Substance dependance

Question 1

what are the different alcohol dependance?

Answer 1

mild-usually dont need assisted withdrawal
moderate- treated in community setting unless at risk of developing withdrawal seizures or delirium
-severe- undergo withdrawal in an inpatient setting

Question 2

what is the treatment for alcohol dependance?

Answer 2

-Cognitive behavioural therapy or with acamprosate or naltrexone (alternative: disulfram)

Question 3

what is the treatment for withdrawal symtpoms?

Answer 3

-long acting Benzos e.g. chlorodiazepoxide or diazepam (alterative: carbamazepine or clomethiazole)

Question 4

what is the treatment for delirium in alcohol dependency?

Answer 4

lorazepam

Question 5

what is the treatment for Wernickes Encephalopathy?

Answer 5

thiamine (vit B1)

Question 6

WHAT IS THE TREATMENT FOR NICOTINE DEPENDACNY?

Answer 6

-varenicline: avoid in epilepsy, cardiovascular disease and psychiatric -nicotine receptor blocker
-bupropion:avoid in psychiatric illness, seziures, eating disorders, can cause serotonin syndrome

-refer back to GP if patient feels depressed when taking these

Question 7

what is NRT?

Answer 7

-NRT: use 16hr patch if pregnant or experience nightmares AND use short term reliever: LOZENGERS, gum, sublingual, tablets, inhalator, nasal spray and oral spray

Question 8

what is opioid dependence? treatment?

Answer 8

-only initiated under supervision of qualified prescribed not just any doctor
-prescribed on an FP10MDA- MAX SUPPLY OF 14 DAYS

Question 9

how many missed doses means the patient has to be referred back to the GP when taking opioid treatment?

Answer 9

3 missed doses

Question 10

can patient on opioid dependency be used in pregnancy?

Answer 10

yes as the risk is greater if its not aken

Question 11

what can be prescribed if patients are at high risk of overdose?

Answer 11

-prescribe naloxone

Question 12

what is the 2 options for opioid dependancy?

Answer 12

-buprenorphine
-methadone

Question 13

what are the information for buprenorphine? sedating, withdrawal, overdose risk?

Answer 13

-less sedating than methadone
-milder withdrawal symptoms
-lower risk of overdose
-suboxone (which is buprenorphine with naloxone) when there is a risk of injecting

Question 14

what is the information for methadone? side effects?

Answer 14

QT prolongation and carefully titrated according to patients needs

Question 15

what is the different when giving sugar free or not sugar free preparations?

Answer 15

-sugared one can causes local irritation if they inject it . If patient at high risk of injecting you give sugared one