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Flashcards in Addiction Deck (12):
1

ICD 10 criteria for addiction

a strong desire to take teh substance
difficulty controling substance use
physiological withdrawl
tolerance
neglact of alternative pleasure
persistance despite evidence of harm

2

how does addiction manifest

natural reward incraeses dopamine. D2 receptors are decreased by addiction as repeated dopamine release causes them to downregulate. so threshold for rewards incraeses

3

how many units a week are recommended

<14

4

indicator of liver injury

GGT

5

describe alcohol wothdrawl

alcohol inhibits the action of excitatory NMDA-glutamate controlled ion channel and potentiates the actions of inhibitory GABA type A controlled channels. Alcohol withdrawal leads to excess glutamate activity and decreased GABA activity. Excess gultamate activity is toxic to nerve cell so acute withdrawal causes CNS excitability and neurotoxiticy

6

symptoms of alcohol withdrawal

symptoms - 6-12 hours - tremor, sweating etc etc
seizures - 36 hours
delirium tremens - 72 hours

7

delerium tremens

nocturnal worsening, clouding of conscioussness, impaired memory, lilliputian hallucinations

8

wernickes encephalopathy

acute confusion, opthalmoplegia and nystagmus, ataxia. leads to irreversible amnetic state. NEEDS PARENTAL B VITAMINS
Give thiamine (B1 vit) 100mg TDS for 4 weeks

9

treatment of alcohol withdrawl syndrome

1st line - benzos - decrease over 7 days, Vit B1 as prophylaxis for wernickes, hydration, antiemetics

10

relapse prevention for alcoholism

CBT
naltrexone - decarese reward. 1st line
acamprostate - decrease cravings

11

managemnt of opiate misuse - detoxification

decrarse prescribed opioids, alpha 2 adrenic agonists - lofexidine

12

opiote substitutes

methodone
buprenoiphone