5: Alcohol dependence disorders Flashcards Preview

CLASP: Alcohol 2017/18 > 5: Alcohol dependence disorders > Flashcards

Flashcards in 5: Alcohol dependence disorders Deck (32)
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1

What is harmful use of alcohol?

Pattern of alcohol use which causes damage to physical or mental health

2

How long does a patient need to be misusing alcohol to qualify as having harmful use disorder?

1 month

3

What are the criteria of alcohol dependence syndrome?

3 or more of:

Strong compulsion to take alcohol

Difficulties in controlling use of alcohol

Using alcohol despite evidence of harm

Preoccupation with alcohol use

Increased alcohol tolerance

Psychological withdrawal

4

What is the biopsychosocial model?

Focuses on the body + the mind

i.e psychology and social factors

5

international classification of diseases - f code is alcohol use disorders

6

What screening tests are used to determine a patient's dependence on alcohol before and after treatment?

FAST screen

AUDIT screen

7

What does MAAW stand for?

Medically assisted alcohol withdrawal

8

Which drugs are used to help patient's withdraw from alcohol use?

Chlordiazepoxide / Diazepam

Oxazepam

9

What is the Child-Pugh score?

Used to calculate prognosis in chronic liver disease / cirrhosis

AND to assess patient's suitability for drugs e.g MAAW drugs like chlordiazepoxide

10

alcohol withdrawal asspit

11

chlordiazepoxide mechanism of action

12

What are supportive treatments given to patients with alcohol use disorders?

Oral thiamine for low risk patients

IM/IV pabrinex (variety of vitamins) for high risk patients (inpatients usually)

---

Nutrition

Rehydration therapy

Anti-emetics

Anti-diarrhoeals

13

B vitamins like thiamine are ___ stored in the body.

minimally

14

A chronic alcoholic is likely to be thiamine ___.

deficient

15

Thiamine is essential for which biochemical process?

What does it act as?

Kreb's Cycle

Co-enzyme

16

What happens to the Kreb's Cycle when a patient is thiamine deficient?

Shuts down, switch to anaerobic respiration

17

Why can patients with thiamine deficiency suffer brain damage?

Lactic acid accumulation in the brain due to anaerobic respiration

18

What should be given to any alcohol-use disorder patient who is nutritionally deficient?

IV pabrinex

19

withdrawal complications

20

What is withdrawal state with delirium?

Alcohol withdrawal + sudden mental/NS changes

21

What should be the next step if you suspect a withdrawal patient is delirious?

Admit to hospital

IV pabrinex

22

What usually occurs 2-3 days into alcohol withdrawal and is associated with hallucinations like shrunken people and the sensation of insects under the skin?

Delirium tremens

23

clinical presentation of alcohol withdrawal

24

Wernicke's encepalopathy is ___.

Korsakoff's syndrome is ___.

(irreversible / reversible)

Wernicke's - reversible

Korsakoff's - irreversible

25

What causes Wernicke's encephalopathy?

Lactic acidosis in the brain

26

What causes Korsakoff's syndrome?

Irreversible brain damage re: lactic acidosis in brain

27

How does disulfiram (antabuse) work?

Blocks action of acetaldehyde dehydrogenase

so when the patient drinks alcohol it's converted to acetaldehyde but no further, which makes them nauseous, flushed etc.

28

Apart from disulfiram, what are some other drugs used to prevent relapse in alcohol-dependent patients?

Acamprosate - neuroprotective, reduces cravings

also baclofen, naltrexone

29

What must be considered before giving patients drugs to prevent relapse?

Liver function - LFTs, history, interactions with other drugs

30

What psychological condition is similar to delirium tremens, but seen in chronic drinkers and tending to have a better prognosis?

Alcoholic hallucinosis