Drug / Alcohol Misuse Flashcards
how many units per week constitutes high risk drinking
35
does alcohol inhibit excitatory or inhibitory transmission?
alcohol inhibits excitatory transmission (at NMDA glutamate channels)
in alcohol withdrawal there are increased _____ neurotransmitters and decreased ______ neurotransmitters
in alcohol withdrawal there are increased excitatory neurotransmitters and decreased inhibitory neurotransmitters
how long after the last drink does alcohol withdrawal peak
24-48 hours
which LFT is a non-specific indicator of liver damage?
GGT
what blood abnormality other than LFTs does alcohol cause
raised mean cell volume
what is the pharmacological management of detoxing alcohol
diazepam + IV pabrinex thiamine
what is the purpose of IV thiamine pabrinex in alcohol detox
Wernicke’s syndrome prophylaxis
what is the mechanism of disulfiram antabuse
inhibits acetaldehyde dehydrogenase
what is the mechanism of acamprostate
decreases alcohol cravings
what is the mechanism of naltrexone
decreases reward from alcohol
what medication is 1st line for relapse prevention in alcoholism
naltrexone
which medication for relapse prevention in alcoholism is known for causing HA, nausea and diarrhea?
acamprostate
how long after the last drink does delirium tremens present?
2 days
how does delirium tremens present?
visual + auditory hallucinations, paranoid delusions, agitation, confusion, fever
in alcohol withdrawal, what comes first, Wernicke’s or Korsakoff’s?
Wernicke’s
what drug class does heroin belong to
opiates
what are the constituents of opium
morphine + codeine
what is the name of the medically approved version of heroin?
diamorphine
heroin _____ crosses the blood brain barrier, where it is metabolised to _____. it has a ____ half-life
heroin rapidly crosses the blood brain barrier where it is metabolised to morphine. it has a short half-life
what is the only blood test that can indicate heroin use <6 hours after use?
6-mono-acetyl-morphine
what drug reverses opiate overdose and what is its mechanism
naloxone opioid antagonist
what is the commonest route for administering heroin?
IV
what drugs are sometimes co-administered with heroin to increase the opioid effects?
gabapentin/pregabalin
the direct effects of heroin are: pupil _____, __HR, __ consciousness, ___BP, ____ depression ___phoria and constipation
the direct effects of heroin are: pupil constriction, <hr>
heroin withdrawal causes visual hallucinations. true or false
opiate withdrawal does not cause psychosis or delirium!!
what are the 2 main management options for a heroin addict?
detox or opiate substitution
which management option for heroin addiction, detox or opiate substitution, has a higher mortality rate?
detox has 10% mortality rate
what are the drug options for opiate substitution therapy?
TAB buprenorphine or liquid methadone
