Addictive behaviour

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Karteikarten am Addictive behaviour, erstellt von Megan Kerr am 13/11/2017.
Megan Kerr
Karteikarten von Megan Kerr, aktualisiert more than 1 year ago
Megan Kerr
Erstellt von Megan Kerr vor mehr als 6 Jahre
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Features of dependance Salience Continued use despite harm Compulsion Withdrawal Return to use after abstinence Tolerance Narrowing of repotoire Problems controlling use
Alcohol intake limits (in units) Safe = 2-3 units/day, 14 units/week Harmful = >6units/day, >35 units/week 1 unit = 1/2 pint ordinary strength beer, 25ml spirit or 50ml wine
Alcohol History TRAP T= type R = route A = amount P=pattern Also look for s&s of dependancy Past use Future use - see it as a problem?
Management of Acute EtOH intoxication Hypoglycaemia (Glucagon resistant) :. 50ml of 50% dextrose Thiamine U&E's to guide fluids Haemodyalisis if EtOH lvls v.high
S&S of chronic alcohol Liver- steatohepatitis, hepatomegaly, cirrhosis, hepatic encapalopathy GI- pancratitis, varices, gastritis, PUD Neuro-Wernickes, Karsakoffs, peripheral neuropathy, seizures, dementia Ca - Bowel, breast, oesophageal, liver CVS - HTN, cardiomyopathy, Trauma/ TBI - Due to falling in acute intoxication
Psychological risks associated with chronic alcoholism Increased risk of depression, anxiety and DSH. Amnesia Dementia and wernickes/korsakoffs Alcoholic hallucinosis Jealous dellusions Social decline
Triad of Wernickes Confusion/dementia Ataxia Opthalmoplegia
Management of Wernickes Immediate Thiamine (Pabrinex). MEDICAL EMERGENCY
Korsakoffs Irreversible retrograde amnesia. Confabulates to fill gaps in memory. Registers events as they happen but cannot remember later.
Managing chronic alcoholism Change behaviour - CBT. Pre-contemplation-> contemplation->preperation->action->maintancence. Detox - Chlorodiazepoxide Thiamine Disulfram and Acamprostate
S&S of alcohol withdrawal Headache Nausea, vomiting and retching tremor Sweating Insomina Anxiety and aggitation Tachy and hypotension
MoA of EtOH withdrawal Supresses CNS though potentiation of GABA receptors. EtOH removal leads to hyper-excitation of neurons leading to (fatal) seizures.
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