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Psychiatry > Alcohol And Substance Misuse > Flashcards

Alcohol And Substance Misuse Flashcards

1
Q

What is the treatment for paracetamol overdose?

A

< 1 hour you can give activated charcoal
N-acetylcistine
(And fluids)
Liver transplant

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2
Q

What’s the treatment for amitriptyline overdose?

A

Iv bicarbonate (to reduce seizure or arrthymias)

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3
Q

What is the management opioids overdose?

A

Naloxone

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4
Q

What is the treatment for benzodiazepines overdose?

A

Flumazenil

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5
Q

Whats the treatment of warfarin overdose?

A

Vitamin k

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6
Q

What is the treatment for heparin overdose?

A

Protamine sulphate

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7
Q

What is used in opiate detoxification?

A

Methadone - safer than opiates. Reduced crime and physical illness.

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8
Q

How does disulfiram work?

A

Acetaldehyde dehydrogenase inhibitor.
Alcohol isn’t broken down so “hangover” is immediately felt.

Also used in cocaine dependant for to prevent dopamine breakdown leading to anxiety, restlessness, and unpleasant symptoms.

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9
Q

How is drug induced psychosis different to schizophrenia?

A

Timings. Amount of drug. Urine/blood tests. Age of presentation.
Hallucinations which are non-auditory.

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10
Q

What’s the mechanism of cocaine?

A

Blocks the uptake of dopamine, noradrenaline and serotonin

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11
Q

What are the cardio side effects of cocaine?

A 
MI
Arrhythmia 
Hypertension
QRS widening and QT prolongation
Aortic dissection

(Ischaemic colitis can occur)

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12
Q

What’re the neurological adverse effects of cocaine?

A

Seizure,
Mydriasis
Hypertonia
Hyperreflexia

Psych- agitation, psychosis, hallucinations

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13
Q

What are the long term effects of cannabis?

A

In adolescence can have effects on neurodevelopment

10-20% of users become dependant (less than heroine, cocaine, and alcohol)

Cannabis increases risk of relapse into psychotic symptoms.

Lung cancer risk is similar to those who smoke.

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14
Q

What is the psychoactive compound in cannabis?

A

THC (9-tetrahydrocannabinol)

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15
Q

Which drugs cause urinary retention

A 
TCAs
Anticholinergics 
Opioids 
NSAIDs
Disopyramide
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16
Q

Which drugs cause large pupils (mydriasis)

A

Amphetamines, cocaine

Tricyclics antidepressants

17
Q

What are the symptoms of delirium tremens?

A

Tachycardia, tremor, fits, visual hallucinations (sometimes auditory)

18
Q

When should acetylcysteine be used in paracetamol overdose?

A

If less than 8 hours, Plot on normograph, if paracetamol level is above or on treatment line then give acetylcystiene.

Give if over 8 hours. If there is uncertainty about timings. If pt is unconscious or have suspected overdose.

19
Q

What are the 3 drugs that can we used to prevent relapse in alcohol dependency?

A

Disulfram- (hangover)
Naltrexone - reduced pleasure from alcohol.
Acamprosate (anti-craving)

Chlordiazepoxide - long acting benzodiapine. Used acutely to stop withdrawal symptoms eg DT. Reduce dose carefully over 5/7days

20
Q

What vitamins are in pabrinex?

A 
Thiamine (b1) 
Ascorbic acid (vit c) 
Riboflavin (b2) 
Nicotinamide (B3)
Pyridoxine (B6)
21
Q

Where are many of the ‘legal highs’ derived from?

A

Khat plant -

22
Q

What are cannibidols used for?

A

Medical uses of cannabis

23
Q

How does MDMA modulate neurotransmitters?

A

Massive cascade of 5-HT

Uses it all up therefore none left, come down.

24
Q

Is heroin withdrawal fatal?

A

No - almost never

Alcohol, benzodiazepines can he.

25
Q

Which heart valve can be infected in Iv drug users?

A

Tricuspid

26
Q

What does methodone look like?

A

Green viscous liquid

Half life- 120hrs (start low and go slow)

27
Q

What is buprenorphine?

A

Heroin substitute.
Sublingual dose, ideally in withdrawal before or get massive withdrawal when commence bupherenorphine.
For less dependant users?

28
Q

What is naltrexone?

A

Opioid antagonist. Blocks heroin effects.

Need to be in withdrawal before starting on they get massive withdrawal

29
Q

Drug services in pregnancy?

A

Can use methadone.

30
Q

Gold standard drug testing?

A

Urine gas microscopy (something like that)

Hair testing (longer)

31
Q

Which drugs can induce tactile hallucinations?

A

Cocaine

Alcohol

Psychiatry (19 decks)

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