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Psychiatry > Substance Misuse > Flashcards

Substance Misuse Flashcards

1
Q

What are the ICD-10 types of substance misuse?

A 
Acute intoxication 
Harmful use
Dependence syndrome
Withdrawal state
Psychotic disorder
Amnesic syndrome
Residual disorder
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2
Q

What is acute intoxication?

A

Acute, usuall transient, effect of the substance

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3
Q

What is harmful use?

A

Recurrent misuse associated with physical, psychological and social consequences without dependence

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4
Q

What is dependence syndrome?

A

Prolonged compulsive substance use leading to addiction, tolerance and withdrawal

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5
Q

What is withdrawal state?

A

Physical/psychological effects from cessation of substance after prolonged use

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6
Q

What is psychotic disorder?

A

Onset of psychotic symptoms within 2 weeks of substance use. Must last >48 hrs

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7
Q

What is amnesic syndrome?

A

Memory impairment in recent memory and ability to recall past experiences

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8
Q

What is residual disorder?

A

Specific features due to substance misuse

Features

  • flashbacks
  • personality disorder
  • affective disorder
  • dementia
  • persisting cognitive impairment
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9
Q

What are the main classes of drugs abused?

A 
Opiates
Cannabinoids
Sedative-hypnotics
Stimulants
Hallucinogens
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10
Q

What are examples of opiates?

A

Morphine
Heroin
Codeine

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11
Q

What are the physical effects of opiate use?

A

Respiratory depression
Hypoxia
Hypotension
Hypothermia

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12
Q

What are the psychological effects of opiate use?

A

Apathy
Disinhibition
Psychomotor retardation
Impaired judgement

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13
Q

What are the signs of opiate withdrawal?

A 
Craving 
Rhinorrhea
Lacrimation 
Myalgia
N+V
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14
Q

What is an example of an cannabinoid?

A

Cannabis

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15
Q

What are the physical effects of cannabis?

A

Increased appetite
Dry mouth
Tachycardia

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16
Q

What are the psychological effects of cannabis?

A

Euphoira
Disinhibition
Agitation
Paranoid ideation

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17
Q

What are the signs of cannabis withdrawal?

A

Anxiety
Irritability
Tremor of outstretched hands

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18
Q

What are examples of sedative-hypnotics?

A

Benzodiazepines

Barbiturates

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19
Q

What are the physical effects of sedative-hypnotics?

A

Unsteady gait
Slurred speech
Hypotension
Nystagmus

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20
Q

What are the psychological effects of sedative-hypnotics?

A 
Euphoris 
Disinhibition 
Apathy 
Aggression 
Labile mood
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21
Q

What are the signs of sedative-hypnotics withdrawal?

A

Tremor - hands, tongue, eyelids
N+V
Tachycardia
Postural hypotension

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22
Q

What are examples of stimulants?

A 
Cocaine
Crack cocaine
Ecstasy 
MDMA
Amphetamine
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23
Q

What are the physical effects of stimulants?

A

Tachycardia
Sweating
Hypertension
Arrhythmias

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24
Q

What are the psychological effects of stimulants?

A 
Euphoria 
Increased energy 
Grandiosity 
Aggressive
Labile mood
25
Q

Whar are the signs of stimulant withdrawal?

A

Dysphoric mood
Lethargy
Psychomotor agitation
Craving

26
Q

What are examples of hallucinogens?

A

LSD

Magic mushrooms

27
Q

What are the physical effects of hallucinogens?

A

Tachycardia/palpitations
Sweating
Tremor
Blurred vision

28
Q

What are the psychological effects of hallucinogens?

A 
Anxiety 
Illusions
Hallucinations
Depersonalisation 
Paranoia
29
Q

What are the signs of hallucinogen withdrawal?

A

None

30
Q

What are the physical complications of drug misuse?

A

Death
Infection - BBV
Endocarditis
Superficial thrombosis

31
Q

What are the psychological complications of drug misuse?

A

Craving
Anxiety
Cognitive disturbance
Drug-induced psychosis

32
Q

What are the social complications of drug misuse?

A

Crime
Imprisonment
Homelessness
Relationship problems

33
Q

How is drug dependence defined?

A

> 3 over 1 month

  • strong compulsion
  • preoccupation with substance use
  • withdrawal state
  • inability to control use
  • tolerance
  • persisting despite harm
34
Q

How is opiate dependence managed?

A

Methadone

35
Q

What is alcohol abuse?

A

Consumption of alcohol at a level sufficient to cause physical, psychological or social harm

36
Q

What is binge drinking?

A

Drinking over twice the recommended level of alcohol per day in one session

37
Q

What is harmful use?

A

Drinking above safe levels with evidence of alcohol related problems

38
Q

What is the UK recommended maximum intake?

A

14 units per week

39
Q

What is 1 unit?

A

10ml alcohol

40
Q

How is units calculated?

A

% (ABV) x volume (ml) / 1000

41
Q

What are the medical effects of alcohol consumption?

A 
Hypertension 
Hepatitis 
Pancreatitis
Peptic ulcers
Varices
42
Q

What are the psychological effects of alcohol consumption?

A

Mood disorders
Anxiety disorders
Self-harm

43
Q

What are the social effects of alcohol consumption?

A 
Domestic violence
Drink driving
Financial problems
Relationship problems
Employment problems
44
Q

What are the features of alcohol intoxication?

A

Slurred speech
Labile affect
Impaired judgement
Poor coordination

45
Q

What are the features of alcohol dependence?

A 
Subjective awarenss of need to drink 
Avoidance/relief of withdrawal symptoms
Withdrawal symptoms
Drink-seeking behaviour
Restarting drinking after trying to stop 
Increased tolerance
Narrowing of repetoire
46
Q

What are the early signs of alcohol withdrawal?

A

Tremor
Swating
Nausea
Anxiety

47
Q

What are the late signs of alcohol withdrawal?

A

Delirium tremens
Disorientation
Hallucinations

48
Q

When does delirium tremens occur?

A

24hrs -> 1 week after cessation

49
Q

What are the features of delirium tremens?

A 
Dehydration 
Electrolyte disturbances
Cognitive impairment
Vivid perceptual abnormalities
Paranoid delusions
Marked tremor 
Autonomic arousal
50
Q

How is delirium tremens managed?

A

Benzodiazepines
Haloperidol
IV pabrinex

51
Q

What is Wernicke’s encephalopathy?

A

Thiamine deficiency

52
Q

How does alcohol abuse cause thiamine deficiency?

A

Poor nutritional intake

Alcohol destroys thiamine pump

53
Q

What are the features of Wernicke’s?

A

Nystagmus
Ataxia
Ophthalmoplegia

54
Q

How is Wernicke’s managed?

A

IV thiamine

55
Q

What is Korsakoff’s psychosis?

A

Profound memory loss due to alcohol

56
Q

What are the features of Korsakoff’s?

A

Short term memory loss
Confabulation
Disorientation to time

57
Q

How is alcohol withdrawal managed?

A

Oral/IV thiamine

Chlordiazepoxide

58
Q

How is alcohol dependence managed?

A

Biological

  • disulfiram
  • Acamprosate

Psychological

  • motivational interviewing
  • CBT

Social
- AA

Psychiatry (22 decks)

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