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Substance Dependence Flashcards

(52 cards)

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1
Q

What can smoking cessation prevent?

A

Illness

Smoking is linked to a number of diseases.

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2
Q

What are some symptoms associated with smoking withdrawal?

A
  • Nicotine cravings
  • Irritability
  • Depression
  • Restlessness

These symptoms can make quitting difficult.

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3
Q

What is the best chance of success for quitting smoking?

A

Stopping in one step

This involves agreeing to stop by a certain date instead of gradually.

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4
Q

What should smokers who are not ready to quit immediately do?

A

Stop gradually

Encouragement is vital in smoking cessation.

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5
Q

What are some pharmacological options offered alongside behavioral support for smoking cessation?

A
  • NRT (Nicotine Replacement Therapy)
  • Varinicline
  • Bupropion

Varinicline or a combination of long-acting and short-acting NRT are effective.

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6
Q

What is considered long-acting NRT?

A

Nicotine patches

Short-acting NRT includes lozenges, gum, tablets, and sprays.

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7
Q

How long are nicotine patches typically applied?

A

16 hours

They are removed overnight.

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8
Q

What should be done if strong craving occurs when waking?

A

Switch to the 24-hour patch

This is to manage cravings effectively.

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9
Q

Is it recommended to combine NRT with varinicline or bupropion?

A

No

Varinicline and bupropion should not be prescribed together.

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10
Q

What should be agreed upon when drugs are prescribed for smoking cessation?

A

Quit dates

This helps in planning the cessation process.

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11
Q

What is the MHRA warning associated with varinicline?

A

Suicidal behaviour

This warning must be considered when prescribing.

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12
Q

What are some side effects of NRT?

A
  • Irritated throat
  • Salivation
  • Patch irritation

Other side effects may include abnormal dreams and paresthesia.

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13
Q

What can oral sprays lead to?

A
  • Paresthesia
  • Rash
  • Hotness
  • Heart flushes

Paresthesia refers to a burning sensation in the arms and feet.

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14
Q

What do e-cigarettes deliver?

A

Nicotine

They do so without the toxins of tobacco.

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15
Q

Are e-cigarettes less damaging than real cigarettes?

A

Yes

However, the long-term effects are unknown.

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16
Q

What should be documented in medical histories regarding e-cigarettes?

A

E-cigarette use

This includes reporting all side effects or adverse effects.

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17
Q

Who is prohibited from purchasing e-cigarettes?

A

Under 18s

This regulation aims to protect minors.

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18
Q

What is alcohol dependence?

A

A strong desire to drink alcohol

Alcohol dependence can manifest in various ways, including cravings and the inability to stop drinking.

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19
Q

What can abrupt withdrawal of alcohol lead to?

A

Withdrawal symptoms, seizures, delirium tremens, or death

Withdrawal symptoms can vary in severity and may require medical intervention.

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20
Q

Do patients with mild alcohol problems need assistance?

A

No

Mild alcohol problems can often be managed without professional help.

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21
Q

Where should severe alcohol dependence be treated?

Study These Flashcards
A

Inpatient setting

Severe dependence requires close monitoring due to the risk of withdrawal symptoms.

22
Q

What type of medication is recommended to reduce withdrawal symptoms?

Study These Flashcards
A

Long-acting benzodiazepines like chlorodioxepoxide or diazepam

These medications help manage withdrawal symptoms effectively.

23
Q

What alternative medication can be used in acute alcohol withdrawal?

Study These Flashcards
A

Carbamazepine

Carbamazepine may lead to suicidal thoughts, requiring careful monitoring.

24
Q

What is a potential danger of using clomethiazole in alcohol withdrawal?

Study These Flashcards
A

Can cause respiratory depression if taken alongside alcohol

Clomethiazole should only be considered in an inpatient setting.

25
What medications can be used to prevent relapse in alcohol dependence?
Acamprosate and naltrexone ## Footnote These medications are designed to reduce cravings and support recovery.
26
What is delirium tremens?
A medical emergency that can lead to agitation, confusion, and paranoia ## Footnote Delirium tremens is a severe form of alcohol withdrawal that requires immediate treatment.
27
What is the first-line treatment for delirium tremens?
Oral lorazepam ## Footnote Parenteral lorazepam and haloperidol may be given if additional sedation is needed.
28
What is Wernicke's encephalopathy?
A risk in alcohol dependence ## Footnote It is a serious condition caused by thiamine deficiency.
29
What should be given if Wernicke's encephalopathy is suspected?
Parenteral thiamine followed by oral thiamine ## Footnote Early treatment is crucial to prevent permanent neurological damage.
30
What initiates opioid dependence treatment?
Supervision of a qualified prescriber ## Footnote This ensures appropriate management and safety in treatment.
31
When do early withdrawal symptoms from untreated heroin dependence start?
Within 8 hours ## Footnote Peak symptoms occur at 36-72 hours.
32
What are the two main medications used in opioid substitution therapy?
Methadone and buprenorphine ## Footnote These are used to reduce drug use and crime.
33
What happens once patients are maintained on methadone and buprenorphine?
They can withdraw safely ## Footnote This indicates a stable treatment phase.
34
How long can complete withdrawal from methadone and buprenorphine take in an inpatient setting?
Up to 4 weeks ## Footnote In the community, it can take up to 12 weeks.
35
For how long should further support be provided after successful withdrawal?
At least 6 months ## Footnote This support is crucial for recovery.
36
What risk do patients face if they miss 3 or more days of treatment?
Risk of overdose ## Footnote This is due to loss of tolerance to buprenorphine and methadone.
37
What should be done if a patient has missed 5 days or more of treatment?
Assessment of illicit drug use is recommended ## Footnote This helps determine the next steps in treatment.
38
Which medication is less sedating, methadone or buprenorphine?
Buprenorphine ## Footnote This makes it more suitable for employed patients.
39
Which medication is safer when used with other sedating drugs?
Buprenorphine ## Footnote It has fewer drug interactions compared to methadone.
40
What is a notable advantage of methadone?
Less withdrawal symptoms ## Footnote This can make it more tolerable for some patients.
41
What can reverse opioid toxicity?
Naloxone ## Footnote This is a critical emergency treatment.
42
What is the dosing frequency for methadone?
Single daily dose ## Footnote This is due to its long-acting nature.
43
When is methadone initiated after the last heroin dose?
8 hours ## Footnote This timing helps to manage withdrawal symptoms.
44
What can happen to methadone levels due to its long half-life?
Methadone levels can continue to rise ## Footnote Even if the dose is maintained.
45
Why should acute withdrawal be avoided in pregnancy?
It can lead to fetal death in the second trimester ## Footnote Monitoring the fetus is crucial.
46
What should be monitored in breastfed babies if the mother is on methadone or buprenorphine?
Increased sleepiness, breathing difficulties or limpness ## Footnote These symptoms should be reported to healthcare professionals immediately.
47
What medication is used to treat diarrhea in opioid substitution therapy?
Loperamide ## Footnote This helps manage gastrointestinal side effects.
48
What is mebeverine used for in opioid substitution therapy?
To treat stomach cramps ## Footnote This can be a common issue during treatment.
49
Which medications are used for muscular pains and headaches in opioid substitution therapy?
Paracetamol and NSAIDs ## Footnote These are standard pain relief options.
50
What is metoclopramide used for in opioid substitution therapy?
Nausea and vomiting ## Footnote Helps manage gastrointestinal side effects.
51
What medications are used for insomnia in opioid substitution therapy?
Zopiclone and benzodiazepines ## Footnote These help patients with sleep issues.
52
In what situations is methadone used in analgesia?
In severe pain and cough in terminal disease ## Footnote It is important to monitor QT level prolongation with methadone.

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