Substance Dependence Flashcards
What is used for assisted alcohol withdrawal?
Chlordiazepoxide
Diazepam
Fixed dose reducing regimen
Alternatives - carbamazepine, clomethiazole
What is used for alcohol withdrawal seizures?
Lorazepam
What is used for delirium tremens?
First line - oral lorazepam
Persistent or if patient declines oral treatment = parenteral lorazepam or haloperidol
What is used for alcohol dependence?
Acamprostate
Naltrexone
Disulfiram
What is used for the reduction of alcohol consumption in patients without physical withdrawal symptoms?
Nalmefene
For patients with a high drinking risk level, who do not require immediate detoxification
What is used to prevent wernickes encephalopathy?
Thiamine
Patients with high alcohol dependence are at risk
High risk - malnourished or decompensated liver disease
What is used for nicotine replacement therapy if strong cravings for cigarettes on waking?
24 hour patch
What is used for the urge to smoke/prevent craving?
Immediate release formulations
What are the side effects of nicotine replacement therapy?
Mild local reactions
GI disturbances
What else is used for stopping smoking?
Bupropion
Varenicline
What is the MHRA advice for varenicline?
Stop and see GP for agitation, depression, suicidal thoughts
What is the risk of three or more missed days for opioid dependence treatment?
Risk of overdose due to reduced tolerance
What is the risk of five or more missed days for opioid dependence treatment?
Check for misuse
How is methadone used for opioid dependence?
Once daily dose
Long half life
Accumulates - toxicity
Increased risk of toxicity in non-dependent adults
What increases the sedating effects of methadone?
Long history of opioid misuse
Increased anxiety during withdrawal
Abuses sedative drugs/alcohol
