addiction

Question 1

problems from heroin

Answer 1

N&V, constipation, respiratory depression, LOC. injections- local abscess, cellulitis, osteomyelitis, septicaemia

Question 2

acute problems from benzos

Answer 2

forgetful, drowsy, impaired concentration. IV- limb ischaemia

Question 3

what does cocaine potentiate (neurotransmitters)

Answer 3

dopamine, serotonin and NA and blocks their reuptake

Question 4

long term effects of stimulants

Answer 4

dependence, anxiety, irritability and restlessness, mood disturbances, psychosis

Question 5

medical side effects stimulants

Answer 5

cardiac arrhythmias, MI, chest pain, resp arrest, CVAs, headache, epileptic seizure

Question 6

what does MDMA do to neurotransmitters

Answer 6

increase serotonin

Question 7

how long can urine tests stay +ve after cannabis

Answer 7

1 month

Question 8

side effects of cannabis

Answer 8

paranoia, panic attacks, delayed reaction times, chronic- dysthmic, anxiety, amotivational syndrome

Question 9

side effects anabolic steroids

Answer 9

hypertension, hypogonadism, gynaecomastia, amenorrhoea, liver damage, impotence, aggressive, fatigue

Question 10

opiate detox what drugs can be used

Answer 10

methadone 50-100mg a day. buprenorphine 16mg a day

Question 11

symptomatic medication used in detox

Answer 11

lofexidine, loperamide

Question 12

what medication is used post detox once opiate free

Answer 12

naltrexone

Question 13

what drug is used in opiate overdose

Answer 13

naloxone

Question 14

what happens to tolerance in detox

Answer 14

decreased tolerance so more chance of OD

Question 15

withdrawal symptoms benzos

Answer 15

anxiety, insomnia, tremor, agitation, headache, nausea, sweating, depersonalisation, delirium

Question 16

what can you use to treat benzo withdrawal

Answer 16

diazepam

Question 17

how does methadone work

Answer 17

saturates the opiate receptors in the brain

Question 18

harm reduction drugs

Answer 18

needle exchange, information about infections, infection testing and vaccination

Question 19

how much alcohol can be metabolised per hour

Answer 19

1 unit (8g)

Question 20

where is 98% alcohol metabolised

Answer 20

liver

Question 21

how is alcohol measured

Answer 21

blood alcohol concentration

Question 22

if you have alcohol tolerance what is the relationship between blood alcohol conc and intoxication

Answer 22

high BAC not intoxicated

Question 23

what happens with alcohol and asian people

Answer 23

metabolically inactive form alcohol dehydrogenase, get a flushing reaction

Question 24

complications alcohol misuse

Answer 24

acute toxicity, coma, risk aspiration, hypoglycaemia, acute renal failure. psych- delirium, amnesia, Wernicke Korsakoffs

Question 25

what markers are there in the blood for excess alcohol consumption

Answer 25

incr MCV, Y-GT, CDT

Question 26

assessment patient alcohol misuse

Answer 26

life time pattern, current pattern, signs de[endence, problems related to alcohol, prev treatment attempts, pt goals, FHx

Question 27

advised units for men and women

Answer 27

21 units a week men, 14 women. at least 2 days non drinking

Question 28

withdrawal alcohol

Answer 28

malaise, nausea, autonomic hyperactivity, tremulousness, labile, insomnia, hallucinations, illusions, seizures. delirium tremens in 5%

Question 29

signs of alcohol dependence

Answer 29

CANT SSTOP . compulsion, aware of harms, neglect of other activities, tolerance to alcohol, stopping causes withdrawal, stereotyped pattern of drinking, time preoccupied with alcohol, out of control use, persistent wish to cut down

Question 30

what questionnaire can be used to detect alcohol dependence

Answer 30

CAGE questionnaire- have you tried to Cut down your drinking; have people Annoyed you by suggesting you do so; have you felt Guilty about drinking; have you needed an Eye opener

Question 31

what is foetal alcohol syndrome characterised by

Answer 31

decreased muscle tone, poor coordination, developmental delay, heart defects, a range of facial abnormalities

Question 32

management alcohol addiction

Answer 32

acute detox- in hospital if risk of delirium tremens or seizures, benzo- chlordiazepoxide or diazepam, rehhydration correction of electrolytes, oral or parenteral thiamine

Question 33

how can delirium tremens be treated

Answer 33

lorazepam or antipsychotics- haloperidol, olanzapine

Question 34

what is delirium tremens

Answer 34

psychotic- delirium, tremors, hallucinations, anxiety

Question 35

medication which may help maintain abstinence after detox

Answer 35

disulfiram- blocks alcohol metabolism, acamprosate- works on GABA, naltrexone