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Year 5-Psychiatry > substance misuse psychiatry > Flashcards

substance misuse psychiatry Flashcards

1
Q

benzodiazepine symptoms

A

extremely anxious
restless
visibly sweating
noticeable tremor

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1
Q

managing benzo withdrawal?

A
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2
Q

what is the use of benzodiazepines

A

sedation, hypnotic, anxiolytic, anticonvulsant, muscle relaxant
* They should only be used for a short time (2-4 weeks) due to addictive potential

epilepsy

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3
Q

benzodiazepine withdrawal can be lethal t/f?

A

true

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4
Q

what do benzo target?

A

GABA- A

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5
Q

gaba a targeting drugs?

A

alcohol
z drugs
benzos
GHB
baclofen

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6
Q

withdrawal features of benzoz?

A

anxiety
irritibilitiy
tremor
sweating
insomnia
appetite
confusion

convulsion
psychosis

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7
Q

benzodiazepine toxicity?

A

drowsy
ataxia
slurred speed
reduced consciousness

severe can lead to hypotension and bradycardia

overdose = resp depression

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8
Q

how to manage benzo addiction?

A

manage by GP/addiction

convert to diazepam equivalent dose once daily

diazepam 40mgOD

reduce by no more than 10% every 2 weeks

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9
Q

what can counteract benzos overdose?

A

flumazenil 200microgram

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10
Q

psychoactive substance defn?

A

substance that has an effect on CNS

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11
Q

substance dependence

A

continued misuse of a psychoactive substance

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12
Q

ICD 10 diagnostic criteria

A

strong desire / compulsion
difficulties in controlling substance taking behaviour
physiological withdrawal state
tolerance
progressive neglect of alternative pleasures / interests

persisiting with substance

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13
Q

ICD-11 dependence criteria

A

impaired control over substance use

increased precedence of substance use over toher aspects of life

physiological features indicating neuroadaptation

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14
Q

stages of change model who was this made by?

A

prochaska and DiClemente

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15
Q

Prochaska and DiClemente’s stages of change model

A

The five stages of change are precontemplation, contemplation, preparation, action, and maintenance.

can enter and renter again and again
So each relapse is a framework to learn!

16
Q

FRAMES

A

feedback
responsibility for change
advice - to change
menu- of alternative
empathic
self-efficacy

17
Q

screening tool for alcohol use

A

CAGE
audit
fast

18
Q

Ix for alcohol dependence?

A

Bloods: FBC, LFT, B12, folate, U&E, clotting screen, glucose
* Blood alcohol level or breathalyser
* Urine drug screen
* Rating scale (e.g. AUDIT, CIWA-Ar, APQ)
* Severity of Alcohol Dependence Questionnaire (SADQ)

19
Q

charity that can help with alcohol addiction?

A

AA
SMART recovery
change
grow

20
Q

therapy for alcohol addiction

A

Offer psychological intervention (e.g.CBT, behavioural therapy, social network and
environment-based) focused on alcohol-related cognitions

21
Q

DT

A

signs of altered mental status : hallucinations
persecutory auditory

confusion
delusions
severe agitation

22
Q

dt mx

A

short term

23
Q

Acamprosate

A

Acamprosate was thought to be slightly more effective at helping people with alcohol use disorder remain off alcohol

reduces craving

24
Q

Naltrexone

A

reduces dopamine release

25
Q

wernickes and korsakoff

A

vit b1 deficiency
wernickes is reversible

26
Q

wernickes symptoms

A

triad
confusion

opthamoplegia
ataxia

27
Q

korsakoff

A

excessive anterograde and retrograde amnesia

frontal lobe dysfunction > confabulation

psychotuc symptoms : may require institutionalisation

28
Q

Community-based assisted withdrawal (best option)

A
  • This can be done through organisations like CGL (Change, Grow, Live)
  • Usually 2-4 meetings in the first week
  • If complex, may need up to 4-7 days per week over a 3-week period
29
Q

acute mx of opiate overdose?

A

abc approach
airway and IV fluids
IV nalozone > short acting antagonist prevents opiates binding

30
Q

opiate substitution therapy

A

buprenorphine
methadone

31
Q

methadone

A

long acting
half life 24 hours

s/e lethargy

32
Q

buprenorphine

A

partial agonist
long half life

competes with opiates in brain

risk of respiratory depression

less sedating
less euphoric
less risk of respiratory depression

33
Q

opiate withdrawal is it lethal

A

no

flu like
tremor
tachy and hypertension
hot / cold
gi: nausea, diarrhoea, vomiting
dilated pupils
joint pain
anxiety
goosebumps / piloerection

34
Q

recommended alcohol intake?

A

drink no more than 14 units of alcohol a week

6 medium glasses of wine

6 pints of beer

across 3 days at least

35
Q

what is binge drinking?

A

5 or more drinks in 2 hours
4 or more in 2 hours

> 35 units per week

36
Q
A

Year 5-Psychiatry (19 decks)

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