Clinic - Outpatients

Question 1

What classifies as dependence?

Answer 1

3 or more of the following:

1. Strong desire or compulsion
2. Difficulty stopping or controlling levels
3. Physiological withdrawal
4. Tolerance
5. Neglecting pleasures or interests
6. Persistant use despite evidence of harm

Question 2

What are the withdrawal symptoms/signs of opiates

Answer 2

Question 3

What are the detox regimes for opiates?

What do you give for an OD?

Answer 3

Methadone or buprenoprhine

Naloxone

Question 4

What is the screening tool for alcohol dependance?

Answer 4

CAGE

Do you ever feel you should Cut down?

Do you get Angry when someone questions your drinking

Do you ever feel Guilty about your intake?

Do you ever need an Eye opener?

2 or more needs further investigation

Question 5

How do you work out units?

Answer 5

Strength (ABV) x volume (ml) ÷ 1,000 = units.

http://www.nhs.uk/Livewell/alcohol/Pages/alcohol-units.aspx

Question 6

What are the symptoms of alcohol withdrawal?

Answer 6

Question 7

What is Delirium Tremens (DT)

How do you treat it?

Answer 7

Rapid confusion about 72 hours after alcohol withdrawal, characteristically hallucinations/paranoia/confusion and things crawling on skin

Treat with benzos

Question 8

What is Wernickes encephalopathy?

How do you treat?

Answer 8

Thiamine deficienly in alcoholics. Characteristically causes:

1. Ataxia
2. Confusion
3. Opthalmoplegia (nystagmus mainly)

Treat with thiamine

Question 9

What is Korsakoffs?

Answer 9

Untreated W.E leads to retrograde and anterograde memory loss

Question 10

What are the regimes for alcohol detox?

Answer 10

Chlordiazepoxide + pabrinex (5-10 days)

Or

Front loading diazepam + pabrinex (2 days)

After can give:

Antabuse, Baclofen and suppoer