Substance Misuse

Question 1

What does narrowing of repertoire mean

Answer 1

Loss in variation of use of substance

Question 2

What is reinstatement

Answer 2

After a period of abstinence, patient restarts substance and rapidly increases level

Question 3

What does acamprosate do for alcoholics

Answer 3

Reduces cravings

Question 4

Disulfiram- what does it do for alcoholics

Answer 4

inDuces flushing when drinking

Question 5

Alcohol withdrawn stages

Answer 5

1- starts 6-12 hours. Tremor, sweating tachycardia and anxiety

2- seizures at 36 hours

3- delirium tremens at 48-72 hours. Coarse tremor, confusion, delusion and hallucination

Question 6

Treatment of delirium tremens

Answer 6

Benzodiazepine (chlordiazepoxide) - reducing regime

Pabrinex parenterally to prevent wernicke korsakoff

Question 7

What is the classical triad seen in wernickes encephalopathy

Answer 7

Ataxia
Occulomotor disturbance
Confusion

Question 8

What is seen in korsakoffs psychosis

Answer 8

Behaviour change and anter and retrograde amnesia

Question 9

Options for opioid substitution therapy

Answer 9

Methadone- full agonist but prolongs QT (needs ECG monitoring)

Buprenorphine (subutex)- partial agonist less risk of OD