Compulsion and Dependence Disorders Flashcards
what is OCD?
recurrent obsessional thoughts and compulsive acts
what are compulsive acts?
repeated rituals or stereotyped behaviour, non enjoyable and functional
what are obsessional thoughts?
ideas/images/impulses enter mind in a stereotypes way, unpleasant and resisted
tx of OCD?
CBT
tricyclic - clomipramine
SSRI
what are the 3 risk categories for alcohol misuse?
high risk >35 a week
increased 15-35 a week
low 14 a week, spread over 3 days
features of alcohol/drug dependence?
desire/compelled to take drug withdrawal state tolerance neglect of other pleasures use despite evidence of harmful consequences
Ix for alcohol dependence?
LFTs (GGT)
MCV
carbohydrate deficient transferrin (MEN)
questionnaires for alcohol dependence?
FAST
features of wernicke’s encephalopathy?
ataxia
opthalmoplegia
nystagmus
reduced consciousness
Tx for alcohol detoxification?
benzodiazepines
thiamine (to prevent WE)
analgesia
antiemetics
what is used for alcohol relapse prevention?
naltrexone
diulfirman
when does alcohol withdrawal state most commonly occur?
24-28hrs from last drink
featurs of alcohol withdrawal state?
tremor sweaty anxiety N+V insomia tachycardia seizures systolic HT
when does alcohol withdrawal state resolve?
5-7days
what is delirium tremens?
rapid onset of confusion caused by alcohol withdrawal
when does delirium tremens occur?
after 2 days of abstinence
features of delirium tremens?
insidious onset night time confusion fever paranoid hallucinations disorientated
why does korsakoff syndrome occur?
hypothalamic damage and cerebral atrophy due to thiamine deficiency
features of korsakoff syndrome?
loss of anterograde memory
lack of insight
lack of apathy
what is used as an opiate substitute?
methadone or buponephrine
how to calculate units of alcohol?
(% x volume) /10
Tx for opiate overdose?
naloxone
what does alcohol withdrawal cause in the brain?
excess glutamate
reduced GABA
what is given to alcoholics to protect against wernicke’s encephalopathy?
thiamine
