Substance abuse Flashcards
Alcohol withdrawal timings?
Symptoms- 6-12 hours
Seizures - 36 hours
Delirium tremens - 72 hours
Treatment of delirium tremens?
Chlordiazepoxide
CAGE?
Cut down
Annoyed
Guilt
Eye opener
More detailed alcohol abuse questionnaire?
AUDIT
ICD 10 harmful use?
Pattern of substance abuse that is causing damage to health
This may be due to direct effects of the drug or a consequence of the intoxication of the drug
ICD 10 dependence syndrome?
3 of:
Strong desire to take substance
Difficulties in controlling substance taking behaviour
Physiological withdrawal state
Tolerance
Progressive neglect of alternative pleasures
Persisting use despite clear evidence of overtly harmful consequences
Acute intoxication with alcohol?
Reduced inhibitions Agression Blurred vision Slurred speech Increased urination Sweating/flushing Amnesia Poor concentration + judgement Nausea and vomiting
Consequences of alcoholism?
Alcoholic liver disease Cirrhosis Acute liver failure Hepatic encephalopathy Acute and chronic pancreatitis Wernicke's encephalopathy Fetal alcohol syndrome Cardiovascular disease
Alcohol withdrawal symptoms?
Tremor Sweating Nausea, Retching Mood fluctuation Tachycardia, Hypertension Seizures Hallucinations Delirum tremens
What is delirium tremens?
Severe withdrawal Coarse tremor Agitation Fever Tachycardia Profound confusion Delusions Hallucination
Treatment of alcohol withdrawal
Pabrinex - thiamine supplement
Benzodiazepine
Naltrexone - relapse prevention
Acemprosate - anti-craving
Acute intoxication with opioids?
Analgesia Respiratory depression Euphoria Relaxation, sleep Constipation Hypotension Pupillary constriction Hypothermia Reduced sex drive Flushed warm skin
Withdrawal from opioids?
Pain, irritability Hyperventilation Dysphoria, depression Restlessness, insomnia Fearfulness, hostility Diarrhoea Hypertension Pupillary dilation Hyperthermia Cold skin Spontaneous ejaculation
Safe injecting advice?
New sterile needles on each occasion
Sterile water
Never share needles, syringes, spoons or filters
Rotate injection sites
Avoid injecting into neck, groin and breast
Avoiding injecting into infected areas
Ensure drug is completely dissolved before injecting
Always inject with blood flow
Do not take heroin alone
Acute intoxication with cocaine?
Hyperthermia Dilation Vertigo Hypertension Tachycardia Tremor, twitches Euphoria Grandiosity Agitation Increased sexual interest
Amphetamines vs cocaine?
Similar effects
Longer duration of action for amphetamines
Cocaine withdrawal?
Isn’t one but marked psychological addiction
MDMA?
Stimulant and hallucination
Acute intoxication of MDMA?
Closeness to others Decreased fatigue Pleasurable agitation Increased sweating Nausea+vomiting Diminished potency
Acute intoxication of cannabis?
Euphoria Blood shot eyes Tachycardia Hypertension Drowsiness Dry mouth Thirst Fluctuations in respiration Hunger Nausea Anxiety, paranoia Altered time sense Impaired judgement
Features of benzo overdose?
Respiratory depression Cyanosis Confusion Disorientation Extreme dizziness Weakness Tremors
What to use in benzo overdose?
Flumazenil - only when no chance of polypharmacy
Acute intoxication with GHB?
Dissociation Euphoria Intoxication Nausea, vomiting Seizures Respiratory depression
Hallucinogenic drugs?
LSD PCP Mushrooms Ketamine Visual distortion Sense of wonder at the normal
