Substance Misuse

benryan95's version from 2016-08-25 18:46


Question Answer
Name features of hepatic encephalopathyalteration in mental state, reversible with treatment, mood disturbance, sleep disturbances, motor disturbances
When do alcohol withdrawal symptoms start?4 to 12 hours after the last drink
What are some features of alcohol withdrawal?Tremors, nausea, sleep disturbance, possibly auditory and visual hallucinations, seizures and confusion, delirium tremens
What is the cornerstone of treatment in alcohol withdrawal?Benzodiazepines
When does delirium tremens start?48 to 96 hours after the last drink
What are symptoms of delirium tremens?Body tremors, changes in mental function, agitation, confusion, seizures, often with infection
How is delirium tremens treated?Rehydration, electrolyte rebalance, parenteral thiamine, treat infection and consider benzos
What is Wernicke's encephalopathy?Rapid onset of delirium from thiamine deficiency
What are features of Wernicke's encephalopathy?acute confusion, horizontal nystagmus, peripheral neuropathy, ataxia, N+V, lethargy
What can occur following Wernicke's encephalopathy?Korsakoff syndrome
How is Wernicke's encephalopathy treated?Thiamine, magnesium, multivitamin supplement
What is a typical feature of Korsakoff syndrome?Can't make new memories. Other cognitive domains relatively intact.
How to treat alcohol addiction? Psychotherapy, and medications to prevent relapse and support abstinence (naltrexone, acomprosate, disulfiram, nalmefene)
Symptoms of opiate withdrawal?rhinorrhoea, lacrimation, sweating, hot and cold flushes, abdominal cramps, n + v + d, bone and muscle aches and cramps
Management of opiate dependence?detoxification (methodone mixture or bupronorphine) gradually reduce dose, regular counsellor meetings, lofexidine relieves withdrawal symptoms (alpha 2 agonist), support with pain and insomnia
Symptoms of opioid overdose?N&V, drowsiness, stupor, cool moist skin, slow deep respiration, hypothermia, bradycardia, hypotension, pin-point pupils, coma, risk of death from respiratory depression
management of opioid overdose?ABC, antidote - naloxone
management of benzo overdose?flumazenil