Drug / Alcohol Misuse

Question 1

how many units per week constitutes high risk drinking

Answer 1

35

Question 2

does alcohol inhibit excitatory or inhibitory transmission?

Answer 2

alcohol inhibits excitatory transmission (at NMDA glutamate channels)

Question 3

in alcohol withdrawal there are increased _____ neurotransmitters and decreased ______ neurotransmitters

Answer 3

in alcohol withdrawal there are increased excitatory neurotransmitters and decreased inhibitory neurotransmitters

Question 4

how long after the last drink does alcohol withdrawal peak

Answer 4

24-48 hours

Question 5

which LFT is a non-specific indicator of liver damage?

Answer 5

GGT

Question 6

what blood abnormality other than LFTs does alcohol cause

Answer 6

raised mean cell volume

Question 7

what is the pharmacological management of detoxing alcohol

Answer 7

diazepam + IV pabrinex thiamine

Question 8

what is the purpose of IV thiamine pabrinex in alcohol detox

Answer 8

Wernicke’s syndrome prophylaxis

Question 9

what is the mechanism of disulfiram antabuse

Answer 9

inhibits acetaldehyde dehydrogenase

Question 10

what is the mechanism of acamprostate

Answer 10

decreases alcohol cravings

Question 11

what is the mechanism of naltrexone

Answer 11

decreases reward from alcohol

Question 12

what medication is 1st line for relapse prevention in alcoholism

Answer 12

naltrexone

Question 13

which medication for relapse prevention in alcoholism is known for causing HA, nausea and diarrhea?

Answer 13

acamprostate

Question 14

how long after the last drink does delirium tremens present?

Answer 14

2 days

Question 15

how does delirium tremens present?

Answer 15

visual + auditory hallucinations, paranoid delusions, agitation, confusion, fever

Question 16

in alcohol withdrawal, what comes first, Wernicke’s or Korsakoff’s?

Answer 16

Wernicke’s

Question 17

what drug class does heroin belong to

Answer 17

opiates

Question 18

what are the constituents of opium

Answer 18

morphine + codeine

Question 19

what is the name of the medically approved version of heroin?

Answer 19

diamorphine

Question 20

heroin _____ crosses the blood brain barrier, where it is metabolised to _____. it has a ____ half-life

Answer 20

heroin rapidly crosses the blood brain barrier where it is metabolised to morphine. it has a short half-life

Question 21

what is the only blood test that can indicate heroin use <6 hours after use?

Answer 21

6-mono-acetyl-morphine

Question 22

what drug reverses opiate overdose and what is its mechanism

Answer 22

naloxone opioid antagonist

Question 23

what is the commonest route for administering heroin?

Answer 23

IV

Question 24

what drugs are sometimes co-administered with heroin to increase the opioid effects?

Answer 24

gabapentin/pregabalin

Question 25

the direct effects of heroin are: pupil _____, __HR, __ consciousness, ___BP, ____ depression ___phoria and constipation

Answer 25

the direct effects of heroin are: pupil constriction, <hr>

Question 26

heroin withdrawal causes visual hallucinations. true or false

Answer 26

opiate withdrawal does not cause psychosis or delirium!!

Question 27

what are the 2 main management options for a heroin addict?

Answer 27

detox or opiate substitution

Question 28

which management option for heroin addiction, detox or opiate substitution, has a higher mortality rate?

Answer 28

detox has 10% mortality rate

Question 29

what are the drug options for opiate substitution therapy?

Answer 29

TAB buprenorphine or liquid methadone