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Phase 2 - Mental Health > Substance Misuse > Flashcards

Substance Misuse Flashcards

1
Q

How do you support alcohol withdrawal?

A 
You give a decreasing benzo regime
Nutritional support
disuphuram (hangover)
acamprosate (reduces cravings)
naltroxone (reduces pleasure)
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2
Q

What is delirium tremens?

A

A hyperadrenergic state, 2 days after withdrawal
An emergency in alcohol withdrawal where the patient reacts badly
Most due to stopping cold turkey too quickly
Can be fatal (30% mortality)

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3
Q

How common is DTs?

A

5% of withdrawals

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4
Q

What are the symptoms of DTs?

A 
Gross Tremor
Sweating (ANS arousal)
Agitation and Confusion
Headache
Convulsions (loss of GABA inhibition)
Hallucinations (tactile, visual)

Hypoglycaemia

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5
Q

How do you treat DTs?

A 
Anti-convulsants
Decreasing Benzo regime
Anti-emetic
Monitor
Fluids and electrolytes
Prevent hypoglycaemia
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6
Q

Long term help for alcohol withdrawal?

A

Group Therapy/AA

Acamprosate (decrease cravings)

Disuphuram (gives bad hangover symptoms due to aldehyde dehydrogenase inhibition)

Support

Nutritional support - B12, folate, thiamine (pabrinex)

Diet - encourage healthy eating

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7
Q

What are the symptoms of dependence?

HINT: Has an acronym

A

Compulsion to take
Aware of risks but cannot help it
Neglecting other activities
Time preoccupied by it

Symptoms if stop
Tolerance
Out of control
Persistant wish to cut down

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8
Q

What does alcohol do to the body?

A

Alcoholic gastritis (snake skin appearance)
GORD
Varices
Liver disease
Erectile dysfunction and infertility (virilisation)
Malignancy
Brain - encephalopathy, Korsakoffs
Pancreatitis - acute and chronic
Foetal Alcohol Syndrome
Injuries whilst intoxicated
Psychosocial - job, psychosis, depression, social life, criminal

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9
Q

What substances are people often addicted to?

A

Opioids - heroin, morphine
Benzodiazapines -
Alcohol (6% men, 2% women)

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10
Q

How do you treat a Benzo overdose?

A

Flumazanil

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11
Q

How do you treat a heroin (opioid) overdose?

A

Naloxone

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12
Q

What substances are depressants “downers”

A

Opioids
Benzos
Glue/solvents

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13
Q

Which drugs are psychotrophic?

A

Cannabis
Ecstasy
LSD

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14
Q

Which drugs are stimulants?

A

Cocaine

Amphetamines

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15
Q

Which substances are less addictive?

A

Cannabis

Solvents

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16
Q

What are the symptoms of an opioid overdose?

A

Pinpoint pupils
Low consciousness/LoC
Low BP
Low HR

(Normal dose - euphoria, relaxation, analgesia)

17
Q

What are the withdrawal symptoms for opioids?

A 
Formication
Painful Cramps
Headaches
Photophobia
Diarrhoea
Shivering/Hypothermia
Piloerection

(everything runs)
Can cause seizures

18
Q

How to help people withdraw from opioids?

A

Give an ant/agonist of the opioid receptor or weak agonist

Methadone

19
Q

Helping people with addiction

A

Treat symptoms and complications
Support - help stages of change
Substitution - methodone/subutex, low alcohol wine/beer
Harm reduction (safe technique, naloxone pens, needle swapping, give blood tests for HIV and Hep B/C)
Vaccinations

Turning Point (for withdrawal and support)

20
Q 
How long do substances stay in urine?
Methadone
Opioids
Cannabis
Cocaine
Amphetamines
A 
7 days Methadone
2 days Opioids 
2- 3 days Cocaine
3-45 days Cannabis (depends on use)
2 days Amphetamines
21
Q

Risk factors for addiction

A 
Male
Young
Low SE Status
Unemployment
Co-existing Mental Health Problem (Depression, Psychosis, Anxiety)
Iatrogenic prescription of medication
Culture and Religion
Availability
22
Q

Screening tools for alcohol addiction?

A 
CAGE - 
Cut Down
Anger
Guilt
Eye-opener
(2+ needed)

FAST

23
Q

What is the unit allowance for men and women?

When?

A

14 units BOTH a week
Have at least 2 alcohol-free days a week
don’t drink more than 3-4 units at a time

24
Q

What are the symptoms of acute alcohol intoxification?

DDx?

A 
Loss of inhibitions
Arousal (hyperactive, louder)
Feel warm (even though hypothermia)
Loss of co-ordination
Slurred speech and blurred vision
Emotionally labile (aggression, depression, euphoria)
Hypoglycaemia

Head Trauma
Delirium
Hypoglycaemia

25
Q

What are the symptoms of alcohol withdrawal?

A

Very bad hangover

Headache
Nausea
Tremor
Labile Mood
Tremor
26
Q

What is the scoring system for treating alcohol withdrawal?

A

CIWA (withdrawal assessment) Ar

27
Q

Risks of substance misuse?

A

Psychotic Disorders
Organ damage - death
Infections (blood borne)
Risk to self and others when using
Injections - infection, abcess, DVT, PE, endocariditis, cellulitis
Dilutional hyponaturaemia - primary polydipsia with ecstasy

Phase 2 - Mental Health (11 decks)

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