Substance misuse Flashcards
What alcohol related conditions might lead someone turning up at A&E?
Alcohol related injury Alcohol withdrawal Alcohol overdose Suicide attempts precipitated by alcohol MI Liver failure Oesophageal bleeds (varicele bleeds) due to vomiting Varicose veins (portal hypertension)
Are you likely to become dependant on alcohol if you binge drink every Friday and Saturday?
No. You pretty much have to drink an amount everyday.
Which organs become tolerant to alcohol?
Liver and the brain. Those who are alcohol dependant rely on it to function cognitively.
What the signs and symptoms of alcohol withdrawal?
Nausea Retching Tremor Tachycardia Affected gait Seizures DT (deliruim tremens) - acute confusion, hallucinations (insects on the floor, snakes on the curtains), intense fear often accompanies the hallucination
Why are delirium tremens common on the ward?
Because alcoholics are often admitted to the ward for other reasons, but they have no access to alcohol on the ward.
When do delirium tremens normally start?
Normally not until 72 hours after the last drink.
When do seizures due to alcohol withdrawal usually occur?
About 36 hours after their last drink.
Why are alcoholics more likely to develop varicose veins?
Portal hypertension from liver failure and cirrhosis.
Why might alcoholics be more likely to bleed?
Liver failure due to cirrhosis therefore not able to make enough clotting factors.
What is Wernicke’s encephalopathy and why are alcoholics more likely to develop it?
It is a loss of short term memory caused by thiamine deficiency. Alcoholics often neglect eating and therefore end up with a deficiency in any number of vital vitamin and amino acids.
What is Korsakoff’s syndrome?
It is the permanent form of Wernicke’s encephalopathy (loss of short term memory), also caused by thiamine deficiency.
What are questions that you would want to ask someone who you suspect might be alcohol dependant?
How much do you drink?
How many times a week?
What happens if you don’t drink during a day?
Do you ever drink in the morning?
What signs might be seen during a physical examination of someone who is alcohol dependant?
Peripheral neuropathy Ascites Bruising Gynecomastia Hepatomegaly Splenomegaly Lack of coordination
What might blood tests reveal in an alcoholic?
Raised LFTs Raised gamma GT Raised AST Raised IgA Raised bilirubin Abnormal clotting factor levels
What drug might you give an alcohol dependant individual to help them with alcohol withdrawal?
Chlordiazepoxide (benzodiazepine )
or lorazepam or diazepam
