Week 5 - Paediatrics (A) and Health promotion Flashcards
Outline the NHS recommended low risk’ level of alcohol consumption per week
Men and women: no more than 14 units per week on a regular basis (around 6 pints of beer or 10 small glasses of wine)
Drinking should be spread over 3 days or more
Outline some of the dangers of excess alcohol consumption (acute binge drinking and chronic over 10-20 years)
Binge (single session) drinking:
- Accidents, leading to injury such as head trauma
- Alcohol poisoning
- Misjudging risky situations
- Loss of control, e.g. violence
10-20 years of regularly drinking above the low-risk drinking level (over 14 units per week):
- Cancer: mouth, throat, breast
- Stroke
- Heart disease
- Liver disease
- Damage to brain
- Damage to nervous system
Additional impacts on mental health, including self-harm and suicide
What advice should be given to pregnant women regarding alcohol?
Current guidance: if you are pregnant and think you could become pregnant, safest approach is not to drink at all to keep risk to the baby to a minimum
Drinking in pregnancy can lead to long-term harm to the baby, with the more you drink resulting in greater the risk e.g. foetal alcohol spectrum disorder (severity linked to the amount drunk and the developmental stage of the foetus at the time) or foetal alcohol syndrome leading to restricted growth, behavioural disorders and facial abnormalities
However, the risk of harm to a baby is likely to be low if you have only drunk small amounts of alcohol before you knew you were pregnant
List some medications that have potential interactions with alcohol
Analgesia:
- Paracetamol
- NSAIDs e.g. Ibuprofen
- Opioids e.g. Codeine
Psychological:
- Sedatives e.g. Diazepam
- Antidepressants e.g. Sertraline
- Anticonvulsants e.g. Phenytoin
Cardiovascular:
- Anticoagulants e.g. Warfarin
- Antihypertensives e.g. ACEi
Endocrine:
- Antihyperglycemics e.g. Insulin and Metformin
+ Metronidazole
Name some screening tools for alcohol consumption
CAGE - basic, quick screening tool
AUDIT (classic questionnaire) or SADQ (severity of alcohol dependence questionnaire) - further detail
What vitamin deficiencies are chronic drinkers at risk of and what condition are they at risk of developing?
Mainly thiamine deficiency (vitamin B1), but also other B vitamins
Risk of developing Wernicke’s encephalopathy and Korsakoff syndrome (related to low B1 levels)
Outline some benefits of stopping smoking
Benefits of stopping smoking – benefits begin as soon as smoking is stopped:
- Reduced risk of smoking-related disease e.g. lung cancer, COPD and heart disease
- Reduced smoke risk to those around you including children
- Children in the family much less likely to smoke
- Reduced harms to foetus if pregnant
- Financial saving
List some common withdrawal symptoms from smoking cessation
- Irritability / aggression
- Depression
- Restlessness
- Poor concentration
- Increased appetite
- Lightheadedness
- Disturbed sleep
- Nicotine cravings
State the recommended calorie intake per day for males and females
Males: 2,500 calories / day
Females: 2,000 calories / day
State the NHS recommendations of exercise per week and how it differs for older people and children/younger people
At least:
150 minutes of moderate intensity activity per week
OR 75 minutes of vigorous exercise per week
- Spread evening over 4-5 days a week
- Try to break up periods of sitting down in the day
Older people:
- Same advice, but try to be physically active every day with a focus on improving strength, balance and flexibility
Children:
- Aim for 60 minutes of moderate or vigorous intensity activity per week
- Importance on variety of types and intensity of exercise to increase aerobic capacity and strengthen muscles and bones
List some limitations of the BMI calculation
- Unable to differentiate between excess muscle or fat (discriminates against muscular adults and athletes and older people who lose muscle may be in the healthy range but carrying excess fat)
- Can tell if you’re too heavy, but not if you’re too fat
- Not beneficial in individuals with eating disorders and pregnancy
Outline the BMI categories with the BMI ranges
< 18.5 = underweight
18.5-25 = normal
25-30 = overweight
30-35 = obese
> 35 = morbidly obese
List 3 groups of agents for substance misuse (rough grouping of unregulated drugs)
- Illegal drugs (regulated by law) e.g. Cocaine or Heroin
- Legal highs (not regulated by law) e.g. Spice or bath salts
- Prescription only medications e.g. Opioids such as Morphine, Benzodiazepines
List some groups of people at risk of drug misuse
- Past or present addictions to other substances, including alcohol and tobacco
- Family history of substance abuse problems
- Certain pre-existing mental health conditions
- Peer pressure or a social environment where there’s drug use
- Young people aged 10-18, including those up to 25 with SEND
List 2 drugs used in opioid substitution
Methadone
Buprenorphine
Outline pharmacological and non-pharmacological approaches to treatment of problematic alcohol
Non-pharmacological:
- Short counselling session (initial step)
- Self-help groups e.g. alcoholics anonymous
- 12-step facilitation therapy (one on one AA meeting)
- CBT
- Family therapy
- At home detoxification (or hospital/clinic +/- Chlordiazepoxide medication)
Pharmacological:
Acamprosate - help prevents relapse in people who have achieved abstinence, to reduce craving (affects GABA signalling)
Disulfiram - stimulates unpleasant reaction to alcohol
Naltrexone or Nalmefene - help prevents relapse or limits drinking by blocking opioid receptors
Outline pharmacological and non-pharmacological approaches to treatment of smoking cessation
Non-pharmacological:
- NHS Quit Smoking app
- Vaping (not provided on NHS prescription)
- Quit smoking support groups
- Free National Smokefree Helpline
Pharmacological:
- Nicotine replacement therapy e.g. patch, nasal spray, chewing gum, losange, inhaler, sublingual microtabs
- Tablets Varenicline (nicotinic receptor partial agonist) or Bupropion (antidepressant)
