Alcohol Use Disorders?

Question 1

What is one unit equal to?

Answer 1

10ml of alcohol

Question 2

What is higher risk drinking defined as?

Answer 2

regularly consuming over 35 units per week

Question 3

Which gender is more prone to chronic consequences of alcohol?

Answer 3

womrn

Question 4

What is carbohydrate deficient transferin?

Answer 4

identifies men drinking 5 or more units per day fro 2 weeks or more

Question 5

What is the most common cause of raised MCV?

Answer 5

alcoholism

Question 6

What is FRAMES brief intervention?

Answer 6

FEEDBACK- problems due to alcohol
RESPONSIBILITY- pt is responsible for change
ADVICE- reduction/abstinence
MENU-options for changing behaviour
EMPATHY
SELF-EFFICACY-optimism

Question 7

When should patients be referred for speciliast tx for alcohol dependence?

Answer 7

signs of mod or severe alcohol dependence; no benefit from brief intervention and want more help; signs of severe alcohol-related impairment or related condition

Question 8

How does alcohol work at a molecular level?

Answer 8

inihibits action of excitatry NMDA-glutamate channels and potenetiates actions of inhibitory GABAA channels

Question 9

What does alcohol withdrawal lead to?

Answer 9

excess glutamate activity and reduced GABA activity leading to excessive glutamate which is toxic to nerve cells

Question 10

What are the molecular consequences of chrnoic alcohol use?

Answer 10

upregulation of excitatry NMDA channels and downregulation of inhibitory GABAa receptors

Question 11

What are the symptoms of alcohol withdrawal syndrome?

Answer 11

restlessness; tremor; sweating; anxiety; N&V; loss of appetite and insomnia; tachy; HT; seiures and delitium tremens

Question 12

When do seizures and delirium tremens normally occur?

Answer 12

first 24 hours

Question 13

When do symptoms of alcohol withdrawal syndrome normally resolve?

Answer 13

5-7days

Question 14

What are the features of delirium tremens?

Answer 14

confusion- often insidious onset at night; disorientation; agitiation; HT; fever; visual and auditory hallucinations and paranoid ideation

Question 15

What causes mortality in delirium tremens?

Answer 15

assoc. with CVS collapse and infection

Question 16

What is the function of BZDs in alcohol withdrawal?

Answer 16

cross tolerant with alcohol (als oact on GABAa receptors)

Question 17

what type of BZD should be used in alcohol withdrawal?

Answer 17

long -acting as short-acting can get peaks and troughs of drug in system with breakthrough symptoms

Question 18

What should be used as prophylaxis against Wernicke’s in alcohol withdrawal?

Answer 18

thiamine

Question 19

How should thiamine be given?

Answer 19

parental as alcohol reduces ability of stomach to abrosrb

Question 20

Who should have inpatient detoxes?

Answer 20

severe dependence; hx of delirium tremens or seizures; hx of failed community detox; poor social support; cognitive impairment; psych co-morbid; poor physical health

Question 21

What 3 psychosocial interventions are equally effective in relapse prevention?

Answer 21

CBT; 12 step’ MET

Question 22

How does disulfiram (antabuse) work?

Answer 22

inhibits acetaldehyde dehydrogenase leading to accumulation of acetaldehyde (flushing; tachy; N&V; arrhythmias and hypotension) if alcohol is ingested

Question 23

How does acamprosate wotk?

Answer 23

acts centrally on glutamate and GABA systems to reduce craving

Question 24

What is the first line agent for relapse prevention?

Answer 24

naltrexone

Question 25

How does naltrexone work?

Answer 25

opioid antagonist and reduces reward from alcohol