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Psychiatry > Alcohol Use Disorder > Flashcards

Alcohol Use Disorder Flashcards

1
Q

How much is one unit of alcohol?

A

10mls

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2
Q

What is the weekly limit of alcohol recommended for men and women?

A

14 units per week

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3
Q

How many people drink at hazardous or harmful levels?

A

20% of adult population

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4
Q

What is the definition of hazardous drinking?

A

Pattern of alcohol consumption that increases risk of harmful consequences for the user
Drinking more than 14 units a week but under 35 for women and 50 for men

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5
Q

What is the definition of harmful drinking?

A

A pattern of alcohol consumption that is causing mental or physical damage
Drinking more than 35 units for women and 50 for men

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6
Q

Describe alcohol dependence

A

Cluster of behaviour, cognitive and physiological factors that typically include strong desire to drink alcohol and difficulties controlling its use

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7
Q

What does alcohol use disorder include?

A

Alcohol abuse and alcohol dependence
Mild, moderate and severe

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8
Q

What is the DSM5 definition for alcohol use disorder (AUD)?

A

Maladaptive pattern of substance use leading to clinically significant impairment or distress
Manifested by 2 or more of criteria occurring any time over 12 months

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9
Q

What is the DSM5 criteria for AUD?

A

Impaired control - persistent desire, urge and takes more than intended
Social impairment - failure to work, school or role at home
Risky use - alcohol consumption in situations which are hazardous
Pharmacological criteria

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10
Q

What is the pharmacological criteria for AUD?

A

Tolerance - need for marked increased amounts to achieve intoxication or marked diminished effect with continued use
Withdrawal - withdrawal symptoms or alcohol taken to relieve these symptoms

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11
Q

What makes AUD mild, moderate or severe?

A

Mild - presence of 2-3 symptoms
Moderate - 4-5
Severe - 6 or more

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12
Q

Describe the alcohol use disorders identification test (AUDIT)

A

Comprehensive 10 question alcohol harm screening tool
Score 1 - 4

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13
Q

What score does the AUDIT give?

A

0-7 - lower risk
8-14 - hazardous drinking
15-19 - harmful drinking
20+ - possible dependence

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14
Q

What does the severity of alcohol dependence questionnaire measure?

A

Physical withdrawal
Affective withdrawal
Withdrawal relief drinking
Alcohol consumption
Rapidity of reinstatement

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15
Q

Describe the clinical institute withdrawal assessment for alcohol (CIWA-AR)

A

Ten item scale used in assessment and management of alcohol withdrawal

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16
Q

Describe motivational enhancement therapy

A

Express empathy by using reflective listening to convey understanding
Support self efficacy by building confidence
Learn deeply held values and current behaviour

17
Q

What is the pharmacological treatment for AUD?

A

Chlordiazepine drug of choice

18
Q

What are the problems of pharmacological treatment of AUD?

A

High rate of relapse
Cognitive impairment
Kindling effect - severity of withdrawal symptoms tends to increase after each withdrawal

19
Q

What are the symptoms of alcohol withdrawal syndrome?

A

Tremor, sweating, nausea, retching, increased HR, BP, temp., anxiety, insomnia, agitation, hallucinations, withdrawal seizures and delirium tremens

20
Q

What is the symptoms of delirium tremens?

A

48-72 hours after
Coarse tremor, confusion, delusion and hallucinations

21
Q

What is included in complicated withdrawal?

A

Seizures, hallucination, delirium tremens and Wernicke encephalopathy

22
Q

What are psychological interventions for relapse prevention?

A

CBT, motivational enhancement therapy, 12 step facilitation therapy and family + couple therapy

23
Q

What are some relapse prevention medications?

A

Acamprosate, naltrexone and disulfiram

24
Q

Describe Acamprosate

A

Action on GABA and glutamate transmission, correct neurotransmission imbalance post withdrawal and reduces cravings
Well tolerated and no need for blood test

25
Q

Describe Naltrexone

A

Blocks opioid receptors
Reduce rewarding effect mediated by endorphin system

26
Q

Describe Disulfiram

A

Psychological deterrent
Anti craving effect through increased dopamine transmission
Dangerous reaction when mixed with alcohol

27
Q

What are the potential side effects of disulfiram?

A

Hepatotoxicity, neuropathy and psychosis

28
Q

Describe baclofen

A

GABA b agonist
Reduces craving
Risk of abuse and severe side effects

Psychiatry (20 decks)

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