Chapter 4 - Substance Dependance Flashcards Preview

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Flashcards in Chapter 4 - Substance Dependance Deck (23)
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1

List some dangerous alcohol withdrawal symptoms

Seizures
Delerium tremens
Death

2

What is used to treat alcohol withdrawal seizures?

Fast acting benzodiazepines e.g. lorazepam

3

With regards to assisted alcohol withdrawal, what is a fixed dosing reducing regime?

Reducing the dose over 7-10 days

4

With regards to assisted alcohol withdrawal, what is a symptom triggered regime?

The reducing dose is determined by the patients withdrawal symptoms

5

What treatment options are available for assisted alcohol withdrawal?

Long acting benzodiazepines e.g. diazepam, chlordiazepoxide

Carbamazepine

Chlormethiazole

6

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

7

What is delerium tremens and how is it managed?

A medical emergency caused by alcohol withdrawal

It is managed with oral lorazepam

8

What drugs are used to prevent relapse in alcohol dependence?

Acamprostate
Naltrexone
Disulfiram

9

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

10

What should be given to patients with suspected Wernicke’s encephalopathy?

Parenteral thiamine
Followed by oral thiamine

11

Why should oral thiamine be given to dependant drinkers in acute alcohol withdrawal?

To prevent Wernickes encephalopathy

12

If a patient who is taking disilfiram for the maintenance of abstinence in alcohol dependence wants a non-alcoholic beer, can they have it?

No
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

13

Which drugs are usually used for opioid substitution therapy?

Methadone
Buprenorphine

14

If a patient has missed 2 days of their methadone, can they still have their methadone?

Yes
If they have missed 3 or more doses then they can’t continue to have it

15

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

16

What is more sedating, buprenorphine or methadone?

Buprenorphine

17

What is lofexidine used for?

To manage opioid withdrawal symptoms

18

When can the following drugs be taken after heroin:
a) buprenorphine
b) methadone

a) 6-12 hours
b) 8 hours

19

What is preferred in pregnancy, acute opioid withdrawal or opioid substitution therapy?

Opioid substitution therapy
This is safer for the foetus

20

List some symptoms of nicotine withdrawal

Cravings
Weight gain
Irritability
Sleep disturbances
Poor concentration

21

What drug treatment is available to help patients stop smoking?

Vareniciline
Bupropion
Nicotine replacement therapy

22

Which formulation is long acting nicotine replacement therapy?

Patch
Apply for 16 hours and leave off overnight

23

Which formulations are short acting nicotine replacement therapy?

Lozenge
Gum
Nasal spray
Oral spray

These are taken when there is a craving