Which percentage of the population drink half of all alcohol consumed in the UK?
Which groups of the population have the highest rates of drinking?
20 - 30
What is a unit of alcohol?
10ml of pure alcohol
What is a high risk drinker?
Someone who consumes > 14 units of alcohol per week
What are the UK guidelines for alcohol consumption?
< 14 units per week
Ideally spread throughout the week
With at least three drink-free days
The harm caused by excessive alcohol consumption may be ___, ___ or ___.
As alcohol is an ___ drug, you can become ___ on it.
According to the ICD-10, what are some signs of dependence on an addictive drug?
Strong desire to take drug
Difficulty stopping once you've started
Persistent use despite evidence of harm (physical, psychological, social)
Neglect of other interests
Development of tolerance
Physiological withdrawal state if abstinent
Which tools can be used to detect harmful drinking in a patient?
CAGE questionnaire - cut down, annoyed, guilty, eye-opener
Which tool is most commonly used in Scotland to detect harmful drinking?
In alcoholic liver disease, which liver enzymes may be raised?
(AST > ALT because you're wASTed)
How can you raise the issue of harmful alcohol consumption in a consultation?
same as with smoking
Which tool is used to measure a patient's alcohol dependence?
severity of alcohol dependence questionnaire
The greater your AUDIT and SADQ scores, the greater the ___ you need.
What are specialist interventions for alcohol dependence?
Alcohol is a (stimulant / depressant).
Which receptor does alcohol inhibit?
NMDA-glutamate (excitatory receptor, remember alcohol is a depressant)
Which receptor does alcohol stimulate?
GABA (inhibitory receptor)
Which receptors are
in chronic alcoholism?
a) Inhibitory receptors are downregulated due to overstimulation
b) Excitatory receptors are upregulated due to inhibition, leading to anxiety, dysphoria and seizures
What happens to dependent patients who don't consume alcohol?
What are some physical symptoms of acute alcohol withdrawal?
What occurs within 3 - 5 days of alcohol withdrawal syndrome?
Seizures, may be fatal
How is alcohol withdrawal syndrome managed?
Benzodiazepines (diazepam, chlordiazepoxide)
Vitamin supplementation (e.g thiamine; vit b1 to prevent encephalopathy)
Which vitamin deficiency can present in alcoholism?
Which neuro problems are caused by
a) Wernicke's encephalopathy (reversible)
b) Korsakoff syndrome (irreversible)
What is the name of the Vitamin B1 supplement given to alcohol withdrawal patients?
What is disulfiram?
Acetaldehyde dehydrogenase inhibitor
Makes patients feel crap when they drink alcohol (flushing, nausea)
What drugs, given for alcohol misuse disorders, reduce
a) alcohol cravings
b) alcohol's rewarding effects?
a) Naltrexone - craviNgs
b) Acamprosate - rewArd