Alcohol and seditive abuse Flashcards

1. Describe the impact of alcohol and sedative/hypnotic use on individuals and society 2. Analyze a clinical scenario and choose the correct treatment for alcohol and sedative/hypnotic withdrawal 3. Analyze a clinical scenario and choose the correct treatment for alcohol dependence

1
Q

def of binge drinking

A

4 (women)/5 (men) drinks in one occasion

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2
Q

def of heavy drinking

A

1(women)/2( men) drinks a day on average

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3
Q

are most binge drinkers Et OH dependant

A

no

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4
Q

% of men/women who will meet criteria for EtOH dependance at some point in their lives

A

17 men/8% women

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5
Q

most common drug in ED misuse/abuse cases

A

benzos

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6
Q

gender most likely to have sedative abuse

A

women

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7
Q

usually fatal BAC

A

.5

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8
Q

sedatives with respiratory compromise by themselves

A

barbos

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9
Q

what must be given before glucose in an ER setting

A

thiamine

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10
Q

why must thiamine must be given before glucose in ER

A

prevent wernicke’s

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11
Q

pathology of wernicke-korsakoff’s

A

atrophy of mammillary bodies/thalmus

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12
Q

sx of wernickes

A

confusion, 3/4 CN lesion signs, ataxia, coma/death

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13
Q

sx of korsakoff’s

A

amnesia, confabulation, hallucinations

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14
Q

NT acted upon by EtOH

A

GABAA, glutamate

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15
Q

why do you “black out” when drunk

A

decrease in glu functioning on NMDA receptors

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16
Q

heritibility rate of EtOH dependance

17
Q

predictors of EtOH withdrawal severity

A
older age
lenght/severity of habit
prior withdrawal (kindling)
major med/surg problems
sedative/hypnotic use
18
Q

lab value to identify heavy drinkers

19
Q

time frame for DT’s

A

72-105hours

20
Q

when do AW seizures occur

A

24-48 hours

21
Q

DT sx

A

marked autonomic arousal
shakes, sweats, HTN, tachycardia
delerium

22
Q

drugs that can cause fatal withdrawal

A

EtOH, benzo, barbo

23
Q

treatment for Acute AW

24
Q

reasons for useing long t 1/2 benzo in AW

A

less seziures. smoother detox

25
long t 1/2 benzos for AW
chlordiazepoxide, diazepam
26
why would you use short t 1/2 benzo for AW
less oversedation, safer in elderly or with liver damage
27
short t 1/2 benzo
lorazepam, oxazepam
28
used to determine AW severity
CIWA
29
the "make you sick" anti EtOH drug
disulfiram
30
SE of disulfram
drowsy, fatigue, exacerbate psychosis/depression
31
SE of naltrexone
liver damage, flu-like sx
32
SE of acamprosate
dirrhea, bloating, rash
33
MOA of disulfram
inhibits aldehyde dehygrongenase to allow unpleasant acetaldehyde accumulation
34
acamprosate MOA
modulates activity of glu
35
naltrexone MOA
modulates activity of endogenous opioids