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Addictions trimmed decks > 02 Alcohol > Flashcards

02 Alcohol Flashcards

1
Q

Ethyl alcohol
Alcohol is the psychoactive substance that causes the greatest harms of health, legal, social and economic costs and problems…second only to?

A

tobacco

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2
Q

Control and sale of alcohol is regulated by?

A

provincial and territorial governments

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3
Q

Revenue in 2003-2004 =

A

$16.1 billion

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4
Q

2002: costs of alcohol abuse in Canada were estimated @ ??????? in additional health care, law enforcement, and loss of productivity in the workplace or at home.

A

$14.6 billion

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5
Q

2002: alcohol abuse accounted for $??? in direct health care costs
*
Majority of hospital admissions involving alcohol-related conditions were?

A 
$3.3 billion
*
men for 
alcohol dependence or abuse, 
alcoholic psychosis, 
liver-related diseases 
other
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6
Q

2004 Canadian Addiction Survey, ?? % of people age 15 or older consumed alcohol in the past year.

A

80%

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7
Q

Of these people:
??% drank 1 X weekly
??% consumed alcohol 4 or more times a week

A

44% drank 1 X weekly

10% consumed alcohol 4 or more times a week

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8
Q

Prevalence of alcohol dependence (2002 Canadian Community Health Survey) revealed that ??% of Canadians 15 and over reported symptoms consistent with alcohol dependence

A

2.6%

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9
Q

Highest in heavy and hazardous drinking?

A

NWT

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10
Q

2004 survey based on the Alcohol Use Disorder Identification Test ??% of current drinkers in NWT had engaged in hazardous drinking in the last 12 months.

A

40%

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11
Q

1998-1999 National Longitudinal Survey of Children and Youth showed that ??% of children aged 12 to 15 reported that they consumed @ least one drink of alcohol in the past.

A

40%

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12
Q

1998-1999 National Longitudinal Survey of Children and Youth showed that what percent of boys and what percent of girls in grade 10 reported weekly alcohol use?

A

35% boys

25% girls

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13
Q

Furthermore, ??% of boys and ??% of girls in grade 10 indicated that they had been “really drunk” @ least twice.

A

around 45% for both

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14
Q

Alcohol-Related Harms (7)

CC DAN LL

A

CV and GI diseases
Cancer

Diabetes
Alcohol dependence syndrome
Neuropsychiatric diseases

Liver cirrhosis
Lungs/kidneys/heart damage

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15
Q

It affects the nervous system and therefore impairs?
JCC
It also lowers?

A

judgment
concentration and coordination
lowers inhibitions

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16
Q

Drinking to intoxication and binge drinking increases?

UV RAI PUS

A

Use of other psychoactive substances
Violent / criminal behavior

Risk of alcohol poisoning
Accidents
Injuries

Problems in the workplace
Unsafe sex / unwanted pregnancy
Suicide

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17
Q

How many people will have severe substance abuse problems?

A

1 in 10!

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18
Q

Alcohol use during pregnancy can cause? (4)

A

birth defects
FASD
FAE
alcohol-related neurodevelopmental disorders

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19
Q

2002-2003 more than half of the alcohol-related severe trauma hospitalizations in Canada were

A

MVAs

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20
Q

Alcohol-related severe trauma hospitalizations in Canada

Falls?

A

20%

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21
Q

Alcohol-related severe trauma hospitalizations in Canada

Assaults and homicides?

A

20%

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22
Q

Admissions:
??% were age 10-24
??% were age 25-29

A

27% were age 10-24

22% were age 25-29

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23
Q

Death: alcohol-related road crashes (Traffic Injury Research Foundation 2002) = 1,055.
Say more.

A

80% male, 2/3 were drivers

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24
Q

Snowmobile accidents (2003-2004)?

A

50% were alcohol related

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25
Q

Drinking Onset – age range and average age

A

12-20, average age 14

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26
Q

Drinking Onset – before 15 = ? (2)

A

4 x more likely to develop alcohol dependence

These rates increase with earlier age of onset

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27
Q

Drinking Onset – Most important factor that predicts progression into adulthood is?

A

an early age of onset of drinking problems

28
Q

Children who drink alcohol frequently have?

A

prior behavioral problems esp. conduct disorder

29
Q

Adolescents: what may precede alcohol abuse?

A

symptoms of depression and anxiety

30
Q

Clinical picture – Skin and Muscle
Many skin conditions are exacerbated by heavy alcohol use:
ABC RR SSS

A

acne
blistering
crusting

rosacea
red palms (palmer erythema)

skin eruptions such as bullous erosions
scarred healing with hyperpigmentation especially to the face, side of neck and back of hands,
spider angiomas

31
Q

Limbs (3)

A

Tremors
Peripheral neuropathy (same as diabetes…losing circulation in fingers/toes and anything out to periphery like tip of nose)
Asterixis (liver flap)

32
Q

Cardiovascular system (3)

A

Hypertension
Arrhythmias (bounding, thumping out of chest)
Cardiomyopathy (deterioration of heart muscle)

33
Q

GI System (11)
EE EE RR
GUI DD

A

Enlarged salivary glands
Enlarged liver
Esophageal tears
Esophageal cancer

Reflux
Red blood (frank vomiting of)

Gastritis
Ulcers - stomach
Intestinal malabsorption

Dark to clay colored stools
Diarrhea

34
Q

Endocrine system

Heavy alcohol consumption can exacerbate (3)

A

hypoactivity of the
thyroid
hyperthyroid
pancreas

35
Q

Immune system

A

Heavy drinkers are more susceptible to developing infections

36
Q

Erythropoiesis: (formation of red blood cells)
What are common?
How can these be seen clinically?

A

Anemias are common and can be seen clinically by inspecting the lower eye-lids and the beds of the finger nails.

37
Q

Erythropoiesis: (formation of red blood cells)

Why are Anemias common?

A

Blood loss from ulcers or cancer

38
Q

Mamm glands?

A

Heavy-drinking women are at increased risk for breast cancer

39
Q

CNS (3)

A

Impairment of cognitive function
Korsakoff syndrome
Dementias

40
Q

what is Korsakoff syndrome?

A

Korsakoff syndrome is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1)
Thiamine (vitamin B-1) helps brain cells produce energy from sugar. When levels fall too low, brain cells cannot generate enough energy to function properly. As a result, Korsakoff syndrome may develop.

41
Q

Lab findings

A 
CBC: (low) anemia
Triglyceride: (elevated)
Abnormal liver function tests (elevated)
– GGT
– bilirubin
– uric acid
42
Q

CBC

A

Hemoglobin normal range women - 110-140 g/L
Hemoglobin normal range men - 140-180 g/L
*
Normal WBC range - 4.0-11.0

43
Q

Triglyceride

A

Normal — Less than 1.7 mmol/L
Borderline high — 1.8 to 2.2 mmol/L
High — 2.3 to 5.6 mmol/L
Very high — 5.7 mmol/L or above

44
Q

gamma-glutamyl transferase (GGT)

an enzyme

A

0-30 IU/L

45
Q

bilirubin

A 
Direct bilirubin: 0 to 0.3 mg/dL 
(made by liver)
*
Total bilirubin: 0.3 to 1.9 mg/dL
 (travels through bloodstream to liver where it is made into direct bilirubin)
46
Q

uric acid

A

> 6.0 mg/dL in females
8.0 mg/dL in males
= Hyperuricemia

47
Q

Acute effects of alcohol on the body.

Initial period.

A

Initial period: up to 30 min. has a stimulating effect followed by sedative and anxiolytic effect.

48
Q

Acute consumption of large amounts of alcohol can lead to…?

A

profound respiratory depression, followed by comma and death.

49
Q

Wernicke encephalopathy: life-threatening condition
associated with ?
from?

A

thiamine deficiency

severe malnutrition

50
Q

Wernicke encephalopathy - tx? (3)

A

(ICU)
– I.V. hydration (fluid/electrolyte support) and thiamin
– Mechanical ventilation
– Magnesium sulfate often used to reduce seizure

51
Q

Wernicke mortality rate?

A

can be > 50%

52
Q

Alcoholism tx must match?

A

the level of use and type of use

53
Q

Along with Wernicke encephalopathy, emergency tx would also be needed when?
Procedure?

A

– Respiratory depression

– Flumazenil to reverse toxic and/or sedative effects. Given I.V.

54
Q

Mild withdrawal symptoms

A

– Vitamin therapy

– Small doses on long-acting benzodiazepines

55
Q 
Typical benzo used?
For how long?
Reason?
Successful for?
Route? Dose?
A 
– Chlordiazepoxide (Librium) 
– Only a few days
– Decreases anxiety
– Successful for alcohol withdrawal, relaxation.
– Given PO 5-10mg tid-qid
56
Q 
Severe withdrawal sx = Hospitalization or detox
detox timeframe
hardest stretch?
What does not happen in detox?
Model used in detox?
A

– can go 5 days - 6 weeks
– if can get through first 48 hours will likely be ok
– person must be able to take oral b/c no IV mgmt in detox
– all detoxes operate from abstinence model

57
Q

Alcohol Withdrawal
Chronic heavy drinkers who abstain from alcohol for more than a few hours can experience withdrawal symptoms.
Early signs? (3)

A

tremors, palpitations & sweating

58
Q

Delirium tremens:
How long after alcohol cessation?
S/S? (3)
Mortality rate?

A 
– 24-48 hours after alcohol cessation
– clouding of consciousness
auditory / visual hallucinations (persecutory type)
seizures
– 5-15%
59
Q

Comorbidity (4)

SNMM

A

Smoking
Narcotics (Hugely used to deal with withdrawal effects)
Misuse of other drugs
Mental illness

60
Q

*Tolerance (3)

A

– a need for more alcohol to get the desired effect. – Builds up the more the person drinks.
– first 5 times is experimentation, past this point, starts taking more/more

61
Q

*Dependence (2)

A

drinkers can become psychologically dependent (they feel they need it) as well as physically dependent (the body needs it) on alcohol.
Experience withdrawal symptoms from mild to severe.

62
Q

Treatment Supports (4)

A

Detox
Treatment Centers
Alcoholics Anonymous
Pharmacotherapy: Disulfiram (Antabuse)

63
Q

what does Disulfiram (Antabuse) do?

A

Inhibits aldehyde dehydrogenase, thereby preventing the metabolism of the primary metabolite of alcohol: acetaldehyde.
This leads to the production of a range of unpleasant side effects, i.e. nausea, vomiting, flushing, sympathetic overactivity & palpitations, if they drink!

64
Q

Why age ltd. for drinking?

A

Brains are just finishing developing. When systems not mature, more damage is done

65
Q

In addition to the physiological, kids are mentally/emotionally not able to handle alcohol. Say more.

A

depression, anxiety, low self-esteem, social rejection
OUTCOME?
self-harm (suicide!) often occurs w/ substance abuse!

66
Q

re. withdrawal, shortest vs. longest timeframes?

A

shortest - booze

longest - benzos

67
Q

Drug used to take down effect of heroin?

A

Narcan

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