Alcohol withdrawal, drug addiction Flashcards
How many grams of pure alcohol in one unit?
8g
recommended units of alcohol per week?
14
can you drink in pregnancy?
no
what syndrome can effect baby if you drink when pregnant?
foetal alcohol syndrome
alcohol blocks absorption of what vitamin?
B1
thiamine is what B vitamine?
B1
asking about drink driving in a history falls under what category of history taking?
forensic history
What is asked in forensic history?
-5
domestic abuse drink driving drunk & disorderly fights harm Othello’s syndrome
paranoid belief about the certainty of your partner’s infidelity is known what?
Othello’s syndrome
which LFT is high in an alcoholic?
↑ALT
what does MCV stand for?
is MCV high or low in an alcoholic?
mean corpuscular volume
↑MCV
a breathalyser measures what specifically?
ethanol
MCV measures what exactly?
size of rbc
is GABA inhibitory or excitatory?
inhibitory
is glutamate inhibitory or excitatory?
excitatory
chronic alcohol decreases levels of what major neurotransmitter?
GABA
if GABA is low the brain will want to increase which neurotransmitter?
is said neurotransmitter excitatory or inhibitory?
glutamate
excitatory
an alcoholic tries to quit and goes through alcoholic withdrawal.
which neurotransmitter is responsible for his symptoms?
is this neurotransmitter in high or low leves?
glutamate
high
why is glutamate high in alcoholic?
to balance out high GABA from drinking
hypercalcaemia is toxic to neurons.
true or false?
true
high glutamate levels influx what ion into the neurons?
Ca2+
what is the kindling effect?
when successive alcohol withdrawals have worse symptoms
why does the kindling effect happen?
with each withdrawal some neurons die that do not recover, so with next withdrawal overall even more neurons have died.
alcohol withdrawal symptoms after 6-12 hours?
-4
tremors
sweating
anxiety
tachycardia
which symptoms peaks 36 hours after alcohol withdrawal?
seizures
which symptoms peaks 48 - 72 hours after alcohol withdrawal?
delirium tremors
what drug do you give for delirium tremors?
-name
diazepam
ataxia, confusion & eye signs are a triad of what condition?
Wernicke encephalopathy
vivid hallucination, tremors, confusion are a triad of what form of alcohol withdrawal?
Delirium tremens
mortality rate of Delirium tremens?
35%
Wernicke encephalopathy can lead to permanent damage of what organ?
brain
treatment of Wernicke encephalopathy?
how long do you give this drug for?
pabrinex + Diazepam
5 days of pabrinex
what does CIWA stand for?
clinical institute withdrawal assessment
is CIWA done at home or hospital usually?
home
how often does nurse check on you in CIWA?
every 90 minutes
CIWA score of 11+ means what drug must be given?
-name
diazepam
how long does CIWA take usually?
1-2 days
how many CIWA scores of <11 are needed before you can stop treatment?
two
what is the 1st line method to detox of alcohol?
CIWA
what is the 2nd line method to detox of alcohol?
FIXED REDUCTION REGIME
what major complication can occur with too much diazepam?
resp depression
which drug makes you feel sick if you drink alcohol?
disulfiram
which drug reduces desire to drink?
Acamprosate
which drug maintains abstinence from not drinking, reduces pleasures & craving?
moa of this drug?
Naltrexone
stops Da release at nucleus accumbens
which drug makes you feel sick when you drink alcohol?
this drug increases what chemical when you drink to make you feel sick?
disulfiram
↑acetaldehyde
someone with hepatic failure is having alcohol withdrawal.
what BZD is given?
lorazepam
BZD increases which neurotransmitter?
GABA
which anticonvulsant medication is used in alcohol withdrawal?
carbamazepine
BZD, opioids, alcohol are what types of drugs?
Depressants
amphetamines, NMDA, cocaine are all what types of drug?
Stimulants
LSD, magic mushrooms, PCP, ketamine are all what types of drugs?
Hallucinogens
ecstasy, heroin and magic mushrooms are what class of drug? -A, B, C?
A
anabolic steroids and tranquilizers are what class of drugs? -A, B, C?
C
Cannabis, amphetamines, ketamine & codeine are what class of drugs? -A, B, C
B
which criteria is used to assess alcohol dependence?
Edwards & Gross Criteria
A patient having opiate withdrawal is getting diarrhoea.
what drug is given to treat?
loperamide
A patient having opiate withdrawal is getting abdo cramps.
what drug is given to treat?
Buscopan
A patient having opiate withdrawal is getting N&V.
what drug is given to treat?
metoclopramide
A patient having opiate withdrawal is getting anxiety.
what drug is given to treat?
class of this drug?
diazepam
BZD
someone overdoses on opioid.
what is the antidote?
will this work quickly or slowly?
Naloxone
quickly
which drug can help maintain opioid abstinence?
naltrexone
naltrexone is hepatotoxic,
thus what must be checked before and after treatment?
LFTs
buscopan drug classes?
-2
antispasmodic and anticholinergic
buscopan moa?
overall effect of buscpan on GI tract?
blocks the muscarinic receptors on the smooth muscle walls
stop muscle contractions in GI tract, so GI tract more relaxed
metoclopramide moa?
metoclopramide effect on stomach?
blocks D2 Receptors
speed up stomach emptying
most common symptom of wernicke encephalopathy?
Confusion
ataxia etymology?
a - without
taxia - order
what is ataxia?
lack voluntary coordination of your muscle movements
treatment of Wernicke encephalopathy?
Diazepam + Pabrinex
difference between relapse and lapse?
Relapse = full blown deterioration Lapse = temporary deterioration then back on feet.
Moa of disulfiram?
effect of this?
blocks aldehyde dehydrogenase
↑acetaldehyde
list all Opiate Withdrawal Symptoms?
-10
Diarrhoea Abdo cramps N&V Anxiety Muscle spasms Restless Fever/chills Tachycardic, high BP Secretions, runny nose & tears
what happens to BP and HR if having opiate withdrawal?
Tachycardic
high BP
antidote to an opioid overdose?
(what drug do you give?
Naloxone
which drug reduces desire to drink?
Acamprosate
untreated Wernicke encephalopathy will lead to what syndrome?
Korkasoff
which drug to stop alcoholic relapses is the most effective?
- has 2 names
disulfiram aka
antabuse
