Substance misuse Flashcards
alcohol abuse risk factors
male
longer duration of problems
single, divorced, widowed
multiple substance abuse
substance abuse and deliberate self harm
40-75% male
12-50% female
tolerance
require more drug to have same effect
downregulate no of post synaptic membranes, with same no of drug concentration
alcohol - more enzymes - increases breakdown
reinforcement
effect of drug negative or positive reinforces increased usage
addiction why
genetic
neurobiological - dopamine
social
behavioural
attachment
hx substance misuse
which drug/s
how long
how much
when did first try
when do you feel became a problem
money
how often
withdrawal
previous tx episodes
complications
overdose - find out what t
PMHx
SHx - housing and support
alcohol prevalence
9 million afults over recommended limits
alcohol mortality causes
fights and falls
liver failure - usually from varices
sudden/long slow
pancreatitis
overdose
withdrawal
wernicke’s encephalopathy
how to calculate unit
percent x volume
sx alcohol misuse
head injury
confusion
shaking/seizures
hallucinations
vomit blood
severe abdo pain
sudden yellow
early alcohol withdrawal sx
tremor
sweating
nausea
anxiety
tachycardia
late alcohol withdrawal sx
delirium tremens
disorientation
hallucination
tremor
BP, pulse, fever, motor incoordination
wernicke’s encephalopathy
deficient thiamine
ataxia
nystagmus
opthalmogplegia
vomiting, altered level of cosnciousness, hypothermia, ptosis and abnormal pupillary reflexes
tx with parenteral thiamine
korsakoff’s
results from repeated episodes of wernicke’s
long term dementia
impaired ability to learn new things
immediate recall preserved
opiates misuse
pin point pupils
decreased consciousness
slow breathing
death
opiate overdose tx
o2
naloxone IM
recovery position
opiate withdrawal sx
sweaty clammy hands, persistent yawning, rhinorrhoea, tachycardia, restless, dilated pupils, lacrimation, goosebumps
days later -
N+V, diarrhoea, insomnia, cramps, muscle pains
methadose use
in opiate addiction as less addictive
buprenorphine uses
partial agonist for heroin
has to go into withdrawal first. once in withdrawal, gets them out of
easiest to withdrawal off
benzo risks
withdrawal
overdose
dependency
disinhibiting with alcohol
benzo tx
reduce on own supply
one off reduction only
pregabalin
stimulants types
amphetamine
cocaine
stimulants effects
acute heart attacks and strokes as increased BP
coke + alcohol - lasts longer - depressive agent in body….bad behaviour
effect on liver
psychosis - similar to schizophrenia
hallucinogens examples
magic mushrooms
LSD
Ket
Novel psychiatric substances types
mamba and spice
NPS risks
psychosis
fits
incoordination
cannabis increases
prevalence of schizophrenia
mechanism of alcohol withdrawal
chronic alcohol consumption enhances GABA mediated inhibition in the CNS (similar to benzodiazepines) and inhibits NMDA-type glutamate receptors
alcohol withdrawal is thought to be lead to the opposite (decreased inhibitory GABA and increased NMDA glutamate transmission)
1st line tx for alcohol withdrawal
long acting benzo - diazepam
or can give carbamezepine
