Substance Use and Addictions Pt.2 Flashcards

1
Q

unit equation for alcohol

A

% strength x ml /1000 = units

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2
Q

safe recommended limits for men and women (alcohol) a week

A

14 units per week

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3
Q

excretion rate of alcohol

A

1 unit per hour

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4
Q

signs of harmful use or dependency of alcohol

A

drink in morning, hot/sweaty, retching, abdo pain, tremor, loss of control, restricted interests, distressed if can’t get alcohol

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5
Q

opiate withdrawal symptoms

A
Tachycardia
Sweating
Restlessness
Dilated pupils
Bone aches
Runny nose
GI upset
Tremor
Yawning
Anxiety/Irritability
Gooseflesh skin
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6
Q

criteria for harmful use

A

pattern of substance use that causes damage to health, damage may be: (1) physical or (2) mental (NECSAARY FOR DIAGNOSIS), adverse social consequences, includes bingeing on substances. Does not include ‘hangover’ alone,

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7
Q

can a patient have a diagnosis of both harmful use and dependence?

A

no

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8
Q

history taking in addiction

A
presenting complaint
history of presenting complaint
substance misuse history
family history
psychiatric comorbidity
social history
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9
Q

substance misuse history

A

Length of current use and when last used.
Current amount and for how long at this level.
Total length of use, max use, and any periods of abstinence.
Mode/method of use
Evidence of withdrawals and severity
Any previous treatments
Any previous substance overdoses
Assess triggers to use substances/alcohol
Assess motivation to change/engage in treatment

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10
Q

common comorbid conditions in addiction

A
Depression
Anxiety
Suicidality
Personality Disorder
PTSD
Bipolar Disorder
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11
Q

list major causes of morbidity and mortality

associated with substance abuse

A
Trauma (e.g. fractures)
Road Traffic Accidents
Homicide
Suicide
Overdose (deliberate, and frequently accidental)
Cirrhosis (Alcohol)
Endocarditis (IV)
Abscesses (IV)
BBV: Hepatitis B/C & HIV (IV)
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12
Q

aspects of examination specific to alcohol

A

Comment on the presence of jaundice, anaemia, clubbing, cyanosis, oedema, ascites, lymphadenopathy, DVT

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13
Q

aspects of examination specific to opioids

A
Collapsed veins / track marks
Endocarditis 
Skin abscesses
Hepatitis / HIV
Pneumonia
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14
Q

CAGE screening for alcohol

A

ever felt the need Cut down?
have people annoyed you by criticizing your drinking?
ever felt Guilty about drinking?
ever felt you needed a drink first thing in the morning (Eye-opener)?

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15
Q

is opiate or alcohol withdrawal more dangerous?

A

alcohol

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16
Q

what withdrawal sign is considered a medical emergency?

A

delirium tremens

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17
Q

onset of alcohol withdrawal is usually?

18
Q

what happens as withdrawal continues?

A

worsening pattern of symptoms

19
Q

what effect do opioids have?

A

analgesic

euphoric

20
Q

what receptors are affected by opiates?

A

opioid receptors mu, delta, kappa

21
Q

list opioid agonists

A

heroin
methadone
fentanyl
codeine

22
Q

list partial opioid agonists

A

buprenorphine

23
Q

list opioid antagonists

A

naltrexone

24
Q

define opiate

A

refer to naturalopioidssuch as morphineandcodeine, and heroin to some extent

25
define opioid
refer to all natural, semisynthetic, and synthetic opioids
26
list natural opioids
opium morphine codeine thebaine
27
list synthetic opioids
fentanyl pethidine methadone tramadol
28
list semi-synthetic opioids
heroin hydrocodone oxycodone hydromorphone
29
signs of opiate overdose
not moving and can't be woken, slow or no breathing, choking, gurgling or snoring, tiny pupils, clammy or cold skin, blue lips and blue nails
30
management of opiate overdose
inject naloxone into upper arm or thigh or nasal spray > if no response after 3 mins > repeat, provide airway support, recovery position
31
list alcohol abstinence drugs
acamprosate disulfiram naltrexone nalmefene
32
list alcohol detox regimes
benzodiazepines
33
list opioid abstinence drugs
methadone | buprenorphine
34
opioid detox regime
maintenance treatment for at least 12 months to sustain changes > lifestyle reduction
35
list benzos/G drugs abstinence regime
maintenance on diazepam with reducing regime
36
benzos/G drugs detox regime
baclofen (GABA agonist) | benzos
37
G drugs refers to what?
GHB (gamma hydroxybutyrate) | GBL (gamma butyrolactone)
38
G should never be mixed with?
alcohol | can be fatal
39
effects of G
depressants produces a high in small doses sedation at higher doses
40
what do people report the effects of G to be?
euphoria loss of inhibitions increased confidence higher sex drive
41
which G drug is a precursor?
GBL precursor to GHB