Alcohol Dependence Flashcards

1
Q

What is classed as harmful alcohol use

A

Using the substance that causes damages to health

Persistent for at least 1 month or occurs repeatedly

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2
Q

What is classed as dependence syndrome

A
Must have 3 or more of: 
Strong desire/ compulsion to drink 
Difficulty in controlling use 
Persistent use despite harm 
Preoccupation with drinking 
Increased tolerance 
Psychological withdrawal
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3
Q

How is alcohol dependence treated

A

combination of treatment is needed
Must assess the trigger and any underlying social problems
Psychological support
Medical treatment to cope with side effects
Aim of initial treatment is to prevent seizures

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4
Q

How do you assess alcohol dependence

A

FAST score - quick questionnaire
If score is above 3 move on to AUDIT scoring
This determines treatment
Can then do SADQ to determine severity

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5
Q

What supportive treatments are available for alcohol dependency

A

oral thiamine - low risk
IM/IV pabrinex - high risk

Also important is nutrition, hydration, anti-emetics and anti-diarrhoeals

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6
Q

What is delirium tremens

A

A medical emergency that occurs due to alcohol withdrawal
Usually appears 72-96 hours after last drink
Can last 1 week to 1 month Higher risk in high dependence & liver damage

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7
Q

What are the symptoms of delirium tremens

A

Confusion, hallucinations, autonomic hyperactivity- tachycardia, sweating, HTN, pyrexia
Body tremors and seizures

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8
Q

What is the management of delirium tremens

A

Inpatient detox
May be able to detain under common law
Give benzodiazepine to stop seizures
Pabrinex

Then give other supportive measures: anti-convulsant - psychotics, fluids et

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9
Q

What is the triad for Wernicke’s encephalopathy

A

ophtalmoplegia (odd eye movement), ataxia, confusion

ataxia will settle with pabrinex

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10
Q

What is Alcoholic Hallucinosis

A

Usually seen in chronic drinkers - in or after heavy drinking
Acoustic hallucinations, delusions, mood disturbances
Arising in clear consciousness
Should recover within 6 months, if not consider a psychotic illness

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11
Q

How do you prevent a relapse

A

Pharmalogocal treatment such as Acamprosate and naltrexone (1st line) then disulfiram
Psychological help and intervention
Social rehabilitation

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