11. Alcohol Caffeine Drugs Flashcards
What syndrome is the signs and symptoms that occur on withdrawal of a drug in a dependent person?
Abstinence Syndrome
What is a drug deemed to have abuse liability that is listed on govermental schedules of controlled substance, such schedules categorize illicit drugs, control prescribing practices and mandate penalties for illegal possession, manufacture and sale of listed drugs?
Controlled Substance
What is an increase in response with repitition of the same dose of the drug (dose response curve shifts to the left instead of the right as seen in tolerance)?
Sensitization
What is the evidence of physical dependence, and also adaptive changes that become fully apparent once drug exposure is terminated- generally due to readaption of the CNS to the absence of the drug of dependence?
Wtihdrawal
Schedule 1= no medical use-high addiction (heroin/LSD)
Schedule 2= medical use high addiction (coke/adderall/ short acting barbs/strong opioids
Schedule 3= medical use w mod addiction= steroids, barbs, dronabinol, ketamine, mod opioid agonists
Schedule 4= medical use, low addiction = benzos, chloral hydrate, mild stimulants, hypnotics, weak opioids
MEOW
List the duration of symptoms in hours for the following... Alcohol: ? Tobacco: ? Marijuana: 2-4 hours Inhalants: 5-8mins Stimulants: 5min-12hours depressants: 1-16 hours Hallucinogens: 5min-12 hours Narcotics:4-24 hours PCP:4-6 hours
Alch: 1 hour per 1 oz/ one serving
Tob: 20 mins
List the associated symptoms with the following drugs…
Alch: odor on breath, slurred speech, lack coordination
Tob: odor on breath/clothes stained teeth and fingers
Mari: red eyes, odor, eyelid tremors, muscle tremors, hungy
Inhalants: odor/residue on mouth clothes, HA/nausea
Stimulants: jittery, talkative, runny nose/dry mouth
Depressants: drowsy, uncoordinated, slow slurred speech
Halluc: spacey, paranoia, memory loss, uncoordinated
Narcotics: sleepy, droopy eyelids, soft low voice, euphoria
PCP: confused, affressive, repeptitive and?
SWEATY
MC drugs of abuse for pain include fentanyl, hydrocodone and oxycodone, for depressents include alprazolam, zolpidem, zaleplon, for stimulants are methylphenidate and?
Adderall
Sx/Signs of OD for stimulants (amphetamine/coke) include agitation, HTN, tachycardia, delusions, hallucinations, hyperthermia, seizures and even?
Death
withdrawal= CRASH sleep long time
Sx/Signs of OD with barbiturates, benzos, and etoh include a drunken behavior, withdrawal sx include anxiety, insomnia, delirium, tremors seizure and even?
death
OD effects of heroin and other strong opioids include constricted pupils, clammy skin, drowsiness, respiratory depression, coma and death, Withdrawal includes nausea, chills cramps, lacrimation, rhinorrhea, yawnign, hyperpnea and?
severe tremors/shaking
The following drugs are abuse but not addictive, including LSD, mescaline, psilocybin, phencyclidine (PCP), and ketamine. Long term effects of PCP may lead to irreversible schizphrenia like psychosis, and LSD can cause flashbacks of altered perception years later because it is stored?
in adipose tissue*
Caffeine is MC used to improve mental alertness, treating migraine headaches, and treating headaches after epidural anesthesia, is used by mouth for asthma, memory and what?
ADHD
also used for weight loss and T2DM
A US drink contains 0.6 ounzes of pure alcohol…
12 ounces of beer
8 ounces malt liquor
5 ounces of wine
1.5 ounces of 80 proof
how long does it take for one serving of alch to be processed?
1 hour per 1 ounce of liquor or per one drink
Excessive drinking or binge drinking for women is 4 or more and men is 5 or more. Heavy drinking (alcoholism) in women is 8 or more drinks per week and for men is how many drinks?
15 drinks per week
metabolism of alcohol is important, there are zero order kinetics meaning the rate remains constant and is independent of concentration or amount of chemical, biological system is the rate limiting factor (US), and the half life increases with?
dose (not a true 1/2 life)
Alcohol is metabolized into acetaldehyde in the liver via alcohol dehydrogenase with NAD, then acetaldehyde is made into acetate with NAD and what enzyme?
Acetaldehyde Dehydrogenase
Ethanol undergoes extensive first pass metabolism, the typical 70kg adult can metabolize 7-10g of alcohol per hour which is equal to one* drink. What is given for methanol or ethylene glycol toxicity?
IV ETOH!! it inhibits alcohol dyhydrogenase which results in no processing of either.
Acute alcohol intoxication- monitor resp depression and aspiration of vomitus, glucose can treat metabolic alteraltions such as hypoglycemia/ketosis, thiamine can be given to protect against what syndrome which presents with double vision, drooping upper eyelid, loss of muscle coordination?
Wenicke-Korsakoff Syndrome
What syndrome can be life threatening, and pharm is used to prevent seizures, delirium, arrhythmias, electrolyte rebalancing, thiamine therapy, also give them benzodiazepines to treat?
Acute Withdrawal Syndrome
Drugs for treatment of acute alcohol withdrawal syndrome includes
1) Diazepam -Valium
2) Lorazepam- Ativan
3) Oxazepam
4) ?
Thiamine (vitamin b1)
Drugs for prevention of alcohol abuse include…
1) ?
2) Disulfiram (antabuse)
3) Naltrexone
Acamprosate***
Drugs for the treatment of acute methanol or ethylene glycol poisoning…
1) ?
2) Fomepizole (same MOA as alcohol)
ETOH
What drug is approved for treatment of alcohol and opiate dependence, u opioid receptor antagonist (long acting), reduces craving for alcohol and rate of relapse to either drinking or alcohol dependence, however dependent pts must be opioid free before initiating therapy?
Naltrexone
What drug is a weak NMDA receptor antagonist and GABAa receptor agonists (also affects serotonergic, noradrenergic, and dopaminergic systems), reduces short term and long term relapse rates (of alcohol abuse)?
Acamprosate
What drug irreversibly inhibits aldehyde dehydrogenase and causes extreme discomfort in pts who drink alcoholic bevarges (flushing, HA, N/V, sweating, hypotension, confusion due to accum of aldhyde), should NOT be admin with any meds that contain alcohol (cough syrups, cold preps, mouthwashes), and pts MUST BE HIGHLY MOTIVATED?
Disulfiram
(windshield washer fluid/antifreeze=ethylene glycol/ methanol - most likely consumed by CHILDREN)**
