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Y3 Psychiatry > Alcohol Misuse Disorders > Flashcards

Alcohol Misuse Disorders Flashcards

1
Q

what screening tool is used to assess for alcohol dependence?

A

CAGE

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2
Q

what screening tool is used to assess for harmful and hazardous drinking?

A

AUDIT

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3
Q

what management is indicated by each result of the AUDIT test?

A 
0-7 = none 
8-19 = brief intervention 
20+ = specialist referral
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4
Q

what alcohol screening tool can be done in A+E?

A

FAST

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5
Q

how do you calculate units of alcohol?

A

strength x volume/1000

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6
Q

what seven types of cancer are associated with alcohol?

A 
mouth/throat 
larynx 
oesophagus
breast 
liver 
bowel
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7
Q

what is hazardous drinking?

A

a pattern of alcohol consumption that increases someones risk of harm

over the recommended limit

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8
Q

what amount of alcohol consumption is considered harmful drinking?

A

regular consumption of >35 units in a week

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9
Q

what acronym represents the elements of a brief intervention?

A

FRAMES

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10
Q

what does FRAMES stand for?

A 
feedback 
responsibility 
advice 
menu 
empathy 
self efficacy
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11
Q

what does the feedback section of the FRAMES model involve?

A

reviewing the problems experienced because of alcohol

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12
Q

what does the responsibility section of the FRAMES model involve?

A

explaining that the patient is responsible for change

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13
Q

what does the advice section of the FRAMES model involve?

A

advise reduction or abstinence

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14
Q

what does the menu section of the FRAMES model involve?

A

providing options for changing behaviour

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15
Q

what does the empathy section of the FRAMES model involve?

A

use an empathic approach

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16
Q

what does the self efficacy section of the FRAMES model involve?

A

encourage optimism about changing behaviour

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17
Q

what is the general pathophysiology behind alcohol withdrawal?

A

chronic CNS depression from alcohol results in increased CNS excitation

this is unopposed when alcohol is removed

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18
Q

when do the symptoms of alcohol withdrawal syndrome begin?

A

within hours

peak at 24-48 hours

19
Q

what are the symptoms of alcohol withdrawal syndrome?

A 
restlessness
tremor
sweating 
anxiety 
N+V
loss of appetite 
insomnia
20
Q

what serious symptom can occur in the first 24 hours of alcohol withdrawal syndrome?

A

generalised seizures

21
Q

what medical emergency can alcohol withdrawal syndrome progress to?

A

delirium tremens

22
Q

how long does it usually take for the symptoms of alcohol withdrawal syndrome to resolve?

A

5-7 days

23
Q

when is the peak onset of delirium tremens?

A

within 2 days of abstinence

24
Q

how does delirium tremens often present?

A

insidiously, with night time confusion

25
Q

what are the symptoms of delirium tremens?

A 
confusion 
agitation 
hypertension 
hallucinations 
paranoid ideation
26
Q

how can delirium tremens result in death?

A

CV collapse

infection

27
Q

what medication can be given to manage alcohol withdrawal syndrome?

A

benzodiazepines

28
Q

what benzodiazepines should be used for alcohol withdrawal syndrome?

A

long acting agents

diazepam, chloriazepoxide

29
Q

why is thiamine given in alcohol withdrawal syndrome?

A

as prophylaxis against Wernicke’s encephalopathy

30
Q

why is thiamine given in alcohol withdrawal syndrome?

A

as prophylaxis against Wernicke’s encephalopathy

31
Q

what are the possible psychosocial interventions for relapse prevention?

A 
CBT
MET
12 step 
behavioural self control 
family/couple therapy
32
Q

what three medications can be used to prevent alcohol relapses?

A

disulfiram
acamprosate
naltrexone

33
Q

what is another name for disulfiram?

A

Antabuse

34
Q

how does disulfiram work?

A

inhibits acetaldehyde dehydrogenase leading to accumulation of acetylhyde if alcohol consumed

causes unpleasant side effects

35
Q

what are the side effects of taking disulfiram and consuming alcohol?

A 
flushing 
tachycardia 
N+V
arrhythmia 
hypotension
36
Q

what is one negative to using disulfiram?

A

relies on the patients compliance

37
Q

how does acamprosate work?

A

acts centrally on glutamate and GABA systems

reduces cravings

38
Q

when should acamprosate be started?

A

as soon as the detox is complete

39
Q

what are the possible side effects of acamprosate?

A

headache
diarrhoea
nausea

40
Q

what should acamprosate be prescribed alongside?

A

psychological intervention

41
Q

what is the first line drug for alcohol relapse prevention?

A

naltrexone

42
Q

what type of drug is naltrexone?

A

opioid antagonist

43
Q

how does naltrexone prevent a relapse?

A

reduces the reward a patient experiences from alcohol

Y3 Psychiatry (24 decks)

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