Management of Addiction

Question 1

Equation to calculate the units of Alcohol

Answer 1

     1000

Question 2

What is the alcohol screening tests called

Answer 2

Alcohol use disorders identification test for consumption (AUDIT – C)

Alcohol use disorders identification test for primary care (AUDIT – PC)

Fast alcohol use screening test (FAST)

Single question alcohol use test (M SASQ)

Question 3

What is the scoring score of the AUDIT - C

Answer 3

5+ Indicates a positive screen

0-4= low risk

5-7= increasing risk

8-10= High risk

11-12= Possible dependence

Question 4

What are the Alcohol withdawal assessment tools

Answer 4

Glasgow Modified Alcohol Withdrawal Score (GMAWS)

Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar)

Severity of Alcohol Dependence Questionnaire (SADQ)

Question 5

What are some alcohol related complications

Answer 5

Alcohol withdrawal syndrome
-Delirium tremens
-Alcohol withdrawal seizures

Wernicke-Korsakoff Syndrome

Question 6

What is Wernicke-Korsakoff Syndrome

Answer 6

A Neurological disorder caused by thiamine (B12) deficiency. This is because Alcohol prevents b12 absorption

Question 7

Symptoms of Wernicke-Korsakoff Syndrome

Answer 7

ataxia,
acute confusion,
ophthalmoplegia,
hypothermia,
hypotension,
coma

Question 8

Treatment of WERNICKE-KORSAKOFF SYNDROME

Answer 8

Parenteral thiamine (e.g. IV Pabrinex for 3-5 days, and then PO thiamine)

• Correct electrolyte imbalances (e.g. potassium, phosphate, magnesium)

Question 9

What are the relapse preventative medication and their dosages

Answer 9

Acromprosate: 666mg TDS with meals and must be with psychological support

Naltrexone: 25mg Stat then 50mg OD

Disulfiram: 1-200mg daily

Nalmefene: 18mg OD PRN for high risk drinking levels

Question 10

How often are the long acting forms administered and how are they administered

Answer 10

weekly (8-32mg) or monthly (64-128mh)

Injections (S/C): Buvidal

Question 11

What are the fast acting forms of Buprenorphine and the dose

Answer 11

oral lyophilisate: 2mg and 8mg

Oramucosal (on the tongue)

Question 12

What formulations is methadone available as

Answer 12

Oral solution - Sugar free or concentrate

Tablets

Solution for injection

Question 13

What formulations is methadone available as

Answer 13

Oral solution - Sugar free or concentrate

Tablets

Solution for injection

Question 14

What drug is combined with Buprenorphine as a sublingual tablet

Answer 14

Nalaxone

Question 15

When is the Buprenorphine-Naloxone used

Answer 15

when supervised dispensing is difficult to deliver or where there is concern about a patient’s risks of reverting to injecting

Question 16

what is the dose of Methadone

Answer 16

doses can be reduced at a rate which will result in zero in around 12 weeks

Question 17

When should Naltrexone be started

Answer 17

Only start after complete opioid free e.g. a minimum of 10 days for methadone.