27 - addictive behaviour Flashcards Preview

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Flashcards in 27 - addictive behaviour Deck (13)
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1
Q

What is addiction

A

Addiction is a strong uncontrollable desire to consume a particular substance or engage in a certain behaviour

2
Q

which groups is addiction more common in?

A

men, young people, people with other psychiatric problems, certain jobs.

3
Q

What is dependence syndrome?

A

behaviours such as: hoarding, binging, craving, withdrawal, ignoring negative consequences, rituals, tolerance, seeking behaviours, loss of control, rituals of consumption and narrowing of repertoire and putting primacy in obtaining.

4
Q

Which receptors involved in reward? other pathway involved in addiction?

A

Dopamine receptors: reward systems.

Mesolimbic pathway: increase in dopamine release
Stimuli reinforced by this release, reward sensitization

5
Q

Short term / long term risks of alcohol dependence?

A

Short term risks of arrhythmia, hypoglycaemia, violence, decreased libido, blackout,

Long term risks of IHD, CVA and stroke, oesophageal varices, Wernicke’s and Korsakoff’s, pancreatitis, infertility, depression, fatty liver disease,

6
Q

Mx of alcohol dependence?

A

Total abstinence is recommended.

Disulfiram - inhibits acetaldehyde dehydrogenase.
Pabrinex – replace B vitamin deficiencies

Psychotherapy and programmes such as 12 step are recommended for motivation.
May need treatment for other problems: liver disease needing a transplant etc.

7
Q

Stages of change

LAMMEEEEE

A
Pre contemplation 
contemplation 
preparation 
action 
maintenance 
relapse
8
Q

Stages of alcohol withdrawal?

A

Short term: sweating, tremor, nausea, agitation, tachycardia, hypertension.

Followed by: delusions, confusion, auditory hallucinations, seizures, diarrhoea

May produce delirium tremens: Lilliputian hallucinations, panic attacks, diaphoresis, ataxia, confusion and death,

9
Q

Mx of alcohol withdrawal?

A

Treat with chlordiazepoxide (benzodiazepine) for sedation and as an anticonvulsant.

Fluid and electrolyte replacement are essential (incl. dextrose).

Thiamine

Consider long term therapy as with alcohol dependence.

10
Q

triad of wernickes

A

nystagmus
ataxia
confusion

give thiamine

11
Q

Define obsession and compulsion

A

Obsession = a preoccupying idea

Compulsion = an irresistible urge to behave in a certain way.

12
Q

What do you need for OCD

A

Obsessions or compulsions must be present on most days for a period of two weeks. The patient must acknowledge their internal presence, they must be regarded as unpleasant and difficult to resist.

13
Q

Mx of OCD

A

CBT -> SSRI

Decks in Sheff 91 core clinical problems Class (51):