substance abuse

Question 1

alcohol substance abuse signs

Answer 1

• erosion
• GORD
• hepatic failure
  
  • need to use amid anaesthetics (not in liver, ise pseudocholinesterase), poor clotting and drug metabolism
• avoid aspirin, azoles and cepahlosporins
• 35x more likely to get oral cancer with synergistically taking with smoking

Question 2

smoking substance abuse signs

Answer 2

• dry socket
• xerostomia
• smokers melanosis
• smokers keratosis (nicontic stomatitis)
• peridondal masking
• whartin’s tumour (8x more likely)
• need higher dose of
  
  • sedatives
  • post-op analgesia

Question 3

heroin/methadone substance abuse signs

Answer 3

opiod family

methadone is rehab for heroin abuse

• methadone - high sugar contect - caries
• heroin - thrombocytopenia
• carbamazepine - dec effect of methadone
• heroin - poorer sedative effect
• heroin hard to find vessel for IV sedation
• delayed gastric emptying with opiods

Question 4

cocain substance abuse signs

Answer 4

• vasoconstrictive effect can cause palatl communication
• loss of nasal septum
• loss of gingivae if rubbed topically
• thrombocytopenia
• inc systemic effect of adrenaline
• seizure risk with GA

Question 5

solvent abuse signs

Answer 5

• circumoral erythema (glue sniffers rask)
• status epileptus
• reduced half life of LA as it dulls down adrenaline

Question 6

anabolic steroids substance abuse signs

Answer 6

aggresive pts (roid rage)

inc carb consumption = caries

poorer clotting

Question 7

amphetamines/ectasy substance abuse signs

Answer 7

xerostomia

TMD

thromobocytopenia

Question 8

hallucinogens (LSD) substance abuse signs

Answer 8

bruxism

TMD

risk of trauma (impaired judgement)

resp depression

panic attacks/flashbacks