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Psychiatry > Substance Use and Addictions Pt.2 > Flashcards

Substance Use and Addictions Pt.2 Flashcards

1
Q

unit equation for alcohol

A

% strength x ml /1000 = units

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2
Q

safe recommended limits for men and women (alcohol) a week

A

14 units per week

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3
Q

excretion rate of alcohol

A

1 unit per hour

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4
Q

signs of harmful use or dependency of alcohol

A

drink in morning, hot/sweaty, retching, abdo pain, tremor, loss of control, restricted interests, distressed if can’t get alcohol

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5
Q

opiate withdrawal symptoms

A 
Tachycardia
Sweating
Restlessness
Dilated pupils
Bone aches
Runny nose
GI upset
Tremor
Yawning
Anxiety/Irritability
Gooseflesh skin
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6
Q

criteria for harmful use

A

pattern of substance use that causes damage to health, damage may be: (1) physical or (2) mental (NECSAARY FOR DIAGNOSIS), adverse social consequences, includes bingeing on substances. Does not include ‘hangover’ alone,

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7
Q

can a patient have a diagnosis of both harmful use and dependence?

A

no

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8
Q

history taking in addiction

A 
presenting complaint
history of presenting complaint
substance misuse history
family history
psychiatric comorbidity
social history
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9
Q

substance misuse history

A

Length of current use and when last used.
Current amount and for how long at this level.
Total length of use, max use, and any periods of abstinence.
Mode/method of use
Evidence of withdrawals and severity
Any previous treatments
Any previous substance overdoses
Assess triggers to use substances/alcohol
Assess motivation to change/engage in treatment

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10
Q

common comorbid conditions in addiction

A 
Depression
Anxiety
Suicidality
Personality Disorder
PTSD
Bipolar Disorder
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11
Q

list major causes of morbidity and mortality

associated with substance abuse

A 
Trauma (e.g. fractures)
Road Traffic Accidents
Homicide
Suicide
Overdose (deliberate, and frequently accidental)
Cirrhosis (Alcohol)
Endocarditis (IV)
Abscesses (IV)
BBV: Hepatitis B/C & HIV (IV)
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12
Q

aspects of examination specific to alcohol

A

Comment on the presence of jaundice, anaemia, clubbing, cyanosis, oedema, ascites, lymphadenopathy, DVT

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13
Q

aspects of examination specific to opioids

A 
Collapsed veins / track marks
Endocarditis 
Skin abscesses
Hepatitis / HIV
Pneumonia
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14
Q

CAGE screening for alcohol

A

ever felt the need Cut down?
have people annoyed you by criticizing your drinking?
ever felt Guilty about drinking?
ever felt you needed a drink first thing in the morning (Eye-opener)?

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15
Q

is opiate or alcohol withdrawal more dangerous?

A

alcohol

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16
Q

what withdrawal sign is considered a medical emergency?

A

delirium tremens

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17
Q

onset of alcohol withdrawal is usually?

A

6 hours

18
Q

what happens as withdrawal continues?

A

worsening pattern of symptoms

19
Q

what effect do opioids have?

A

analgesic

euphoric

20
Q

what receptors are affected by opiates?

A

opioid receptors mu, delta, kappa

21
Q

list opioid agonists

A

heroin
methadone
fentanyl
codeine

22
Q

list partial opioid agonists

A

buprenorphine

23
Q

list opioid antagonists

A

naltrexone

24
Q

define opiate

A

refer to naturalopioidssuch as morphineandcodeine, and heroin to some extent

25
Q

define opioid

A

refer to all natural, semisynthetic,andsyntheticopioids

26
Q

list natural opioids

A

opium
morphine
codeine
thebaine

27
Q

list synthetic opioids

A

fentanyl
pethidine
methadone
tramadol

28
Q

list semi-synthetic opioids

A

heroin
hydrocodone
oxycodone
hydromorphone

29
Q

signs of opiate overdose

A

not moving and can’t be woken, slow or no breathing, choking, gurgling or snoring, tiny pupils, clammy or cold skin, blue lips and blue nails

30
Q

management of opiate overdose

A

inject naloxone into upper arm or thigh or nasal spray > if no response after 3 mins > repeat, provide airway support, recovery position

31
Q

list alcohol abstinence drugs

A

acamprosate
disulfiram
naltrexone
nalmefene

32
Q

list alcohol detox regimes

A

benzodiazepines

33
Q

list opioid abstinence drugs

A

methadone

buprenorphine

34
Q

opioid detox regime

A

maintenance treatment for at least 12 months to sustain changes > lifestyle reduction

35
Q

list benzos/G drugs abstinence regime

A

maintenance on diazepam with reducing regime

36
Q

benzos/G drugs detox regime

A

baclofen (GABA agonist)

benzos

37
Q

G drugs refers to what?

A

GHB (gamma hydroxybutyrate)

GBL (gamma butyrolactone)

38
Q

G should never be mixed with?

A

alcohol

can be fatal

39
Q

effects of G

A

depressants
produces a high in small doses
sedation at higher doses

40
Q

what do people report the effects of G to be?

A

euphoria
loss of inhibitions
increased confidence
higher sex drive

41
Q

which G drug is a precursor?

A

GBL precursor to GHB

Psychiatry (9 decks)

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