Addiction and Aminoglycosides Flashcards
What is the number 1 problem with psychological problems? How do you respond/treat?
Denial
Confront them by pointing out the difference between what they say and what they do
What is DABDA?
Denial
Anger
Bargaining
Depression
Acceptance
How do you respond differently for denial in loss compared to abuse?
Loss –> support
Abuse –> confront
What is dependency vs co-dependency?
Dependency: when the get the significant other to do things or make decisions for them. Therefore the abuser is dependent
Co-dependency: when the significant other derive self-esteem for doing things or making
decisions for the abuser
How is dependency/co-dependency treated?
Dependent abuses need to be confronted
Co-dependent need to set limits and ENFORCE them. Say NO. Work on self-esteem
What is manipulation? How is it different than co-dependency?
Manipulation is when the abuser gets the significant other to do things or make decisions
that are not in the best interests of the significant other
Manipulation leads to harm of SO and co-dependency is not harmful/dangerous
What is Wernicke Korsakoff syndrome? What is the cause?
Wernicke - encephalopathy
Korsakoff - psychosis
Vitamin B1 deficiency
What are the s/s of Wernicke Korsakoff syndrome? Treatment?
Amnesia (memory loss) and confabulation (making up stories that they believe are real)
- Preventable … Take B1
- Arrestable (stop it from getting worse) … Take B1
- Irreversible (70%) … Will kill brain cells
What is a medication that can be used to help treat alcohol abuse? How does it work?
Antabuse and Revia (disulfiram)
Works by creating a aversion. When taken and mixed with alcohol it creates a unpleasant effect leading to hatred of alcohol
How long does it take for disulfiram (antabuse/revia) to start working? Stop working?
What should pt avoid?
2 weeks to start and 2 weeks to stop
Anything with alcohol including mouth wash, cologne, perfume, aftershave, ANY med with name elixir, insect repellant, hand Sani, vanilla extract
What drugs are an upper?
Caffeine
Cocaine
PCP/LSD
Methamphetamines
Adderall
If a drug is NOT one of the 5 uppers then what is it?
A downer
What s/s does an upper cause? Biggest concern?
THINGS GO UP!
Euphoria, seizures, restlessness,
irritability, hyperreflexia (3+, 4+),
tachycardia, increased bowels (borborygmi), diarrhea, spastic
SIEZURES –> suction
What s/s does a downer cause? Biggest concern?
THINGS GO DOWN!
Lethargic, respiratory depression/arrest,
constipated, etc.
RESPIRATORY DEPRESSION/ARREST –> intubation/ventilate
What does an overdose on an upper look like?
TOO MUCH
Everything goes up?
What does an withdrawal on an upper look like?
TOO LITTLE
Everything goes down. Looks like overdose on an downer
What does an overdose on a downer look like?
TOO LITTLE
Everything goes down
What does an withdrawal on a downer look like?
TOO MUCH
Looks like an overdose on an upper
When there is drug abuse in a neonate what does you assume within 24 hours of birth? After 24 hours?
ALWAYS assume intoxication in a newborn less than 24 hours
ALWAYS assume withdrawal in a newborn after 24 hours
What will every alcoholic go through ___ hours after they have stopped drinking?
Is it life threatening?
Alcohol withdrawal syndrome occurs 24 hours after drinking stops
NON life threatening (reg diet, semiprivate room anywhere on unit, pt is ad lib, no restraints)
Less than 20% of alcoholics in Alcohol withdrawal syndrome will progress to _____ in _____ hours
Less than 20% of alcoholics in Alcohol withdrawal syndrome will progress to DELIRIUM TREMENS in 72 hours
Is Delirium Tremens harmful? What changes should occur?
LIFE THREATENING to self and others
NPO/clears d/t seizures
Private room near nurses
Restraints w/ bed rest (2 point lock letter restraints)
What do you give both patients with Alcohol Withdrawal Syndrome and Delirium Tremens?
Why these meds?
Anti-HTN meds, Tranquilizer, multivitamin with B1
Anti-HTN and tran - withdrawal on downer so everything goes up
B1 - metabolize alcohol and prevent Wernicke/Korsakoff
What do Aminoglycosides treat?
A mean old mycin
A mean and old infection such as TB, sepsis
END in MYCIN
What drugs end fun MYCIN but are not Aminoglycosides and how do you know?
Azithromycin, Clarithromycin, Erythromycin
ALL have THRO is throw them out
What are toxic side effects of Aminoglycosides? How do you remember?
Ototoxic - hearing, tinnitus, balance
Nephrotoxic - creatinine
MCYIN sound like mice. Mice have big ears. It is toxic to ears and the kidneys look like ears
What CN are aminogylcosides toxic to? How often do you administer them?
How do you remember?
Toxic to CN8 (ear nerve)
Administer every 8 hours
MCYIN sound like mice. Mice have big ears. You can easily draw an 8 in the ears
Why are mycins given PO? What happens if they are?
They are not absorbed –> no systemic effects
If given they sterilize the gut
What 2 situations would you sterilize the gut? What meds would you use?
Hepatic encephalopathy/hepatic coma (too much ammonia)
Pre-op bowel prep
“Who can sterilize my bowel? Neo Kan!”
Neomycin and Kanamycin
What 2 routes are Aminoglycosides given?
IM or IV
When is a trough drawn?
30 minutes before the next dose no matter the route (at medications lowest concentration in blood)
When is a peak drawn for SubL?
5-10 minutes after drug dissolved
When is a peak drawn for IV?
15-30 minutes after a drug is finished/bag empty
When is a peak drawn for IM?
30-60 minutes
If there are 2 correct answers regarding a time frame should you big the longer time frame or shorter?
ALWAYS pick the longer time frame
For example if an IM med was given and you need to draw peak, pick the answer that says it should be drawn in 60 minutes (30-60 min timeframe)
OR
For example a patient states they haven been on their antidepressant meds for 1 week and they were told it would work in 2-4 weeks but it still doesn’t have any effect you should tell the patient it can take 3 more weeks before seeing effects
