alcohol withdrawal and dependance Flashcards
Flashcard 1:
Question: What determines the need for assisted alcohol withdrawal?
Answer: Patients with mild dependence usually don’t need assisted withdrawal. Moderate dependence can be managed in a community setting unless there’s a high risk of severe withdrawal symptoms. Severe dependence requires inpatient withdrawal.
Flashcard 2:
Question: What setting is recommended for treating patients with decompensated liver disease due to alcohol dependence?
Answer: Patients with decompensated liver disease should be treated under specialist supervision.
Flashcard 3:
Question: What benzodiazepines are recommended for attenuating alcohol withdrawal symptoms?
Answer: Long-acting benzodiazepines like chlordiazepoxide hydrochloride or diazepam are recommended; local clinical protocols should be followed.
Flashcard 4:
Question: What are the approaches used for alcohol withdrawal in primary care versus inpatient settings?
Answer: In primary care, fixed-dose reducing regimens are used. In inpatient settings, both fixed-dose and symptom-triggered regimens are employed.
Flashcard 5:
Question: How does a symptom-triggered approach to alcohol withdrawal management work?
Answer: It tailors the drug regimen based on the severity of withdrawal and individual complications, requiring adequate monitoring facilities.
Flashcard 6:
Question: What’s crucial when administering treatment for alcohol withdrawal?
Answer: Regular monitoring of the patient’s withdrawal symptoms is essential, and treatment should only continue while withdrawal symptoms persist.
Flashcard 1:
Question: What determines the need for assisted alcohol withdrawal?
Answer: Patients with mild dependence usually don’t need assisted withdrawal. Moderate dependence can be managed in a community setting unless there’s a high risk of severe withdrawal symptoms. Severe dependence requires inpatient withdrawal.
Flashcard 2:
Question: What setting is recommended for treating patients with decompensated liver disease due to alcohol dependence?
Answer: Patients with decompensated liver disease should be treated under specialist supervision.
Flashcard 3:
Question: What benzodiazepines are recommended for attenuating alcohol withdrawal symptoms?
Answer: Long-acting benzodiazepines like chlordiazepoxide hydrochloride or diazepam are recommended; local clinical protocols should be followed.
Flashcard 4:
Question: What are the approaches used for alcohol withdrawal in primary care versus inpatient settings?
Answer: In primary care, fixed-dose reducing regimens are used. In inpatient settings, both fixed-dose and symptom-triggered regimens are employed.
Flashcard 5:
Question: How does a symptom-triggered approach to alcohol withdrawal management work?
Answer: It tailors the drug regimen based on the severity of withdrawal and individual complications, requiring adequate monitoring facilities.
Flashcard 6:
Question: What’s crucial when administering treatment for alcohol withdrawal?
Answer: Regular monitoring of the patient’s withdrawal symptoms is essential, and treatment should only continue while withdrawal symptoms persist.
Patients with mild alcohol dependence usually do not need assisted alcohol withdrawal.
Patients with moderate dependence can generally be treated in a community setting unless they are at high risk of developing alcohol withdrawal seizures or delirium tremens
; individuals with severe dependence should undergo withdrawal in an inpatient setting. Patients with decompensated liver disease should be treated under specialist supervision.
Carbamazepine [unlicensed indication] can be used as an alternative treatment in acute alcohol withdrawal
Carbamazepine [unlicensed indication] can be used as an alternative treatment in acute alcohol withdrawal
Flashcard 1:
Question: What alternative medication can be used in acute alcohol withdrawal besides benzodiazepines?
Answer: Carbamazepine can be used as an alternative treatment in acute alcohol withdrawal.
Flashcard 2:
Question: What important safety information is related to the use of antiepileptic drugs in alcohol withdrawal?
Answer: The MHRA/CHM have issued safety information regarding the risk of suicidal thoughts and behavior associated with antiepileptic drugs in alcohol withdrawal. More details can be found in the Epilepsy guidelines.
Flashcard 3:
Question: When might clomethiazole be considered in alcohol withdrawal treatment?
Answer: Clomethiazole may be considered as an alternative to benzodiazepines or carbamazepine but only in an inpatient setting. It should not be prescribed if the patient is likely to continue drinking alcohol due to the risk of fatal respiratory depression, especially when combined with alcohol, particularly in patients with cirrhosis.
Use these flashcards to review and retain the key information regarding alternative medications and safety considerations when managing alcohol withdrawal, particularly focusing on carbamazepine, the safety information regarding antiepileptic drugs, and the use of clomethiazole in specific settings and patient populations.
Flashcard 1:
Question: What alternative medication can be used in acute alcohol withdrawal besides benzodiazepines?
Answer: Carbamazepine can be used as an alternative treatment in acute alcohol withdrawal.
Flashcard 2:
Question: What important safety information is related to the use of antiepileptic drugs in alcohol withdrawal?
Answer: The MHRA/CHM have issued safety information regarding the risk of suicidal thoughts and behavior associated with antiepileptic drugs in alcohol withdrawal. More details can be found in the Epilepsy guidelines.
Flashcard 3:
Question: When might clomethiazole be considered in alcohol withdrawal treatment?
Answer: Clomethiazole may be considered as an alternative to benzodiazepines or carbamazepine but only in an inpatient setting. It should not be prescribed if the patient is likely to continue drinking alcohol due to the risk of fatal respiratory depression, especially when combined with alcohol, particularly in patients with cirrhosis.
Use these flashcards to review and retain the key information regarding alternative medications and safety considerations when managing alcohol withdrawal, particularly focusing on carbamazepine, the safety information regarding antiepileptic drugs, and the use of clomethiazole in specific settings and patient populations.
If alcohol withdrawal seizures occur, a fast-acting benzodiazepine (such as lorazepam [unlicensed indication]) should be prescribed to reduce the likelihood of further seizures. If alcohol withdrawal seizures develop in a person during treatment for acute alcohol withdrawal, review their withdrawal drug regimen.
If alcohol withdrawal seizures occur, a fast-acting benzodiazepine (such as lorazepam [unlicensed indication]) should be prescribed to reduce the likelihood of further seizures. If alcohol withdrawal seizures develop in a person during treatment for acute alcohol withdrawal, review their withdrawal drug regimen.
Flashcard 1:
Question: What is delirium tremens, and how should it be managed?
Answer: Delirium tremens is a medical emergency characterized by agitation, confusion, paranoia, and hallucinations. Specialist inpatient care is necessary. Oral lorazepam is the first-line treatment.
Flashcard 2:
Question: What medications can be used if symptoms persist or if oral medication is declined in delirium tremens?
Answer: If symptoms persist or oral medication is refused, parenteral lorazepam (unlicensed) or haloperidol (unlicensed) can be given as adjunctive therapy.
Flashcard 3:
Question: What action should be taken if delirium tremens develops during treatment for acute alcohol withdrawal?
Answer: If delirium tremens develops during treatment, the withdrawal drug regimen should be reviewed.
Use these flas
Flashcard 1:
Question: What is delirium tremens, and how should it be managed?
Answer: Delirium tremens is a medical emergency characterized by agitation, confusion, paranoia, and hallucinations. Specialist inpatient care is necessary. Oral lorazepam is the first-line treatment.
Flashcard 2:
Question: What medications can be used if symptoms persist or if oral medication is declined in delirium tremens?
Answer: If symptoms persist or oral medication is refused, parenteral lorazepam (unlicensed) or haloperidol (unlicensed) can be given as adjunctive therapy.
Flashcard 3:
Question: What action should be taken if delirium tremens develops during treatment for acute alcohol withdrawal?
Answer: If delirium tremens develops during treatment, the withdrawal drug regimen should be reviewed.
Use these flas
Flashcard 1:
Question: What intervention is recommended for harmful drinkers or those with mild alcohol dependence?
Answer: Psychological interventions, such as cognitive behavioral therapy, should be offered.
Flashcard 2:
Question: When can acamprosate calcium or oral naltrexone hydrochloride be used in alcohol dependence treatment?
Answer: They can be used in combination with a psychological intervention for patients who have not responded to psychological interventions alone or have requested pharmacological treatment.
Flashcard 3:
Question: When are acamprosate calcium or oral naltrexone hydrochloride recommended for relapse prevention?
Answer: They are recommended for relapse prevention in patients with moderate and severe alcohol dependence after successful assisted withdrawal.
Flashcard 4:
Question: What is an alternative medication for alcohol dependence if acamprosate calcium or oral naltrexone hydrochloride are not suitable?
Answer: Disulfiram is an alternative for patients for whom acamprosate calcium and oral naltrexone hydrochloride are not suitable or if the patient prefers disulfiram and understands the risks.
Use these flashcards to reinforce and retain the key information about interventions and medications for alcohol dependence, focusing on psychological interventions, the use of acamprosate, naltrexone, and disulfiram in different severity levels of alcohol dependence, and their roles in relapse prevention.
Flashcard 1:
Question: What intervention is recommended for harmful drinkers or those with mild alcohol dependence?
Answer: Psychological interventions, such as cognitive behavioral therapy, should be offered.
Flashcard 2:
Question: When can acamprosate calcium or oral naltrexone hydrochloride be used in alcohol dependence treatment?
Answer: They can be used in combination with a psychological intervention for patients who have not responded to psychological interventions alone or have requested pharmacological treatment.
Flashcard 3:
Question: When are acamprosate calcium or oral naltrexone hydrochloride recommended for relapse prevention?
Answer: They are recommended for relapse prevention in patients with moderate and severe alcohol dependence after successful assisted withdrawal.
Flashcard 4:
Question: What is an alternative medication for alcohol dependence if acamprosate calcium or oral naltrexone hydrochloride are not suitable?
Answer: Disulfiram is an alternative for patients for whom acamprosate calcium and oral naltrexone hydrochloride are not suitable or if the patient prefers disulfiram and understands the risks.
Use these flashcards to reinforce and retain the key information about interventions and medications for alcohol dependence, focusing on psychological interventions, the use of acamprosate, naltrexone, and disulfiram in different severity levels of alcohol dependence, and their roles in relapse prevention.
Flashcard 1:
Question: When is nalmefene recommended in alcohol dependence treatment?
Answer: Nalmefene is recommended for reducing alcohol consumption in patients with alcohol dependence who have a high drinking risk level, no physical withdrawal symptoms, and do not require immediate detoxification.
Flashcard 2:
Question: Under what conditions can corticosteroids be administered to patients with severe alcohol-related hepatitis?
Answer: Corticosteroids can be given to patients with severe alcohol-related hepatitis, specifically those with a discriminant function of 32 or more. However, it should only be initiated after addressing active infections, gastrointestinal bleeding, controlling renal impairment, and after discussing the potential benefits and risks of treatment.
Flashcard 3:
Question: What are the short-term and long-term effects of corticosteroid treatment in severe alcohol-related hepatitis?
Answer: Corticosteroid treatment has shown improvement in short-term survival (1 month) but not in longer-term survival (3 months to 1 year). Additionally, it increases the risk of serious infections within the first 3 months of starting treatment.
Use these flashcards to reinforce and remember the key information about specific treatments like nalmefene for alcohol dependence and the use of corticosteroids in severe alcohol-related hepatitis, particularly focusing on the eligibility criteria and potential benefits and risks associated with each treatment.
Flashcard 1:
Question: When is nalmefene recommended in alcohol dependence treatment?
Answer: Nalmefene is recommended for reducing alcohol consumption in patients with alcohol dependence who have a high drinking risk level, no physical withdrawal symptoms, and do not require immediate detoxification.
Flashcard 2:
Question: Under what conditions can corticosteroids be administered to patients with severe alcohol-related hepatitis?
Answer: Corticosteroids can be given to patients with severe alcohol-related hepatitis, specifically those with a discriminant function of 32 or more. However, it should only be initiated after addressing active infections, gastrointestinal bleeding, controlling renal impairment, and after discussing the potential benefits and risks of treatment.
Flashcard 3:
Question: What are the short-term and long-term effects of corticosteroid treatment in severe alcohol-related hepatitis?
Answer: Corticosteroid treatment has shown improvement in short-term survival (1 month) but not in longer-term survival (3 months to 1 year). Additionally, it increases the risk of serious infections within the first 3 months of starting treatment.
Use these flashcards to reinforce and remember the key information about specific treatments like nalmefene for alcohol dependence and the use of corticosteroids in severe alcohol-related hepatitis, particularly focusing on the eligibility criteria and potential benefits and risks associated with each treatment.
Flashcard 1:
Question: Who is at risk of developing Wernicke’s encephalopathy among patients with alcohol dependence?
Answer: Patients at high risk include those who are malnourished, at risk of malnourishment, or have decompensated liver disease.
Flashcard 2:
Question: What is the recommended treatment for suspected Wernicke’s encephalopathy?
Answer: For suspected Wernicke’s encephalopathy, malnourished patients, those at risk of malnourishment, or patients with decompensated liver disease, parenteral thiamine followed by oral thiamine should be administered.
Flashcard 3:
Question: When should prophylactic oral thiamine be given to harmful or dependent drinkers?
Answer: Prophylactic oral thiamine should be given to harmful or dependent drinkers if they are in acute withdrawal or before and during assisted alcohol withdrawal.
Flashcard 4:
Question: In what form is parenteral thiamine available for administration?
Answer: Parenteral thiamine is available as part of a vitamin B substance with ascorbic acid preparation.
Flashcard 1:
Question: Who is at risk of developing Wernicke’s encephalopathy among patients with alcohol dependence?
Answer: Patients at high risk include those who are malnourished, at risk of malnourishment, or have decompensated liver disease.
Flashcard 2:
Question: What is the recommended treatment for suspected Wernicke’s encephalopathy?
Answer: For suspected Wernicke’s encephalopathy, malnourished patients, those at risk of malnourishment, or patients with decompensated liver disease, parenteral thiamine followed by oral thiamine should be administered.
Flashcard 3:
Question: When should prophylactic oral thiamine be given to harmful or dependent drinkers?
Answer: Prophylactic oral thiamine should be given to harmful or dependent drinkers if they are in acute withdrawal or before and during assisted alcohol withdrawal.
Flashcard 4:
Question: In what form is parenteral thiamine available for administration?
Answer: Parenteral thiamine is available as part of a vitamin B substance with ascorbic acid preparation.
