of titration (taking both heroin and methadone)

- After just getting out of prison (taking same dose despite now reduced tolerance)

21
Q

What drug is given in an alcohol detox

A

High dose BZDs eg chlordiazepoxide, diazepam

22
Q

What drug can be given to cause unpleasant effects when drinking alcohol.

How does this work

A

Disulfuram

Inactivates liver ALDH -> causes buildup of acetaldehyde when drinking leading to unpleasant symptoms eg flushing

23
Q

What drug can be given to reduce pleasurable effects of alcohol

A

Naltrexone (opioid receptor antagonist)

24
Q

What drug can be given to reduce alcohol cravings

A

Acamprosate (enhances GABA transmission)

25
Q

4 questions in cage

A
  1. Have you ever felt you should CUT down on your drinking
  2. Have people ANNOYED you by criticising your drinking
  3. Have you ever felt GUILTY about your drinking
  4. Have you ever had a drink 1st thing in the morning to steady your nerves or get rid of a hangover (EYE OPENER)
26
Q

Features of Korsakoff’s

A

Irreversible short term memory loss
Confabulation (unconsciously filling memory gaps with stories)
Disorientation

27
Q

Treatment for delirium tremens

A

Oral lorazepam

If insufficient, give parental lorazepam, haloperidol

28
Q

What drug is given to former opioid addicts to help with continued abstinence

A

Naltrexone (long acting opioid antagonist) to reduce pleasure in taking opioids

29
Q

What drug can reduce cravings for alcohol

A

Acamprosate

Increased GABA transmission, reduced release of glutamate, reduced cravings

Stage 3: EJR - Mental Health (8 decks)

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