Alcohol Abuse Flashcards
What is the most commonly abused substance in the U.S.?
Alcohol
Alcoholism is the primary __________?
Chronic disease
What are the factors that play into alcohol abuse?
Genetic, psychosocial, and environmental
True or false.
The pattern of dependence is always the same in each patient and situation?
False. The pattern of dependence varies.
Alcohol is a ____ depressant.
CNS
Creates an addititive effect with _____, which is the most prevalent _________ ____________; decreases neuronal _______.
GABA, inhibitory neurotransmitter, excitability
What does alcohol inhibit, that is a major excitatory neurotransmitter?
Glutamate.
What 3 things can affect the rate of alcohol metabolism and absorption?
Body mass, food intake and liver function.
What is the co-occurring substance abuse and psychiatric illness typically referred to?
Dual diagnoses/dual disorder.
How many of the nation’s adult population consumes alcohol regularly?
2/3’s
How many Americans are estimated to have an alcohol use disorder or alcohol abuse?
18 million
How many estimated under age drinkers were there is 2011?
9.7 million
What are the risk factors of alcohol abuse?
- Genetic (phenotypes)
- biological
- sociocultural
- developmental considerations
- COA’s
What does COA stand for?
Child of alcoholics
When used in moderation there are positive effects…what are these positive effects?
Decreases CAD, protects against stroke.
If alcohol is consumed in excess what can occur?
Disminishes ability to function, can be life threatening
What type of severe damage can occur with chronic alcohol abuse?
Liver
What type of nutrition is a complication of chronic alcohol abuse?
Malnutrition.
What is Wernicke encephalopathy?
The presence or neurological symptoms cause by biochemical lesions of the CNS after exhaustion of B-vitamin reserves, in particular thiamine (b1)
What is Korsakoff psychosis?
Something that results from thiamine deficiencies.
What are some clinical manifestations of alcohol abuse?
- malnutrition
- sleep disturbances
- produces tolerance (have to drink more and more for the same effect)
- severe manifestations of alcohol withdrawal
What are the 3 severe manifestations of alcohol withdrawal?
Seizures, Convulsions, DT’s
What are the toxic effects on the GI system?
Esophageal varices, pancreatitis, GERD, gastritis, decreased appetite and nutritional defiencies.
What are the toxic effects of alcohol abuse on the liver?
Cirrhosis, fatty liver, cancer
What are the toxic effects of alcohol abuse on the CV system?
CAD, HTN, arrhythmias.
What are the toxic effects on the respiratory system?
Pnuemonia
WHat are the toxic effects on the hematological system?
Bone marrow depression.
What are the toxic effects on the neuro system?
Blackouts, dementia, seizures, labeled moods
What are the toxic effects of the endocrine system?
Hyperglycemia, decreased thyroid
What are the toxic effects of the reproductive system?
Menstrual, decreased sex drive.
Alcohol withdrawal syndrome typically begins about how many hours after last drink?
6-8 hrs
What are the symptoms of withdrawal?
Irritability, insomnia, tremors, sweating
When does alcohol withdrawal delirium usually occur?
On days 2 and 3
What are the symptoms of alcohol withdrawal delirium?
Confusion, hallucinations, tachycardia, HTN or hypotension, diaphoresis, fever, extreme tremors
What are the symptoms with overdosing on alcohol?
- N/V
- lack or coordination
- slurred speech
- staggering
- disorientation
- irritability
- labile emotions
- poor judgement
- lack of inhibition
- unconsciousness
What are the diagnostic tests for alcohol abuse?
Breathalyzer. (BAL)
What are the treatments for withdrawal?
- Symptomatic and to minimize adverse outcomes
- medications
What are the complimentary and alternative therapy for alcohol abuse?
EEG biofeedback, Yoga
What is disulfiram?
Alcoholism medication, it can create an unpleasant reaction to alcohol.
What is the action of disulfiram?
It inhibits the enzyme that metabolizes alcohol.
When alcohol is consumed, highly unpleasant symptoms occur.
What are the contraindications of disulfiram?
Heart disease, recent intake of alcohol or metronidazole, DM, epilepsy, renal disease, cirrhosis.
What are the adverse effects of disulfiram?
Drowsiness, fatigue, h/a, tremor, hepatoxicity, SEVERE effects with indigestion of alcohol including respiratory depression, convulsions and death
How fast does a reaction occur after taking disulfiram and then ingesting alcohol?
10-15 minutes
How long after discontinuation of disulfiram can you expect to see a sensitivity to alcohol?
2 weeks
What is the CAGE questionnaire?
Four questions asked to screen for alcohol abuse.
What are the four CAGE questions?
- Have you ever felt like you should cut down on your drinking?
- Have people annoyed you by criticizing you drinking?
- Have you ever felt bad or guilty about your drinking?
- Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?
What are some of the challenges of caring for a pt with a history of alcohol abuse?
- intoxicated client
- pt will have impaired senses, increased risk-taking behaviors.
