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Psych Final Final > Alcohol and Disorders of Nicotine - Berges > Flashcards

Alcohol and Disorders of Nicotine - Berges Flashcards

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1
Q

ethyl alcohol

A

in meds
cough syrups
aerosols
topicals

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2
Q

alcoholic beverages

A

water and ethyl alcohol

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3
Q

fermentation

A

stops at 12-13%

so no more than this concentration in wines

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4
Q

50% of all alcohols

A

consumed by 10% all drinkers

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5
Q

typical drink

A

10-14 grams of ETOH

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6
Q

BAC 0.25g/dL

A

0.025

1-2 alcohol drinks

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7
Q

alcohol metabolism

A

ADH
ALDH

ADH - 1 oz per hour

to acetic acid (vinegar)
acetic acid - then CO2 and H2O

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8
Q

ADH

A

in liver

alcohol to acetaldehyde

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9
Q

ALDH

A

acetaldehyde to acetic acid

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10
Q

alcohol PK

A

oral rapid absorbed

peak BAC 30min - slower with food

absorption - small intestine

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11
Q

BAC in female

A

higher compared to males

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12
Q

BAC 50-100

A

sedation
high
rxn time slow

2-4 drinks

0.08 - legally drunk in many states

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13
Q

BAC 100-200

A

impaired speech - slur, repeat

impaired motor fxn

clumsy walk - ataxia

can’t tandem walk - heel-toe

increasingly disinhibited

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14
Q

blackout

A

anterograde amnesia

disruption sleep pattern - primary reduction in REM

relax muscles of pharynx - increased snoring and sleep apnea

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15
Q

reduction in REM

A

with blackout in alcohol use

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16
Q

BAC 200-300

A

emesis stupor

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17
Q

BAC 300-400

A

coma

18
Q

BAC >500

A

resp depression
death

alcohol poisoning

19
Q

alcohol intox tx

A

thiamine
monitor labs
prevent aspiration
tx resp depression

20
Q

chronic alcoholism

A

multi-system disease common

do vitals

monitor labs

cover pt with vitamines, thiamine, benzo (withdrawal sx)

21
Q

long acting benzos

A

clorazepate dipotassium
diazepam

for withdrawal sx of alcohol

22
Q

liver in chronic alcoholic

A

cirrhosis

women - more susceptible to men

if hep C present - liver effects more severe

23
Q

GI chronic alcoholic

A

pancreatitis

3x more common alcoholics

chronic gastritia dn diarrhea

vit deficiency - malabsorption

weight loss

24
Q

chronic alcoholic in CNS

A

peripheral neuropathy- distal

cerebellar degeneration - gait and balance deterioration

wernicke - thiamine deficiency
korsakoff - memory problems

25
Q

cancer with alclhol

A

rate 10x nondrinkers

26
Q

HTN in males

A

alcohol use

27
Q

early alcohol withdrawal

A

early withdrawal - the shakes

12-18 hours after
peak 24-48 hours
subside 5-7 days

28
Q

late alcohol withdrawal

A

seizures

7-48 hours after
peak 36 hours

status epilepticus rare

29
Q

alcoholic hallucinations

A

begin within 48 hours of cessation of drinking

may last 7 days

30
Q

alcohol withdrawal delirium

A

2-3 days after cessation

peak 4-5 days

mortality 15%

31
Q

tx alcoholic withdarwal

A

long acting benzo - diazepam, chlordiazepoxide, clorazepate dipotassium

severe liver disease - short acting benzo - lorazepam / oxazepam

also - thiamine

haloperidol - if psychosis

32
Q

CAGE test

A

tried to CUT DOWN?
ANNOYED about ppl asking you?
felt GUILTY about drinking?
ever needed EYE OPENER?

33
Q

antabuse

A

disulfiram

inhibit ALDH - accumulation of acetaldehyde

nausea, vomiting, hypotension, palpitations

34
Q

naltrexone

A

mu opioid antagonist

reduce pleasure and craving

35
Q

campral

A

acmprosate

glutamate receptor modulation

reduced craving

36
Q

american public

A

25% smokes

down from 32% in 1989

37
Q

nicotine

A

highly addictive and stimulating

half life 2 hours - unpleasant withdrawal effecdts

38
Q

nicotine effects

A 
HR increase
increased BP
increased RR
dizzy, lightheaded
tremor 
nausea
39
Q

nicotine withdrawal

A 
craving for nicotine
irritable, anger, frustrated
anxiety
diff concentrating
decreased HR
HA
sleep disturbance
weight gain
40
Q

tx nicotine dependence

A 
transdermal patch
gum
lozenges
inhaler
E-cigs
41
Q

other tx of nicotine dependence

A

acupuncture
hyponosis
bupropion - 30% effective alone
varenicline - 44% effective

combo therapy best

42
Q

health issues of nicotine dependence

A 
COPD, asthma, cancer
CV disease - MI, peripheral vasc disease, stroke
stroke
HA
impotence in males

Psych Final Final (9 decks)

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