Drug abuse

Question 1

How do you define dependance?

Answer 1

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

Question 2

Questions to ask in drug history taking?

Answer 2

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?

Question 3

Alcohol history?

Answer 3

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?

Question 4

What tests are sent off from someone with a history of drug abuse?

Answer 4

FBC
LFTs
BBV
Urine drug screen

Question 5

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?

Answer 5

Clinical institude of withdrawal assessment
Thiamine
10 units in woman
15 units in man

Question 6

4 drugs used to aid in alcohol withdrawal?

Answer 6

Nalmofene
Acamprosate
Naltrexone
Disulfiram

Question 7

What is thiamine?

Answer 7

A co enzyme in glucose for lipid metabolism

Question 8

What dose of oral thiamine can be given?

Answer 8

10mg

Question 9

What is the IM/IV form of thiamine known as?

Answer 9

Pabrinex

Question 10

Triad of Wernickes Syndrome?

Answer 10

Ataxia
Opthalmoplegia
Change in mental state

Question 11

2 serious infections you can get from IV drug abuse?

Answer 11

Anthrax

Gangrene

Question 12

Opioids effects on the body?

Answer 12

Reduce pain
Euphoria
respiratory depression
Constipation
Nausea and vomiting
Sedation

Question 13

What drug is used for mild opioid dependancy? Mode of action?

Answer 13

Lofexidine

Centrally acting antihypertensive

Question 14

What is used for heavy dependance opioid users? (2) How is dosage determined and changed over time?

Answer 14

Buprenorphine - partial agonist
Methadone - full agonist
Titrate to comfortable dose over 2-3 weeks then taper over 2-6 months

Question 15

What is given as long term relapse prevention of opioids?

Answer 15

Naltrexone

Question 16

What receptors to Benzodiazepines effect and what effects do they have?

Answer 16

GABA and GABAa
Sedative
Muscle relaxant
Anxiolytic
Anticonvulsant
Hypnotic

Question 17

What is the mainstay of Cocaine addiction management?

Answer 17

CBT

Question 18

Acute effects of Ecstasy?

Answer 18

Heightened awareness
Jaw clenching
Awake
Loss of appetite
Intense feeling of love
Raised temperature
Tachycardia

Question 19

Effects that LSD can have on you?

Answer 19

Increase temperature
BP increase
HR increase
Sleeplessness
Flashbacks
Psychosis

Question 20

2 components of cannabis and their effects?

Answer 20

THC - psychotic effects, impairment of memory/ attention/ learning
CBD - antipsychogenic, anxiety relieving

Question 21

What can be given to manage cannabis withdrawal?

Answer 21

Lithium carbonate
Oral THC
Anticonvulsants
Antidepressants
Baclofen
Busiprone
Hypnotics

Question 22

Effects of GHB? what are withdrawal symptoms similar to?

Answer 22

Euphoria
Inhibitions
Drowsiness
Sedative, anaesthetic
Withdrawal similar to alcohol

Question 23

What is the substance contained within Khat? what does it do?

Answer 23

Cathinone - stimulates and dissociates

Question 24

What are the effects of Mephedrone?

Answer 24

Alert
Affection
Paranoia
Anxiety
Raised BP
Tachycardia
Seizures
Nose bleeds, mouth ulcers
Palpitations
Breathlessness
Fatigue and insomnia

Question 25

What receptors does Pregabalin work on?
Main effects of the drug?
POsitive and negative effects of the drug?

Answer 25

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

Question 26

Symptoms of pregabalin withdrawal?

Answer 26

Muscle spasticity
Tachycardia
Sweating
Confusion, aggression
Hypertension
Palpitations
Nausea, diarrhoea
Balance disturbed