Drugs of misuse Flashcards
What are legal highs?
Essentially drugs which are illegal, which have been slightly modified and therefore aren’t illegal but still potentially harmful, designed not to be picked up by drug tests!
Name three novel psychoactive drugs
Mephedrone - miaw miaw
GHB/GBL solvent
Methoxetamine
Name three depressants
Opiod
Benzo
Alcohol
Name two NPS depressants
GBL
Phenibut
Name three stimulant drugs
Cocaine
Amphentamines
MDMA
Caffeine
Name three NPS stimulants
m-cat NRG-1 BZP MDAI Synthacaine
What is the ICD-10 criteria of ‘dependence syndrome’?
3 or more in the last year:
Strong desire or compulsion to use substance
Difficulty controlling use/amount/recidivism (failed to quit)
Tolerance to drug effects
Neglect of other activities
Persistent use despite adverse consequences
Withdrawal symptoms
Use of substance in a particular way - narrowing repertoire
What is recidivism?
Failure to quit, therefore return to substance
What does alcohol do to the brain?
increases inhibitory GABA-receptor activity
antagonises excitatory NMDA-receptor
Substance misuse history
What substances? Quantity Route When is it used Why is it used (triggers) First use When did you start to use it regularly? Heaviest use/cumulative use Any features of dependence? Withdrawal effects
1 bottle of whisky
30 units
1 pint of beer
2.5 units
1 large glass of wine
3.25 units
1 bottle of wine
10 units
1 can of beer
4 units
How do you work out the units?
percentage ABV x volume / 1000
Signs of injecting drug use
Punctures Track marks Cellulitis DVTs bacterial endocarditis
Signs of acquired illnesses due to substance abuse
Hepatitis
HIV
Injuries
What is insufflation?
Nasal septum damage due to insufflation
What is formication?
Feeling that little bugs ar eon your skin
Withdrawal symptoms + what is kindling
Delirium tremens 3 days after withdrawal - psychosis from alcohol withdrawal
Tremors
Kindling - more likely to get seizures/withdrawl symptoms second time round if you’ve already had it
Hallucination
Formication
Seizures
Generalised seizures over 6 hrs
How does delirium tremens present?
Agitation
Paranoia
Intense fear
What drug do you give for alcohol withdrawal?
Chlordiazepoxide (librium)
Also prophylaxis for wernicke’s
Treatment for seizures
Diazepam IV or rectally
Antimitochondrial antibodies and jaundice
Primary biliary cirrhosis
Wernicke syndrome
Confusion
Ataxia
Nystagmus/Opthalmoplegia
Korsakoff syndrome
Anterograde amnesia/dementia (not really psychosis)
Why do you get wernicke-korsakoff syndrome
Thiamine deficiency - alcohol reduces duodenal transport of thiamine, and CLD reduces activaiton and storage of thiamine
Signs
Diplopia
Broad based gait
Cognitive decline
Episodic memory loss
Pin point pupils and reduced resp rate
Opiate overdose
