presentations of drug misuse Flashcards
what type of drug is heroin ?
opiate
what is the mechanism of heeroin ?
opiate drug that is a mu-receptor agonist
has a sedative and analgesic effect
what is the presentation of heroin overdose?
pinpoint pupil
shallow respiration
respiratory depression
cyanosis
low oxygen saturation
loud snoring and unrousable
what is the overdose treatment for heroin ?
naloxone
which drug will reverse benzodiazepine effect ?
flumazenil
what is the acute drug effect of GBL/GHB ?
liquid weak action at GABA-B
causes a sedative effeect
what are the physical , infection related complication associated with drug abuse ?
site of injection infection
cellulitis
abscess
septicemia
what are the vascular complications associated with drug abuse ?
deep vein thrombosis complicated by pulmonary embolism
acute endocarditis
ischaemia
what are the complications associated with the different methods of administration of drugs ?
IV - blood borne viruses
smoking - effect on lung function
snorting - perforated septum
what is the presentation of opiate withdrawal ?
sweat, mild tremor, aches, muscle jerks, pilorecetion
dilated pupils
runny nose
yawning
what is the treatment for opiate withdrawal ?
symptomatic treatment : diazepam , loperamide , buscopan
methadone may be used to prevent further withdrawal symptoms
what is the presentation of GBL withdrawal ?
from mild anxiety to confusion
agitation
tremor
paranoia with hallucinations
what is the treeatmeent for GBLK withdrawal ?
benzodiazeepam and balcofen
what is baclofen ?
antispasmodic muscle relaxant
what is the presentation of benzodiazepines withdrawal ?
anxiety
depresonalization
derealisation
sensitivity to light and sound
fits
what is the treatment for benzo withdrawal ?
beenzo detoxification
what are examples of drug seeking behaviour ?
request for specific opioid
doctor shopping
self diagnosis
request for lost methadone or buprenorphine
what is the mechanism of action of methadone ?
synthetic opioid receptor agonist
what is the presentation of alcohol withdrawal ?
sweating
tremor
tachycardia
anxious
nausea and vomiting
withdrawal seizures
delirium tremens
what is delirium tremens ?
a rapid onset delirium syndrome marked by agitation
Cognitive impairments with poor concentration and disorientation
hallucinations
autonomic disturbances
when is the onset of delirium tremens ?
72 to 96 hours after the patients last drink
what is the association between wernicks encephalopathy and
alcohol use disorder is associated with depleted thiamine levels which eventually may cause wernicks encephalopathy
what is the presentation of wernick’s encephalopathy ?
opthalmoplegia
nystagmus
ataxia
confusion
what is the treatment for wernick’s encephalopathy ?
intravenous thiamine administration
what is the korsakoff’s syndrome ?
also caused by thiamine deficiency, sequelae of wernicke’s ,
associated with short term memory loss
what is the management plan for alcohol dependence ?
supportive measures
chlordiazepoxide
thiamine
what is the management for delirium tremens ?
medical emergency
benzo - diazepam or lorazepam as first line
with benz resistant delirium tremens use haloperidol
what is the appropriate dose of haloperidol for delirium tremens ?
5-10 mg orally
or 5 mg IM
what is the most appropriate management for wernicke’s encephalopathy ?
IV thiamine
correct magnesium deficiency and hypoglycaemia
what is the most appropriate managemeent for seizures ?
10 mg diazepam rectally
what is the AUDIT score ?
Alcohol use identification test
score from 0 - 12
a score above 4 is positive , the higher the number the more likely it is that the patient’s drinking is affecting their health
what is balcofen used for ?
to relieve muscle spasticity
