Alcohol dependence disorder Flashcards
What is the defintion of harmful use?
A pattern of use that is causing damage to health
Clear evidence that substance use was responsible for physical or psychological harm
Nature of harm should be clearly identifiable
Persisted for at least one month
How can you diagnose dependence syndrome?
3 or more of: Strong desire to take alcohol Difficulties in controlling use Persistent use despite clear evidence of harm Preoccupation with substance use Increased tolerance Psychological withdrawal state
What is the prochaska and diclemnte stages of change?
Pre-contemplation Contemplation Preparation Action Maintenance Relapse
What inpatient alcohol assessment is used?
FAST alcohol screening
What does a FAST score of 3 or more mean?
Possible hazardous drinking
How can you asses the risk of alcohol withdrawal?
Amount of alcohol consumed
Frequency of drinking
History of liver disease
Requirement to take a drink to alleviate withdrawal symptoms
History fo previous withdrawal symptoms; seizures, hallucinations, shaking hands, agitation, sweats
What medication can be given for medically assisted alcohol withdrawal?
Diazapine or chlordizepoxide
What are the different stages for AUDIT score?
0-7 low risk
8-15 hazardous
16-19 harmful
20+ possible dependence
What supportive treatments can be given for alcohol withdrawal?
Vitamins - oral thiamine for low risk or IM/IV Pabrinex for high risk Nutrition Hydration Anti-emetics Anti-diarrhoeals
What are some complications for alcohol withdrawal?
Seizures - 6/48 hours. Tend to be generalised T/C and breif
Delerium Tremens - 3/10 days
Wernicke-korsakoff syndrome
What is withdrawal state with delerium?
A severe form of alcohol withdrawal that includes sudden changes and severe mental and/or nerrvous system changes
What is delirium tremens?
Confusion, hallucinations, autonomic hyperactivity - tachycardia, sweating, HTHN, pyrexia
How is delirium tremens managed?
Inpatient detox - common law Benzodiazapines Pabrinex Anticonvulsants Antipsychotics Antiemetics Fluids
What are alcoholic hallucinations?
Acoustic hallucinations
Delusions
Mood disturbances
Arising in clear consciousness
What are the pharmacological relapse preventions?
Acamprosate and naltrexone (1st line)
Disulfirma (2nd line)
