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Pharmacy 409 exam > Alcohol abuse > Flashcards

Alcohol abuse Flashcards

(42 cards)

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1
Q

What is 1 standard drink? (4 points)

A
  • 10g alcohol
  • 1 port/sherry/small glass wine
  • 1 nip cocktail
  • 1 small glass beer
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2
Q

What are the safe alcohol limits for women to reduce long term health risks? (3 points)

A
  • No more than 2 SD daily
  • No more than 10 SD a week
  • at least 2 alcohol free days/week
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3
Q

What are the safe alcohol limits for women to reduce risk of injury?

A

-no more than 4 SD on any single occassion

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4
Q

What are the safe alcohol limits for men to reduce long term health risks? (3 points)

A
  • No more than 3 SD daily
  • no more than 15 SD a week
  • at least 2 alcohol free days per week
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5
Q

What are the safe alcohol limits for men to reduce risk of injury?

A

-no more than 5 SD on any single occassion

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6
Q

When is alcohol consumption more risky? (6 points)

A
  • Pregnancy: risk of birth defects is greater. No safe drinking limit in pregnancy
  • Thin people, young people, older people: metabolise alcohol slower
  • Alcohol dependant
  • Strong family Hx of alcoholism
  • Are, or have been dependant on other drugs
  • Poor diet, or are under-nourished
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7
Q

What activities are alcohol consumption more risky in? (6 points)

A
  • When driving, operating machinery
  • Boating, scuba driving etc
  • with medication: sedatives, antidepressants, narcotics, NSAIDs,
  • acute/chronic physical disease
  • recovering from an accident, injury or operation
  • mental illness
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8
Q

How do we define problematic drinking? (2 points)

A
  • traditionally binary view,

- spectrum view more informative and less judgmental

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9
Q

What are the main categories on the alcohol continuum use? (6 points)

A
  • no use
  • moderate
  • problematic
  • hazardous
  • harmful
  • dependence
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10
Q

What is moderate use? (2 points)

A
  • experimental use/social use

- no major problems

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11
Q

What is problematic use? (3 points)

A

some problems such as:

  • missed work
  • comedown/hangover
  • family/whanau quarrels
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12
Q

What is hazardous use? (2 points)

A

problems AND increased risk of long term harm such as:

  • relationship problems
  • crime
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13
Q

What is harmful use? (4 points)

A

Problems AND increased risk of harm and long term damage such as :

  • health
  • violence
  • break ups
  • loss of job
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14
Q

What is dependence? (5 points)

A

All problems AND 3 or more of:

  • withdrawal
  • using to relieve withdrawal
  • not able to predict/control use
  • persist despite harm
  • rapid return to dependence if relapse after abstinence
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15
Q

What are the 4L problem areas?

A
  • Liver: (health problems)
  • Lover: relationship problems
  • Livelihood: employment-related issues
  • Law: legal problems
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16
Q

What treatments are available for dependent drinking? (4 points)

A
  • medication supported detox to manage withdrawal
  • management of craving
  • Psychosocial support
  • prevent vitamin B deficiency
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17
Q

What is alcohol withdrawal? (5 points)

Study These Flashcards
A
  • affects 50% of dependent individuals
  • onset 6-24 hours
  • peaks 48 hours
  • most severe Sx (delirium tremens) occurs after 3-7 days
  • severe withdrawal can last up to 10 days
18
Q

What are the withdrawal signs and symptoms? (9 points)

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A
  • Tremor
  • Sweating
  • Anxiety
  • N&V
  • diarrhoea
  • insomnia
  • tachycardia
  • Hypertension
  • dehydration
19
Q

What are examples of severe alcohol withdrawal? (3 points)

Study These Flashcards
A
  • seizures
  • hallucinations
  • confusion
20
Q

What is delirium tremens? (9 points)

Study These Flashcards
A
  • occurs 2-5 after cessation
  • lasts 3-14 days
  • autonomic instability
  • paranoid delusions
  • hypersensitivity to stimuli
  • hallucinations (usually visual)
  • confusion and disorientation
  • agitation
  • exclude head injury, sepsis etc.
21
Q

What is detoxification?

Study These Flashcards
A

short course medicine to prevent withdrawal symptoms when stopping alcohol

22
Q

What does detox allow? (4 points)

Study These Flashcards
A
  • proactively apply motivational techniques
  • facilitate insight building
  • explore opportunities for after care
  • facilitate links and transfer to aftercare
23
Q

What medications are used in detox? (5 points)

Study These Flashcards
A
  • long acting benzo like diazepam

- start Tx early, when breath alcohol

24
Q

What causes weincke encephalopathy and korsakoff syndrome?

Study These Flashcards
A

thiamine deficiency (vitamin B1)

25
What are the symptoms of Wernicke's? (3 points)
- eye movement abnormalities - imbalance/other cerebellar signs - confusion
26
What are the symptoms of Korsakoff? (5 points)
- memory - blackouts - minimal content in conversation - lack of insight - apathy
27
How is WE and KS treated and prevented? (2 points)
- Tx: B1 injection, nutrition and hydration. May be irreversible - Prevention: healthy diet, thiamine supplements, may reduce development of WKS
28
What are some pharmacological supports for abstinence? (2 points)
- Antabuse | - Naltrexone
29
How does Antabuse work? (4 points)
- causes disulfiram reaction by inhibiting adlehyde dehydrogenase - results in build up of acetaldehyde which is toxic - within 5-30min of alcohol, hot flushes, throbbing of head and neck occur. - Lasts up to several hours and may be ill for several days
30
Is disulfiram effective? (2 points)
- does not reduce craving for alcohol, but likely to deter drinking - best with psychosocial support
31
What are the contraindications to disulfiram? (5 points)
- frailty - Hx serious heart disease - pregnancy - advanced liver disease - psychotic illness, severe personality disorder, risk of suicide
32
What cautions should be taken with disulfiram use? (5 points)
- may interact with metronidazole, isoniazid - warn about sauces, mouthwash, cough mixtures, perfume, aftershave - Px must be alcohol free for at least 24 hours - must have full Px consent, disulfiram reaction explained, Family informed - 3 weeks washout period if they want to drink again.
33
How does naltrexone work? (4 points)
- opioid antagonist which can be used after detox - reduces craving for alcohol - reduces feeling of intoxication - reduces continuation of drinking
34
How much naltrexone is given? (2 points)
- 50mg daily - initial dosage for Px at risk of ADRs are 12.5mg/day or 25mg/day for 1 week taken with food (2 weeks if necessary); then gradually increase to 50mg/day
35
Why does naltrexone work with alcohol abstinence?
-alcohol facilitates the brain opioid systems
36
What are the side effects and C/Is with naltrexone? (5 points)
- nausea, headache, dizziness, fatigue, insomnia, anxiety, sleepiness - usually mild and short duration - can have toxic effects on liver so LFTs are performed before Tx - C/Ied in Px receiving opioid analgesics - SA required for Px in Tx programmes
37
What is Audit C? (3 points)
- screening tool to identify Px who are risky drinkers - enables health professionals to bring up the conversation without stigmatising and judging them - total of 5+ indicates increasing or higher risk drinking: auditC positive
38
What are the questions in the shortened version of audit C? (3 points)
- how often do you have a drink containing alcohol? - how many units of alcohol do you drink on a typical day when you are drinking - how often hae you had 6+ units if female, or 8+ if male, on a single occasion in the lats year?
39
Once Px have been screened, what can we do? (5 points)
- determine how harmful the drinking currently is - advise or refer - willingness to change (HCPs and patients) - teachable moments - appropriate environment
40
What is the NNT for alcohol interventions?
-for every 7 interventions, 1 Px will reduce drinking to safer levels
41
What brief advice can you give to Px? (5 points)
- explain units/guidelines - give feedback (risk level) - offer info/advice - establish goals/strategies - empathy and encouragement
42
What are some barriers to alcohol intervention in pharmacies? (5 points)
- preventative health not my responsibility - screening/brief intervention are not the things i should be doing - don't know who to refer to - Px won't take my advice and change their drinking behaviour

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