Substance dependence Flashcards
What is the treatment for withdrawal symptoms in alcohol dependence?
Chlordiazepoxide OR diazepam
Seizures: lorazepam
Delirium tremens: Oral lorazepam
- Persistent/declines: parenteral OR haloperidol
What is the treatment for alcohol dependence?
Acamprosate OR naltrexone AND psychological therapy
- Reduce alcohol consumption: Nalmefene (high risk of drinking risk but no w/drawal symptoms
- Wernicke’s encephalopathy: thiamine
What is the treatment for nicotine dependence?
Most effective approach: Abrupt quitting AND cessation aids AND behavioural support
Varenicline OR
- Counsel: makes you sleepy, driving may be affected
Long + short acting NRT
Patch: 16H OR 24H
- 16H: removed at night
- Strong craving on waking: offer 24H
- Cause skin irritation
Gum, lozenge, nasal spray, sublingual tablet, inhalator
- For when you have Urge to smoke + prevent cravings
Bupropion (SNRI)
- Counsel: report worsening of depression, suicidal behaviour, behaviour changes
- MHRA: Risk of serotonin syndrome w/ other serotonergic drugs
Use of methadone in opioid dependence
Dose: OD
Side effect: QT prolongation
Long HL
More sedating:
- Long hx of misuse
- Abuses sedative drugs or alcohol
- INC anxiety during w/drawal
Use of buprenorphine in opioid dependence
Dose: OD
- Can be given 6-12H after using heroin
Side effect: precipitates w/drawal
- Take 1st dose on w/drawal signs
Less sedating:
- Job or drives
- Safer w sedating drugs + less drug interactions
- Milder w/drawal + lower risk of overdose
