Flashcards in Chapter 4 - Substance Dependance Deck (23)
List some dangerous alcohol withdrawal symptoms
What is used to treat alcohol withdrawal seizures?
Fast acting benzodiazepines e.g. lorazepam
With regards to assisted alcohol withdrawal, what is a fixed dosing reducing regime?
Reducing the dose over 7-10 days
With regards to assisted alcohol withdrawal, what is a symptom triggered regime?
The reducing dose is determined by the patients withdrawal symptoms
What treatment options are available for assisted alcohol withdrawal?
Long acting benzodiazepines e.g. diazepam, chlordiazepoxide
Why should chlormethiazole only be used in patients who are not likely to continue to drink alcohol?
There is a risk of fatal respiratory depression when chlormethiazole is combined with alcohol
What is delerium tremens and how is it managed?
A medical emergency caused by alcohol withdrawal
It is managed with oral lorazepam
What drugs are used to prevent relapse in alcohol dependence?
When is nalmefene used to reduce alcohol consumption in alcohol dependence?
When the patient has a high drinking level
When there aren’t any physical withdrawal symptoms
When there isn’t an immediate need for detoxification
What should be given to patients with suspected Wernicke’s encephalopathy?
Followed by oral thiamine
Why should oral thiamine be given to dependant drinkers in acute alcohol withdrawal?
To prevent Wernickes encephalopathy
If a patient who is taking disilfiram for the maintenance of abstinence in alcohol dependence wants a non-alcoholic beer, can they have it?
People taking disulfiram need to abstain from alcohol completely
Even in alcohol free beer, there is still a small amount of alcohol. This is enough to cause a disulfiram-alcohol reaction which may be life threatening
If a patient is still drinking alcohol, naltrexone or acamprostate will be more appropriate
Which drugs are usually used for opioid substitution therapy?
If a patient has missed 2 days of their methadone, can they still have their methadone?
If they have missed 3 or more doses then they can’t continue to have it
Why can’t patients who have missed over 3 days of their methadone continue at that dose?
Risk of overdose due to a loss of tolerance
What is more sedating, buprenorphine or methadone?
What is lofexidine used for?
To manage opioid withdrawal symptoms
When can the following drugs be taken after heroin:
a) 6-12 hours
b) 8 hours
What is preferred in pregnancy, acute opioid withdrawal or opioid substitution therapy?
Opioid substitution therapy
This is safer for the foetus
List some symptoms of nicotine withdrawal
What drug treatment is available to help patients stop smoking?
Nicotine replacement therapy
Which formulation is long acting nicotine replacement therapy?
Apply for 16 hours and leave off overnight