substance use disorder-alcohol

Question 1

drug abuse definition

Answer 1

continued and prolonged drug use giving rise to functional impairment(social complications like relationship probs, occupational probs,financial probs,recurrent hazardous use,recurrent legal problems

Question 2

drug dependence

Answer 2

continued and prolonged drug use giving rise to both loss of function and loss of control over the drug use.

loss of ctrl indicated by:
1.craving
2.drug seeking behaviour
3.priority in life
4.development of physical and psychiatric complications due to drug use and continued drug use despite the knowledge that the complications and exacerbations are due to the drug use
5.tolerance
6.withdrawal

Question 3

tolerance definition

Answer 3

the need to increase the amount of the drug to achieve the desired effect as there is diminished effect with the previous dose

Question 4

withdrawal symptoms definitions

Answer 4

the dev of unpleasant physical and mental symp on abstinence of the drug and relief of the symptoms on taking back the drug

Question 5

components of HOPI

Answer 5

1.establishing pattern of use: abuse/dependence?
2.complications due to substance use
-social complications due to substance use
-psychiatric complications: intoxication,withdrawal,delirium,dementia,amnestic disorder,psychosis,mood changes,anxiety,personality change,sleep disorder
-any medical complications due to prolonged substance use
-any psychiatric disorders that comorbid with substance use (depression,anxiety disorders,mania,schizo)

Question 6

establish pattern of alcohol use

Answer 6

1.reason for initial alcohol use

2. reason for cont alcohol use but within limits(type of liquor,freq)

3.excessive alcohol use that causes no problems (at risk drinking)

4.is there any reason for excessive drinking?consider underlying psychiatric illness

5.excessive alcohol use which is causing social problems

6.elicit symptoms of dependence

Question 7

elicit craving

Answer 7

over time did u dev a persistent and intense desire to take alcohol resulting in heavy and frequent use

Question 8

elicit subjective awareness of loss of ctrl over drinking

Answer 8

did u feel that u have lost ctrl over your drinking?

Question 9

elicit priority in life

Answer 9

did u have a persistent desire to cut down your drinking but unsuccessful? did u neglect all duties, responsibilities and recreational activities to obtain alcohol

Question 10

elicit drug seeking behaviour

Answer 10

did u spend a lot of time in activities to obtain alcohol.beg,borrow or even steal for a drink

Question 11

elicit tolerance

Answer 11

over time did u increase the amount of alcohol consumed or switch to hard liqour to achieve desired effects as the usual amount becomes ineffective

Question 12

elicit withdrawal symp

Answer 12

have u tried to stop/reduce drinking?when doing so did u experience umpleasant mental symptoms like anxiety,depression,irritability,physical symptoms such as palpitation,tremors,sweating and sleep problems?
are your symptoms relieved by further drinking?

Question 13

elicit social complications

Answer 13

because of your drinking did u face any:

-relationship prob( marital,spouse abuse,child abuse,interpersonal)

-occupational prob (absenteeism,poor work performance,job termination

-financial prob-debts,poverty

-hazardous use-accidents,fall

-law breaking behaviour- stealing,violence,fights,sexual offenses,serious crimes

-vagrancy-homeless and landing on the streets

Question 14

alimentary system symptoms

Answer 14

-abdominal pain (peptic ulcer disease,alcohol liver disease,pancreatitis)

-jaundice

-vomiting blood( peptic ulcer,esophageal varices,Mallory-Weiss syndrome,vitamin K deficiency)

-nutritional deficiencies due to malnourishment,
malabsorption and blood loss ( anaemia,
avitaminosis,
hypoglycaemia)

Question 15

neuro symptoms

Answer 15

head injuries
confusions
memory prob
tremors
epilepsy
impotence
peripheral neuropathy
cerebellar symptoms:DANISH
Dysdiadokokinesis
Ataxic gait
Nystagmus
Intention tremor
Slurred speech
Hypotonia

Question 16

heart disease

Answer 16

shortness of breath due to cardiomyopathy and cardiac failure

Question 17

alcohol use during pregnancy:foetal alcohol syndrome

Answer 17

mental retardation
retarded growth
craniofacial,limb,cardiovascular defects

Question 18

psychiatric disorders/comp

Answer 18

depressive symptoms

suicidal attempts

delusion of infidelity/jealousy

alcoholic hallucinosis- deragatory
auditory hallucination

amnesia-korsakoff psychosis

personality change

sleep disorder: hypersomnia due to intoxication,rebound insomnia due to withdrawal,rebound REM sleep-excessive dream and nightmares during withdrawal,rebound anxiety

Question 19

alcohol detoxification

Answer 19

treating alcohol withdrawal and alcohol withdrawal delirium/delirium tremens

Question 20

alcohol withdrawal symp

Answer 20

ANS hyperactivity
-palpitaion,sweating,tremors,insomnia,anxiety,agitation,abdominal symptoms,rum fits

Question 21

delirium tremens symp

Answer 21

-clouded consciousness + ANS hyperactivity
-disorientation to time,place, and person
-unresponsive
-poor attention
-sundowning (more active at night,sleepy in the morning)
-illusions and hallucinations: Liliputian hallucination,tactile hallucination,insects crawling on skin(formication)

Question 22

CAGE questionaire- detect problem drinkers/ at risk drinkers fr social drinkers

Answer 22

Cut
-have u ever felt that u should cut down on your drinking

Annoyed
-have u ever felt annoyed when anyone criticised your drinking

Guilt
- have u felt guilty about your drinking

Eye-opener
have u ever had morning drinking as an eye-opener

2/4 (2 positive answer suggest problem drinker)

Question 23

good prognostic factor in alcohol dependence

Answer 23

high motivation
stable background
supportive fam

Question 24

bad prognostic factor

Answer 24

poor insight,low motivation
unemployment
illiteracy
uncupportive family
young patient
anti-social personality disorders
criminal records
polydrug abuse
comorbid psychiatric disorders