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FINALS - PSYCH > substance misuse > Flashcards

substance misuse Flashcards

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1
Q

alcohol intake men and women

A

14 units a week spread evenly over 3+ days

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2
Q

how is units calculated

A

milimeters x ABV/ 1000

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3
Q

what is a binge

A

8 units in one sitting for men and 6 for women

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4
Q

what is hazardous drinking

A

8-14 units a week / not impacting life

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5
Q

what is harmful drinking

A

15+ units / harmful to help

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6
Q

mechanism of alcohol withdrawal

A

alcohol enhances GABA (inhibitory pathway) and inhibits NMDA (excitatory pathway) // so withdrawal is opposite (decreased GABA and increased NMDA)

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7
Q

when do withdrawal alcohol symptoms occur

A

6-12 hours after last drink

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8
Q

symptoms alcohol withdrawal

A

tremor, sweating, tachycardia, anxiety

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9
Q

peak incidence seizures alcohol withdrawal

A

36 hours

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10
Q

when does delirium tremens occur

A

48-72 hours

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11
Q

symptoms delirium tremens

A

coarse tremor, confused, delusions, hallucinations, fever, tachy

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12
Q

1st line mx alcohol withdrawal

A

decreasing dose of long acting benzos eg chlordiazepoxide or diazepam

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13
Q

mx alcohol withdrawal if hepatic failure

A

lorazepam

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14
Q

what AED can be used in alcohol withdrawal

A

carbamazepine

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15
Q

questionnaires to assess drinking

A

CAGE (cut down? annoyed? guilty? ever drink for neves?) // audit (20+)

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16
Q

what supplement should all alcoholics take

A

thiamine

17
Q

meds to help alcoholics cut down

A

disulfram (makes hangovers horrific) // acamprosate (reduces cravings)

18
Q

what causes wernickes

A

thiamine deficiency –> petechial haemorrhages in brain

19
Q

triad of wernickes

A

opthalmoplegia/ nystagmus, ataxia, encephalopathy // (+ peripheral sensory neuropathy)

20
Q

invx wernickes

A

decreased red cell transketolase // MRI

21
Q

mx Wernickes

A

thiamine

22
Q

what can wernickes develop into

A

korsakoff

23
Q

symptoms korsakoff

A

anterograde amnesia (cant make new memories), retrograde amnesia, confabulation

24
Q

which part of brain is damaged in korsakoffs

A

mammillary bodies of hypothalamus and medial thalamus

25
Q

symptoms opioid misuse

A

runny nose, needle tracks, pinpoint pupils, drowsy, watery eyes, yawning

26
Q

complications opioid misuse

A

viral infection HIV, hep B+V // endocarditis, septic arthitis, nec fasc // VTE // resp depression // social problems

27
Q

symptoms opioid overdose

A

pinpoint // low GCS // resp depression // hypotension + tachy

28
Q

mx opioid overdose

A

IV or IM nalaxone (short duration)

29
Q

mx opioid dependence

A

methadone or buprenorphine

30
Q

how long should opioid detox last

A

4 weeks inpatient // 12 weeks community

FINALS - PSYCH (10 decks)

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