Alcohol & Substance Use Disorders Flashcards
Due to the recent ingestion of alcohol; clinically problematic behavioral or psychological changes (slurred speech, incoordination, unsteady gait, nystagmus, coma, etc.)
Alcohol Intoxication
Cessation (or reduction in) alcohol that has been heavy and prolonged; involves autonomic hyperactivity (sweaty, tachycardia), hand tremor, insomnia, hallucinations, seizures, etc.
Alcohol Withdrawal
Problematic pattern of alcohol use leading to clinically significant impairment or distress; involves large binges, persistent desire to cut down or control (usually unsuccessful), craving, desire and inability to complete obligations at work, school or home
Alcohol Use Disorder
Numerical definitions of at-risk drinking per gender
Female: >3 drinks (one sitting) or 7/week
Male: >4 drinks (one sitting) or 14/week
What does the Alcohol Screening mnemonic CAGE mean
C: Cut down?
A: Annoyed by others commenting?
G: Guilt associated?
E: Eye opening drink in the morning?
What does the Alcohol Screening mnemonic CRAFFT mean?
C: Car (drive with anyone intoxicated) R: Relax (use to relax) A: Alone (drink/use alone) F: Family or Friends (tell you to cut down) F: Forget (things while drinking) T: Trouble?
What labs are elevated with Alcohol consumption
LFT (GGT, AST, ALT)
HDL
LDH
Uric Acid
Consequence of alcohol withdrawal; onset is 2-4 days after last drink; hyperactivity, tachycardia, HTN, fever, halluinations and disoriented; CAN BE FATAL
Delirium Tremens
Triad of confusion, ataxia and ophthalmoplegia (paralysis of eye muscles); can also see Korsakoff’s Syndrome; due to dec. thiamine (Vitamin B1); EMERGENCY as 20% of untreated patients will die; MUST give Thiamine before glucose
Wernicke’s Encephalopathy
Potential consequence of Wernicke’s Encephalopathy; impaired memory in an otherwise alert, responsive patient; either retrograde or anterograde memory loss or confabulations
Karsakoff Syndrome
Delirium Tremens (in alcohol withdrawal) is due to a deficiency in what vitamin
Vitamin B1 (Thiamine)
Treatment for Delirium Tremens
Benzodiazepines (long acting)
Thiamine
Folate
What if your Delirium Tremens patient starts to seize? (what treatment)
Benzodiazepines
What if your Delirium Tremens patient starts to hallucinate?
Haloperidol (low dose)
Examples of treatment for Alcohol Dependence (pharmacologic)
Disulfiram
Acamprosate
Naltrexone
Drug for Alcohol Dependence; opioid receptor antagonist to reduce cravings
Naltrexone
Sedative infamous for respiratory depression
Barbiturates
Flumazenil is good for sedative (overdose/withdrawal)
Overdose
Benzodiazepines are good for sedative (overdose/withdrawal)
Withdrawal
Symptoms of Opioid OVERDOSE
Mood elevation Sedation Analgesia Resp. Depression Pupil Constriction
*everything kinda relaxes
Symptoms of Opioid WITHDRAWAL
Depression "Flu-like" symptoms (muscle aches, chills, etc.) Piloerection Pupil Dilation Stomach Cramps
*everything kinda get excited
Drug for Opioid overdose
Naloxone (Narcan)
Drugs for Opioid Withdrawal
Naltrexone
Buprenorphine
Methadone taper
Partial opioid agonist + opioid antagonist
Buprenorphine
Symptoms of Stimulant use
Elevated mood Anxiety Insomnia Psychosis HTN DILATED pupils
Symptoms of Stimulant withdrawal
Depression Irritable Lethargy Fatigue Hypotension Dec. Neurologic activity
Symptoms of Stimulant withdrawal
Cardiac monitoring
Benzodiazepines
Antipsychotics (if psychosis)
Symptoms of Hallucinogen use
Hallucinations (visual)
Hyperalert (EEG)
Examples of NMDA antagonists (Dissociatives)
Dextromethorphan
PCP
Ketamine
NO
Symptoms of NMDA antagonists (Dissociatives)
Dissociation/Hallucinations Invulnerability Agitation/Violence Nystagmus HYPERreflexia HTN/Tachycardia
Treatment for NMDA antagonists (Dissociatives)
Benzodiazepines
Antipsychotics
Examples of Inhalants/Fumes
Fuels
Paint
Anesthetics
NO
Symptoms of Inhalants/Fumes
Euphoria Disinhibited Dizzy Ataxia Dysrhythmias Slurred speech
