Alcohol And Substance Misuse Flashcards
What is the treatment for paracetamol overdose?
< 1 hour you can give activated charcoal
N-acetylcistine
(And fluids)
Liver transplant
What’s the treatment for amitriptyline overdose?
Iv bicarbonate (to reduce seizure or arrthymias)
What is the management opioids overdose?
Naloxone
What is the treatment for benzodiazepines overdose?
Flumazenil
Whats the treatment of warfarin overdose?
Vitamin k
What is the treatment for heparin overdose?
Protamine sulphate
What is used in opiate detoxification?
Methadone - safer than opiates. Reduced crime and physical illness.
How does disulfiram work?
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.
How is drug induced psychosis different to schizophrenia?
Timings. Amount of drug. Urine/blood tests. Age of presentation.
Hallucinations which are non-auditory.
What’s the mechanism of cocaine?
Blocks the uptake of dopamine, noradrenaline and serotonin
What are the cardio side effects of cocaine?
MI Arrhythmia Hypertension QRS widening and QT prolongation Aortic dissection
(Ischaemic colitis can occur)
What’re the neurological adverse effects of cocaine?
Seizure,
Mydriasis
Hypertonia
Hyperreflexia
Psych- agitation, psychosis, hallucinations
What are the long term effects of cannabis?
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.
What is the psychoactive compound in cannabis?
THC (9-tetrahydrocannabinol)
Which drugs cause urinary retention
TCAs Anticholinergics Opioids NSAIDs Disopyramide
Which drugs cause large pupils (mydriasis)
Amphetamines, cocaine
Tricyclics antidepressants
What are the symptoms of delirium tremens?
Tachycardia, tremor, fits, visual hallucinations (sometimes auditory)
When should acetylcysteine be used in paracetamol overdose?
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.
What are the 3 drugs that can we used to prevent relapse in alcohol dependency?
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
What vitamins are in pabrinex?
Thiamine (b1) Ascorbic acid (vit c) Riboflavin (b2) Nicotinamide (B3) Pyridoxine (B6)
Where are many of the ‘legal highs’ derived from?
Khat plant -
What are cannibidols used for?
Medical uses of cannabis
How does MDMA modulate neurotransmitters?
Massive cascade of 5-HT
Uses it all up therefore none left, come down.
Is heroin withdrawal fatal?
No - almost never
Alcohol, benzodiazepines can he.
Which heart valve can be infected in Iv drug users?
Tricuspid
What does methodone look like?
Green viscous liquid
Half life- 120hrs (start low and go slow)
What is buprenorphine?
Heroin substitute.
Sublingual dose, ideally in withdrawal before or get massive withdrawal when commence bupherenorphine.
For less dependant users?
What is naltrexone?
Opioid antagonist. Blocks heroin effects.
Need to be in withdrawal before starting on they get massive withdrawal
Drug services in pregnancy?
Can use methadone.
Gold standard drug testing?
Urine gas microscopy (something like that)
Hair testing (longer)
Which drugs can induce tactile hallucinations?
Cocaine
Alcohol
