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Psychiatry > Alcohol/substance misuse > Flashcards

Alcohol/substance misuse Flashcards

1
Q

Harmful drinking

A

Pattern of alcohol consumption causing health problems directly related to alcohol

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2
Q

Alcohol dependence

A

Craving, tolerance, preoccupation with alcohol and continued drinking in spite of harmful consequences

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3
Q

Recommended weekly limits for alcohol

A

No more than 14 units with two drink-free days a week

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4
Q

How to calculate units of alcohol

A

Volume (mls) x ABV (%) /1000

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5
Q

How to screen for alcohol misuse?

A

AUDIT questionnaire

(AUDIT-C) when time is limited

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6
Q

AUDIT score for a) hazardous drinking

b) harmful drinking
c) possible alcohol dependence

A

a) 8-15
b) 16-19
c) >20

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7
Q

If AUDIT suggests alcohol dependence, how can severity be assessed?

A

SADQ- Severity of Alcohol Dependence Questionnaire

LDQ- Leeds Dependence Questionnaire

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8
Q

Symptoms of Wernicke’s?

A

Nystagmus
Opthalmoplegia
Ataxia
Confusion

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9
Q

Possible long-term sequelae of Wernicke’s?

A

Korsakoff syndrome

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10
Q

Features of Korsakoff syndrome?

A

Inability to form new memories, confabulation

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11
Q

DVLA guidance for alcohol misuse?

A

People who are dependent on alcohol are required to notify DVLA and will have to surrender their license.

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12
Q

Management of alcohol misuse in GP (2)

A

Brief intervention regarding risks/consequences of drinking, possible strategies for reducing
Refer to community addictions team for consideration of detox/relapse prevention

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13
Q

Treatments used in alcohol relapse prevention and their mechanism (3)

A

Acamprosate- reduces cravings
Disulfiram (antabuse)- prevents breakdown of acetaldehyde, causes an unpleasant reaction to alcohol
Naltrexone- blocks endogenous opioids, reducing pleasurable effects of alcohol

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14
Q

Drugs approved by NICE for opiate detoxification (2)

A

Methadone

Buprenorphine

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15
Q

When is the risk of methadone overdose highest?

A

During the first two weeks

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16
Q

Why does buprenorphine have a lower risk of overdose?

A

At increasing doses, has a mixed agonist-antagonist effect

17
Q

Rationale for the use of suboxone? (buprenorphine + naloxone)

A

Discourages abuse- if tablet is crushed and injected, the nalaxone has a high bioavailability and is likely to induce withdrawal. If taken orally as intended, naloxone has a low bioavailability

18
Q

How long does it take for tolerance to hypnotics to develop?

A

Around 1 month

19
Q

Strategy for reduction of benzos/hyponotics?

A

Switch to equivalent diazepam dose and reduce by 1mg/week

Psychiatry (10 decks)

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