Substance Misuse Flashcards
Alcohol misuse (history)
Clarify HPC (understanding, onset, course, typical day)
Core features (control, tolerance, withdrawal - shakes, seizures, Hns)
Other features (primacy, eye-opener, abstinence)
Complications (daily life, physical health, work, relationships, finances, Police)
Mental state (mood, enjoyment, sleep, appetite, hallucinations, delusions)
Risk (self, others)
Insight and readiness for change
Alcohol dependence (d/w family)
Clarify concerns
Explain complications of alcohol use (liver, withdrawal, depression/anxiety, dementia, Police)
Medical management (diazepam, thiamine, Antabuse)
Psychological management (CBT, groups)
Prognosis (insight, family support)
Questions and leaflets
Opioid dependence (history)
Clarify HPC (substances, onset, course, typical day, route)
Dependence symptoms (tolerance, control, cravings, withdrawal)
Complications (physical health, work, relationships, finance, Police)
Mental state (mood, enjoyment, sleep, appetite, hallucinations, delusions)
Risk (self, others, pregnancy)
Insight and readiness for change
Substance use in pregnancy (history)
Clarify HPC (substances, onset, course, typical day, route)
Dependence symptoms (tolerance, control, cravings, withdrawal)
Pregnancy (planned, attitude)
Social history (work, finances, relationships, help)
Risk (self, others, child)
Methadone in pregnancy (explanation)
Clarify concerns
Explain risk of drug use in pregnancy (stillbirth, prematurity, LBW, use of methadone)
Neonatal abstinence syndrome
Management (withdrawal in 2nd trim or dose adjustment in 3rd trim)
Breastfeeding (fine if <20mg per day, other meds)
Social services
Delirium tremens (d/w consultant)
Case summary
Differential diagnosis (DTs, other delirium, other psychosis)
Environmental management (orientation, quiet room, familiar staff, use of MHA)
Drug management (IV Pabrinex tds, CIWA protocol with diazepam or chlordiazepoxide, haloperdiol)
Psychological management (addictions services)
