Alochol Flashcards

1
Q

What are the effects of alcohol at low doses?

A
  • euphoria
  • reduced anxiety
  • relaxation
  • sociability
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2
Q

What are the effects of alcohol at higher doses?

A

intoxication (the pathological state produced by a drug, serum, alcohol, or any toxic substance; poisoning)

  • impaired attention and judgement
  • unsteadiness
  • flushing
  • nystagmus
  • mood instability
  • disinhibition
  • slurring
  • stupor
  • unconsciousness
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3
Q

What is harmful use?

A
  • pattern of use causing damage to physical or mental health.
  • Use >1 month or repeatedly over 12 months
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4
Q

What is alcohol dependence according to the ICD-10?

A

3 or more of the following for >1month or repeatedly over 12 months:

WTC DNP

Withdrawal - Physiological withdrawal on reduction/cessation

Tolerance

Cravings/compulsions to take

Difficulty controlling use

Neglect of other activities

Persistence despite harmful consequences

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5
Q

What is a withdrawal state?

A

Group of symptoms of variable clustering and severity on complete/relative withdrawal of a psychoactive substance, after persistent use of that substance

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6
Q

What are the signs of alcohol withdrawal state?

A
  • Tremor
  • weakness
  • nausea
  • vomiting
  • anxiety
  • seizures
  • confusion
  • agitation
  • death
  • Delirium Tremens
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7
Q

Some signs of alcohol withdrawal state include;

  • Tremor
  • weakness
  • nausea
  • vomiting
  • anxiety
  • seizures
  • confusion
  • agitation
  • death
  • Delirium Tremens

What is delirium tremens? When does it occur?

A
  • Profound confusion, tremor, agitation, hallucinations, delusions, sleeplessness, autonomic over-activity
  • Mortality in DTs = 5%
  • Death: cardiovascular collapse, infection, hyperthermia, seizures or self injury
  • Usually 48-72 hours after alcohol stopped
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8
Q

What negative impacts can alcohol have on mental health?

A
  • Anxiety
  • Depression
  • Sleep disruption
  • Morbid Jealousy
  • Alcoholic hallucinosis
  • Deliberate self-injury
  • Suicidal thoughts/acts
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9
Q

Chronic alcoholism can cause Wernicke’s encephalopathy.

What are the signs?

Is it reversible?

A

Signs

  • Confusion
  • ataxia
  • opthalmoplegia
  • nystagmus

–Reversible

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10
Q

What is the relation between Wernicke’s encephalopathy development as a consequence of alcoholism and Korsakoff’s psychosis?

A

–If Wernicke’s encephalopathy is not treated 80% go onto develop Korsakoff’s psychosis

Must treat with Thiamine ASAP!!

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11
Q

If Wernicke’s encephalopathy is not treated, 80% go onto develop Korsakoff’s psychosis.

What are the signs?

Is it reversible?

A
  • Prominent impairment of recent and remote memory
  • preservation of immediate recall
  • no general cognitive impairment
  • retrograde and anterograde memory
  • impaired learning and disorientation
  • may exhibit nystagmus and ataxia

- not reversible

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12
Q

In alcoholism, what is the cause of Wernicke’s encephalopathy and Korsakoff’s psychosis?

A

Thiamine Deficiency

Vitamin B1

–Poor intake and absorption, poor hepatic function, increased requirement for alcohol metabolism

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13
Q

In alcoholism, what is the cause of Wernicke’s encephalopathy and Korsakoff’s psychosis?

A

Thiamine Deficiency

Vitamin B1

–Poor intake and absorption, poor hepatic function, increased requirement for alcohol metabolism

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14
Q

Wernicke’s Encephalopathy and Korsakoff’s Psychosis are caused by a deficiency in which vitamin?

A

Vitamin B1

Thiamine deficiency

–Poor intake and absorption, poor hepatic function, increased requirement for alcohol metabolism

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15
Q

How might alcoholism affect relationships?

A
  • Aggression
    • Verbal
    • Physical
  • Marital difficulties
    • Morbid jealousy
  • Poor parenting/neglect +/- loss of parenting rights
  • Loss of friendships and social supports
  • Othello disorder – delusional belief that spouse is being unfaithful
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16
Q

What are the screening tools for alcoholism?

A
  1. CAGE (2 or more = likely alcohol problem)
  • Have you tried to Cut down?
  • Have you felt Annoyed by people criticising your drinking?
  • Have you felt Guilty about drinking?
  • Have you felt the need to have an Eye-opener?
  1. AUDIT (Alcohol Use Disorders Identification Test)
  2. FAST (4 questions)
  3. PAT (Paddington Alcohol Test; used in A&Es)
17
Q

What is the broad management of alcoholism?

A
  • Practical advice, education, harm reduction
  • Holistic/bio-psycho-social approach
    • Support for patient and family
    • Psychological help (e.g. CBT, group therapy)
    • Social work input (benefits, housing, child protection)
    • Skills training
    • Community Support (eg AA, ADA)
    • Inpatient or residential treatment
    • Medication
18
Q

What medication should you give for the prevention of Wernicke-Korsakoff Syndrome?

A

Thiamine - vitamin B1

19
Q

Which medications should you give for the management of alcohol withdrawal?

A

Benzodiazepines

  • commonly Chlordiazepoxide
20
Q

What medication can you give to deter alcoholics from drinking?

A

Disulfiram (Antabuse)

– prevents the breakdown of alcohol = causes severe hypotension, nausea, vomiting – unpleasant symptoms

21
Q

Disulfiram can be used to deter alcoholics from drinking.

How does it work?

A

prevents the breakdown of alcohol

22
Q

Disulfiram can be used to deter alcoholics from drinking.

it prevents the breakdown of alcohol.

What are the effects?

A
  • causes severe hypotension
  • nausea
  • vomiting

– unpleasant symptoms

23
Q

What are the anti-craving medications used for alcoholism?

A
  • Acamprosate (Campral) – GABA agonist
  • Naltrexone – long acting opioid antagonist
  • Nalmefene – long acting opioid antagonist
  • (Baclofen)
24
Q

What is alcohol dependence according to the ICD-10?

A

3 or more of the following for >1month or repeatedly over 12 months:

WTC DNP

Withdrawal - Physiological withdrawal on reduction/cessation

Tolerance

Cravings/compulsions to take

Difficulty controlling use

Neglect of other activities

Persistence despite harmful consequences

25
Q

CAGE is the most important screening tool you must know.

What does it stand for?

A

Cut down- Have you ever felt you should Cut down on your drinking?

Annoyed- Have people Annoyed you by criticising your drinking?

Guilty- Have you ever felt bad or Guilty about your drinking?

Eye opener- Have you ever had a drink in the morning to get rid of a hangover (Eye opener)?

26
Q

CAGE is the most important screening tool you must know.

What does it stand for?

A

Cut down- Have you ever felt you should Cut down on your drinking?

Annoyed- Have people Annoyed you by criticising your drinking?

Guilty- Have you ever felt bad or Guilty about your drinking?

Eye opener- Have you ever had a drink in the morning to get rid of a hangover (Eye opener)?