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General Practice YR3 > Health Promotion > Flashcards

Health Promotion Flashcards

1
Q

Advice NHS on alcohol

A
  • Men and women advised to drink no more than 14 units per week
  • Spread them over at least 3 days
  • To cut down, try to have several drink free nights in the week
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2
Q

How to work out units?

A

Alcohol % x mls /1000

Or alcohol % = that many units in 1L

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3
Q

Dangers excessive alcohol consumption

A
  • Mouth, throat or breast cancer
  • Stroke
  • heart disease
  • Liver disease
  • brain damage
  • damage to nervous system
  • Worsening mental health
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4
Q

Why is alcohol limit per week called ‘low risk’ and not safe?

A

There is no safe level of alcohol to drink

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5
Q

Dangers of binge drinking

A
  • Accidents resulting in injury and even death
  • Misjudging risky situations
  • Losing self control - unprotected sex or violence
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6
Q

Advice to pregnant women re alcohol

A
  • Recommended to not drink alcohol - if trying to conceive or pregnant
  • Alcohol crosses placenta
  • Increase risk miscarriage, low birth weight and premature delivery
  • Foetal alcohol spectrum disorder - lifelong
  • FASD can cause behavioural problems, joints/bones/muscle probs, regulating emotions problems, speech problems
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7
Q

Support for stopping alcohol

A
  • Alcoholics anonymous
  • Al-Anon family groups
  • We are with you
  • Adfam
  • SMART recovery
  • National association for children of alcoholics
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8
Q
A
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9
Q

How to keep risks low when drinking on single occasion?

A
  • limit amount of alcohol
  • drink more slowly
  • drink with food
  • alternate with water
  • plan ahead to avoid problems eg make sure you can get home
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10
Q

Advice for if pregnant woman has drunk in early pregnancy without knowing

A
  • unlikely that baby has suffered harm
  • avoid further drinking
  • if you are concerned speak to doctor or midwife
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11
Q

Alcohol risk and medication - why at more risk as we age

A
  • metabolise alcohol differently - less able to break it down, more sensitive to toxic effects
  • reacting badly with medication - more likely to be taking medication as you age
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12
Q

Warnings on medication if not to take with alcohol/other warnings

A

Do not drink alcohol
This medicine may make you sleepy
Do not drive or use tools

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13
Q

Normal units in typical drinks

A
  • pint lower strength- 2.2
  • can average strength (440ml) - 2
  • small glass wine - 1.5
  • single shot - 1.4
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14
Q

Medication groups that react bad with alcohol - can alter blood levels or impair judgement

A
  • Sedatives - increases effects of both
  • Pain killers - increase risk overdose of both drug and alcohol
  • antidepressants - makes depression symptoms worse
  • Anticoagulants - increase risk bleeding
  • Antihyperglycaemics - difficult to spot signs of hypoglycaemia
  • anticonvulsants - drowsy
  • Antihypertensives - alcohol can raise BP and reduce effectiveness of medication
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15
Q

What is harmful drinking?

A

Pattern of alcohol consumption causing health problems directly related to drinking alcohol
Psychological, accidents or illness or long term conditions eg cirrhosis, cancer etc

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16
Q

What is alcohol dependence?

A

Craving, tolerance, a preoccupation with alcohol and continued drinking despite harmful consequences (eg liver disease)

Associated with increased criminal activity, DV and increase rate mental and physical disorders

Exists on a scale of severity - mild, moderate and severe (SADQ questionnaire)

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17
Q

Screening took in primary care for alcohol dependence

A

CAGE questionnaire

If score 2 or more prompt more detailed questioning eg AUDIT for high risk alcohol use or SADQ for alcohol dependence

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18
Q

Principles of care for those with alcohol dependence

A
  • Build trusting relationship and provide information
  • Work with and support families and carers
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19
Q

Principles of assessment of alcohol dependence

A
  • assess severity using a tool eg SADQ, AUDIT, CIWA-Ar for withdrawal
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20
Q

Treatment goals of alcohol dependence

A

Abstinence is appropriate for most

Consider moderate level if mild dependence or harmful drinking if there is adequate support

Harm reduction is considered when severe dependence who are unwilling to consider abstinence as goal despite significant co-morbidity

21
Q

When to consider comprehensive assessment?

A

Referred to specialists services who score more than 15 on AUDIT

22
Q

Interventions for harmful drinking and mild dependence

A

CBT
Behavioural couples therapy
Acamprosate or oral naltrexone if psych not worked

23
Q

When to consider referral for assisted alcohol withdrawal

A

Over 15 units per day +/- score more than 20 on AUDIT need to go to community withdrawal
Or specialist services if there are safety concerns

24
Q

Serious risk of excess alcohol consumption

A

Wernickes encephalopathy
Korsakoff syndrome
Related to low thiamine

Also at risk of other vit B deficiencies

Prescribe thiamine and other vitamin B preps to prevent this

25
Q

Benefits of smoking cessation

A
  • Reduce risk of death and ill health due to smoking related diseases, esp lung cancer COPD and heart disease
  • stopping smoking 60,50,40,30 adds about 3,6,9,10 years into life
  • reduces harm to children exposed to environment smoke
  • children living with parents who smoke are almost 3x more likely to smoke than others
  • no safe level during pregnancy
  • table which shows time since quitting and effects - even 72hrs after breathing is easier
26
Q

Withdrawal symptoms of stopping smoking

A

Irritability
Frustration
Anger
Difficulty conc
Increased appetite
Depressed mood
Insomnia
Restlessness

27
Q

Options for stopping smoking - non pharmacy

A

Inform Cravings set off by stress, others smoking or intoxication
-
Manage cravings with talking to friends or family, short exercise, keeping busy (eg smokefree app) or changing environment
-
One step abrupt quitting by a certain date is better - not a puff rule - otherwise relapse is likely
-
Smoke free national helpline
QUIT - telephone support
ASH - action on smoking and health website

28
Q

Options for stopping smoking - pharm

A

Nicotine replacement therapy - eg patches, sprays, lozenges, gum
Or Bupropion
-
Patch works for background cravings (eg 16hrs or 24hr patch if wake up and want to smoke)
Then need fast acter like spray or lozenge
If ask for e cigs recommend another

29
Q

If a person does not want to give up smoking, what are the harm reduction stratergies that can be used?

A
  • Stopping smoking but continue to use NRT
  • Cutting down before stopping +/- NRT
  • Smoking reduction +/- NRT
  • Temporary abstinence +/- NRT
  • Better to use NRT to cut down on how much they smoke rather than continue smoking as they are
30
Q

How safe are vaping devices?

A
  • Less harmful than cigarettes
  • Not recommended for non-smokers
  • They do not produce tar or carbon monoxide
  • Regulated for UK
31
Q

Do vapes have a role in helping people stop smoking?

A

Yes - lots of evidence shows people have successfully stopped by managing nicotine cravings with e-cigs

32
Q

Recommended calorie intake for male and females

A

2000 women
2,500 men

33
Q

Proportions of different foods on eat well plate

A
  • Fruit and veg - 5 portions, just over 1/3 of total what we eat
  • Starchy foods - just over 1/3
  • Protein - 2 portions fish weekly (1 should be oily)
  • Dairy
  • Fats

Last 1/3rd is split between mostly protein, then dairy then fats

34
Q

5 a day recommendations for fruit and veg

A
  • Portion is 80g
  • Minimum 400g fruit and veg (altogether) per day
  • Lowers risk stroke, heart disease and cancer
35
Q

Why eat 5 a day?

A
  • Good source vitamins and potassium
  • Source of fibre - prevent constipation, reduce risk bowel cancer
  • Reduce risk heart disease, stroke and cancer
  • Delicious, lots of variety
36
Q

Recommendations for exercise from NHS

A
  • Do some physical activity every day
  • exercise just twice a week reduces risk of heart disease or stroke
  • Do strengthening exercises twice a week
  • Do at least 150 mins of moderate or 75 minutes of vigorous intensity exercise
  • Spread over 4/5 days a week
  • Reduce time spent sitting down for long periods of time

Different guidelines for those under 19 and over 65

37
Q

Why is waist circumferance importantt?

A
  • Linked to high blood fat levels
  • High BP
  • Diabetes
  • This fat around waist builds up around organs
  • Larger waist usually means increase fat in organs
38
Q

Weight loss stratergy from NHS

A
  • Reduce their calorie intake to 600kcal/day below
    their daily requirement to sustain weight loss at a rate of 0.5 – 1kg per week
39
Q

the three groups of agents with have ability to be abused?

A
  • Illegal substances
  • Legal highs
  • Prescription only medicines
40
Q

Places to target people vulnerable to substance misuse

A
  • Attending festivals/nightclubs
  • Those who attend sexual and reproductive health services
  • Those in supported accomodation or hostels for homeless
  • Gyms for those considering steroids/performance enhancing drugs
41
Q

People who are vulnerable to substance misuse

A
  • Mental health problems
  • Sexually exploited
  • Commercial sex work
  • Lesbian, gay, bisexual or trans
  • Unemployed, those not in education or training
  • Children whos carer uses drugs
  • Young people in contact with young offender teams
  • Homeless
  • Nightclubs and festival attenders
42
Q

History taking for someone who uses drugs

A
  • What type and method of taking
  • What quantity
  • How frequently
43
Q

Management of substance misuse

A
  • Contingency management - incentives for clean samples eg vouchers or priveliges such as take home methadone
  • Behavioural couples therapy - non-drug using partner and present with stimulant or opioid misuse
  • Naltrexone following opioid detoxification - stops pleasurable feeling from opioids
  • CBT but ONLY if depression/anxiety, cannabis/stimulants abuse or successful opioid detox
44
Q

What are brief interventions?

A
  • For people not in contact with drug services or rare contact with them eg needle exchanges
  • Give information and advice about reducing blood borne viruses
  • Ask about possibility of treatment
  • Aim to increase motivation to change behaviour
45
Q

Sources of help for substance abuse in community

A
  • Contingency management
  • Behavioural couples therapy
  • CBT
  • Residential treatment - for those seeking abstinence with severe social problems eg homeless
  • Methadone/buprenorphine
  • Turning point in Leicester
  • Non-NHS - Private rehab
46
Q

Overall goal of harm reduction in substance misuse

A

Minimise negative impacts on health, social and legal aspects from substance abuse

47
Q

Examples of harm reduction in substance misuse

A
  • Syringe and needle exchanges
  • Drug consumption rooms
  • Drug testing in clubs
  • Crush dab wait - crush drug, dab wet finger in and try, wait couple hours before trying more
  • Take home naloxone - England lagging behind rest of the UK in this
48
Q
A

General Practice YR3 (31 decks)

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