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Flashcards in Substance misuse Deck (6)
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1

Alcohol misuse (history)

- Clarify HPC (understanding, onset, course, typical day)
- Core features (control, tolerance, withdrawal - shakes, seizures, Hns)
- Other features (primacy, eye-opener, abstinence)
- Complications (daily life, physical health, work, relationships, finances, Police)
- Mental state (mood, enjoyment, sleep, appetite, hallucinations, delusions)
- Risk (self, others)
- Insight and readiness for change

2

Alcohol dependence (d/w family)

- Clarify concerns
- Explain complications of alcohol use (liver, withdrawal, depression/anxiety, dementia, Police)
- Medical management (diazepam, thiamine, Antabuse)
- Psychological management (CBT, groups)
- Prognosis (insight, family support)
- Questions and leaflets

3

Opioid dependence (history)

- Clarify HPC (substances, onset, course, typical day, route)
- Dependence symptoms (tolerance, control, cravings, withdrawal)
- Complications (physical health, work, relationships, finance, Police)
- Mental state (mood, enjoyment, sleep, appetite, hallucinations, delusions)
- Risk (self, others, pregnancy)
- Insight and readiness for change

4

Substance use in pregnancy (history)

- Clarify HPC (substances, onset, course, typical day, route)
- Dependence symptoms (tolerance, control, cravings, withdrawal)
- Pregnancy (planned, attitude)
- Social history (work, finances, relationships, help)
- Risk (self, others, child)

5

Methadone in pregnancy (explanation)

- Clarify concerns
- Explain risk of drug use in pregnancy (stillbirth, prematurity, LBW, use of methadone)
- Neonatal abstinence syndrome
- Management (withdrawal in 2nd trim or dose adjustment in 3rd trim)
- Breastfeeding (fine if <20mg per day, other meds)
- Social services

6

Delirium tremens (d/w consultant)

- Case summary
- Differential diagnosis (DTs, other delirium, other psychosis)
- Environmental management (orientation, quiet room, familiar staff, use of MHA)
- Drug management (IV Pabrinex tds, CIWA protocol with diazepam or chlordiazepoxide, haloperdiol)
- Psychological management (addictions services)