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Year 2 Psych exam2 > Alcohol Disorders & Nicotine > Flashcards

Alcohol Disorders & Nicotine Flashcards

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1
Q

main component in alcohol

A

ethyl alcohol

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2
Q

fermentation stops at what percent alcohol

A

12-13%

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3
Q

50% of all alcohol consumed by

A

10% of all drinkers

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4
Q

how many gr of ETOH per drink

A

10-14 grams
1.5 oz whiskey
12 oz beer
4 oz wine

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5
Q

how is blood alcohol concentration BAC measured

A

g/dL or mg/dL

1-2 drinks is 0.25g/dL or 0.25%

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6
Q

enzymes for alcohol metabolism

A

alcohol dehydrogenase

aldehyde dehydrogenase

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7
Q

where is alcohol dehydrogenase ADH found

A

liver

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8
Q

what does AldDH do

A

acetaldehyde to acetic acid

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9
Q

acetic acid in normal metabolic pathway becomes

A

carbon dioxide and water

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10
Q

peak BAC occurs how

A

30 minutes when alcohol taken orally

longer if taken with food

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11
Q

primary site alcohol absorption

A

small intestine

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12
Q

why is BAC higher in females than males

A

smaller total body water distribution due to fat stores

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13
Q

effects of BAC 50-100 mg/dL

A

sedation
subjective sensation of high
reaction slowed
80mg/dL legally drunk

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14
Q

how many drinks to cause 50-100 BAC in nontolerant

A

2-4 drinks in short period of time

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15
Q

BAC 100-200 mg/dL signs

A 
impaired speech
impaired motor function
gait disturbance, clumsiness, ataxia
increasingly disinhibited
blackouts, anterograde amnesia
disruption in REM sleep
snoring and sleep apnea
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16
Q

BAC 200-300 mg/dL signs

A

emesis and stupor

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17
Q

BAC 300-400 mg/dL signs

A

coma

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18
Q

BAC 500+ mg/dL

A

respiratory depression and death

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19
Q

management of acute alcohol intoxication

A

treat and prevent respiratory depression
monitor/prevent aspiration
give thiamine oral or IM
monitor labs for electrolytes, glucose, thiamine etc

20
Q

use of thiamine in acute alcohol intoxication

A

reduce risk of Wernickes encephalopathy from lactic acidosis

21
Q

management of chronic alcoholism

A

vital signs
monitor labs like BAC, CBC, LFT, CMP
vitamins thiamine benzo if withdrawal
vital signs again to monitor for deterioation

22
Q

what benzo best for withdrawal of alcohol

A

long acting like clorazepate dipotassium or diazepam

23
Q

chronic effects of alcohol on liver

A

cirrhosis in 25%
women>M
concurrent Hep C, liver effects more severe

24
Q

chronic alcohol effects on GI

A

pancreatitis 3x likely
chronic gastritis and diarrhea
vit deficiency from malabsorption
weight loss

25
Q

CNS effects chronic alcohol

A

peripheral neuropathy
cerebellar degeneration- gait and balance
wernickes encephalopathy- confusion
korsakoffs psychosis- memory problems and chronic confabulation

26
Q

CV effects chronic alcohol

A

HTN in M>W
50% HTN 3-4 drinks a day
100% HTN 6-7 drinks.day

27
Q

neoplastic risks of chronic alcohol

A

cancer 10x risk

28
Q

uncomplicated alcohol withdrawal

A

shakes 12-18 hours after
peak 24-48 hr
no Tx subsides in 5-7 days

29
Q

alcohol withdrawal seizures

A

7-48 hrs post
peak 24-48 hrs
status epilepticus rare

30
Q

alcoholic hallucinosis

A

auditory visual or tactile hallucinations
48 hrs post
may last up to 7 days

31
Q

delerium tremens

A

2-3 days post
Sx peak 4-5 days
last 3-5 days to weeks
mortality rates 15%

32
Q

mangement alcohol withdrawal syndromes

A

long acting benzos
short acting benzos if liver disease (lorazepam of oxazepam)
thiamine oral or IM once
folic acid 1 mg daily
haloperidol or risperidone for hallucinosis

33
Q

CAGE test

A
  • tried to Cut down?
  • felt Annoyed by questions?
  • felt Guilty about drinking?
  • needed Eye opener in morning?
34
Q

Tx options for alcohol disorders

A 
AAA
structured detox
inpatient alcohol Tx
physician support
family support and interventions
35
Q

Antabuse

A

disulfiram

inhibits AldDH causeing accumulation acetaldehyde causing nausea, vomiting, hypotension and palpitations

36
Q

Naltrexone

A

mu opioid antagonist

reduce pleasurable effects and craving for alcohol

37
Q

campral (acmprosate)

A

reduce craving for alcohol via glutamate R modulation

reduces physical and emotional discomfort in alcohol cessation

38
Q

what % of Americans public smoke

A

25%

39
Q

major psychoactive substance in tobacco

A

nicotine

40
Q

half life nicotine

A

2 hours

41
Q

effects nicotine

A

inc HR, BP , RR
dizziness, lightheadedness
tremor
nausea

42
Q

nicotine withdrawal effects

A 
craving nicotine
irritability, anger, frustration
anxiety
difficulty concentrating
restlessness
dec HR
increased appetite/weight gain
HA
sleep disturbance
43
Q

Nicotine replacement Tx

A 
transdermal patches
nicotine gum
nicotine lozenges
nicotine inhaler
electronic cigarette
44
Q

tx options for nicotine dependence

A 
acupuncture
hypnosis
bupropion
varenicline (chantix)
combination therapy!!!
45
Q

health issues with smoking

A

lung disease like COPD asthma and cancer
CV: MI PVD stroke
HA
impotence in males!!

Year 2 Psych exam2 (13 decks)

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