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PSYCHIATRY > Alcohol Misuse Disorder > Flashcards

Alcohol Misuse Disorder Flashcards

1
Q

How many units is a bottle of wine?

A

9 units

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2
Q

What is the max. alcohol consumption per week?

A

12- 14 units (F, M resp.)

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3
Q

What is “hazardous drinking”?

A
  • pattern of alcohol consumption that increases the risk of HARMFUL consequences for the user
  • drinking 14-35 units of alcohol for WOMEN
  • 14-50 units for men
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4
Q

Why alcohol consumption differ across nations?

A
  • depends on the average income of the person

- the culture of the people

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5
Q

What is meant by harmful drinking? (3)

A
  • pattern of alcohol consumption that cause MENTAL and PHYSICAL damage
  • > 35 units in women
    50 units in men
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6
Q

What does alcohol dependence mean?

A
  • cluster of behavioural, cognitive and physiological factors that contribute to the STRONG desire to drink
  • diff. in controlling it
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7
Q

What does DSM IV state?

A

-describes TWO distinct disorders, alcohol ABUSE and alcohol DEPENDENCE, with specific criteria for each

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8
Q

What does DSM 5 involve?

A

-integrates the two DSM IV disorders, into a SINGLE disorder called alcohol use disorder (AUD); mild, moderate, severe.

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9
Q

How to screen for Alcohol misuse?

A
  • with AUDIT (involves 10 qs)

- Alcohol Use Disorders Identification Test

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10
Q

What is the scale for alcohol withdrawal assessment?

A

CIWA-AR

Clinical Institute Withdrawal Assessment for Alcohol

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11
Q

What does Brief intervention involve?

F.R.A.M.E.S

A
  • FEEDBACK (review problems experienced d.t alcohol)
  • RESPONSIBILITY (pt. resp. for CHANGE)
  • ADVISE (reduction or abstinence)
  • MENU (alternative options for drinking)
  • EMPATHY
  • SELF-EFFICACY (encourage efficacy)
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12
Q

What are the symptoms of alcohol withdrawal?

A
  • tremor, sweating, nausea, retching
  • increased HR, BP, T*
  • anxiety, agitation
  • insomnia, nightmares
  • Hallucinations (v.a.tactile)
  • withdrawal seizures (0-48hrs)
  • delirium tremens (48-72hrs)
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13
Q

What are signs of COMPLICATED alcohol withdrawal?

A
  • SEIZURES
  • HALLUCINOSIS
  • delirium tremens
  • Wernicke- Korsakoff $
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14
Q

What do you start the patients on after successful withdrawal from alcohol?

A
  • Naltrexone
  • Acamprosate
  • Disulfiram
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15
Q

What is seen in the DSM 5 Criteria AUD?

A

A maladaptive pattern of SUB. use > clinically sign. IMPAIRMENT/distressed as manifested by 2/more (within 12-month period):

  • alcohol often taken in larger AMOUNTS or over a longer period
  • persistent, unsuccessful effort to CUT down
  • craving to use alcohol
  • a lot of time spent in activities to OBTAIN or use alcohol.
  • recurrent alcohol use results in FAILURE to fulfil work obligations
  • social, recreational or occup. activities GIVEN up
  • alcohol use in hazardous situations
  • continued alcohol use despite recurrent SOCIAL and INTERPERSONAL problems, PHYSICAL n Psychological probs
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16
Q

How is tolerance define as?

A
  • need for increase in alcohol amounts for desired effects

- markedly DIMINISHED effect with continued use of SAME amount

17
Q

How may alcohol withdrawal be featured as?

A
  • characteristic withdrawal $ for alcohol

- closely related subst. is taken to RELIEVE withdrawal symptoms

18
Q

What are the 5 elements of Alcohol dependence?

A
  1. Physical Withdrawal
  2. Affective withdrawal
  3. Withdrawal relief drinking
  4. Alcohol consumption
  5. rapidity of reinstatement
19
Q

When is Brief intervention delivered after an AUDIT?

A
  • when you score 8-14 or 15-19 on the AUDIT
20
Q

What is one form of therapy to help people out of alcoholism?

A 
- Motivational Enhancement Therapy 
> by expressing empathy
> sidestep RESISTANCE 
> developing discrepancy between current behaviour and values
> by building confidence
21
Q

What are some psychosocial interventions for relapse?

A
  • CBT
  • MET
  • 12 step facilitation Therapy
  • family and couple therapy
22
Q

What is used to treat alcohol withdrawal, in severe and moderate DEPENDENCE?

What are the issues with Chlordiazepoxide?

A

-Chlordiazepoxide

  • high RELAPSE rate
  • cognitive withdrawal, cumulative NEURONAL damage
  • kindling effect (severity of withdrawal symptoms tends to increase FTER each withdrawal)
23
Q

What is delirium tremens?

A
  • coarse TREMOR
  • confusion
  • delusions
  • hallucinations
24
Q

When is Acamprosate best for the pt?

A
  • if the pt is completely abstinent and compliant to the meds
25
Q

What is thought to be the MOA of ACAMPROSATE?

A
  • axn on GABA and glutamate transmission

corrects the NT imbalance; post withdrawal, reducing craving

26
Q

What is the MOA of Naltrexone?

A
  • blocks opioid receptors

- reducing the REWARDING effect mediated by endorphins

27
Q

What is given as a psychological deterrent?

A
  • DISULFIRAM
    > interaction with alcohol causes an unpleasant reaction (bad compliance)
    > increased DOPAMINE transmission

PSYCHIATRY (32 decks)

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