Drug abuse Flashcards
How do you define dependance?
3 of the following symptoms for more than a month of repeatedly for a year: Craving the drug Cant control the dependance Tolerance build up Psychological withdrawal
Questions to ask in drug history taking?
First took the drug, pattern of use, dependant
Ever periods of abstinence ? reasons started again
Maximum used at one time
Route of admin
Alcohol history
Do they want to change? why now? how are they going to change?
Alcohol history?
Age first drank Age became a problem Why did it become a problem Periods of abstinence Alcohol pattern of intake over the years Why do they want to change now? how will they achieve this?
What tests are sent off from someone with a history of drug abuse?
FBC
LFTs
BBV
Urine drug screen
During an alcohol detox, what is CIWA? What levels need to be tested? How many units a day will cause withdrawal symptoms in men and women?
Clinical institude of withdrawal assessment
Thiamine
10 units in woman
15 units in man
4 drugs used to aid in alcohol withdrawal?
Nalmofene
Acamprosate
Naltrexone
Disulfiram
What is thiamine?
A co enzyme in glucose for lipid metabolism
What dose of oral thiamine can be given?
10mg
What is the IM/IV form of thiamine known as?
Pabrinex
Triad of Wernickes Syndrome?
Ataxia
Opthalmoplegia
Change in mental state
2 serious infections you can get from IV drug abuse?
Anthrax
Gangrene
Opioids effects on the body?
Reduce pain Euphoria respiratory depression Constipation Nausea and vomiting Sedation
What drug is used for mild opioid dependancy? Mode of action?
Lofexidine
Centrally acting antihypertensive
What is used for heavy dependance opioid users? (2) How is dosage determined and changed over time?
Buprenorphine - partial agonist
Methadone - full agonist
Titrate to comfortable dose over 2-3 weeks then taper over 2-6 months
What is given as long term relapse prevention of opioids?
Naltrexone
What receptors to Benzodiazepines effect and what effects do they have?
GABA and GABAa Sedative Muscle relaxant Anxiolytic Anticonvulsant Hypnotic
What is the mainstay of Cocaine addiction management?
CBT
Acute effects of Ecstasy?
Heightened awareness Jaw clenching Awake Loss of appetite Intense feeling of love Raised temperature Tachycardia
Effects that LSD can have on you?
Increase temperature BP increase HR increase Sleeplessness Flashbacks Psychosis
2 components of cannabis and their effects?
THC - psychotic effects, impairment of memory/ attention/ learning
CBD - antipsychogenic, anxiety relieving
What can be given to manage cannabis withdrawal?
Lithium carbonate Oral THC Anticonvulsants Antidepressants Baclofen Busiprone Hypnotics
Effects of GHB? what are withdrawal symptoms similar to?
Euphoria Inhibitions Drowsiness Sedative, anaesthetic Withdrawal similar to alcohol
What is the substance contained within Khat? what does it do?
Cathinone - stimulates and dissociates
What are the effects of Mephedrone?
Alert Affection Paranoia Anxiety Raised BP Tachycardia Seizures Nose bleeds, mouth ulcers Palpitations Breathlessness Fatigue and insomnia
What receptors does Pregabalin work on?
Main effects of the drug?
POsitive and negative effects of the drug?
GABA analogue that binds to alpha2delta1 on the Ca voltage gated channel
GABA increase
Relaxation, anxiolytic, anticonvulsant
Positive - relaxed, more motivated, lifts mood, euphoria
Negative - light headed, mild visual distortion, vivid imagination, clumsiness, grogginess, dizziness, weight gain, thirst
Symptoms of pregabalin withdrawal?
Muscle spasticity Tachycardia Sweating Confusion, aggression Hypertension Palpitations Nausea, diarrhoea Balance disturbed
