CNS - Substance Dependence Flashcards
Alcohol dependence treatment?
- CBT (Cognitive behavioural therapy)
- Acamprosate or Naltrexone
(Alternative disulfram can be used - puts pt off alcohol by bad reaction to it)
Treating withdrawal symptoms?
Long acting benzodiazepines
(Chlorodiazepoxide or Diazepam)
(Alternative: Carbamazepine or Clomethiazole)
Treating Delirium?
Lorazepam
Treating wernicke’s encephalopathy?
Vitamin B1 (THIAMINE)
Nicotine dependence treatment ?
- Varenicline (BLOCKS RECEPTOR NUMB)
AVOID IN EPILEPSY, CVD, Psychiatric illness - Bupropion
AVOID IN SEIZURES, psychiatric illness and eating disorders
If taking varenicline or bupropion the pt is feeling depressed, what should they do?
STOP IMMEDIATELY & Refer to GP
When should 16hr NRT patch be used?
If pregnant or having nightmares
Opioid dependence who can prescribe it
Appropriate Qualified prescriber (Not any doctor)
Blue script are called? Max supply?
FP10MDA
Max supply 14 days
What if 3 or more methadone doses are missed?
Refer back to specialist
Pregnancy and methadone, when to stop?
Continue through treatment!
More harm to stop for mother/foetus
High risk of overdose of methadone, what is prescribed?
Naloxone
Why is Buprenorphine preferred over methadone?
Can be Less sedating
Milder withdrawal symptoms
Lower risk of overdose
Given as Naloxone as suboxone when risk of injecting
Methadone side effect?
QT PROLONGATION
Why is high in sugar sometimes preferred to prescribe in methadone?
Due to misuse, high in sugar hurts more when injecting —-> DETERRENT
Local irritation caused
Important to give correct one
