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HC > Alcohol use disorder > Flashcards

Alcohol use disorder Flashcards

1
Q

Define substance use disorder

A

Substance use disorder is defined as a
cluster of cognitive, behavioural, and
psychological symptoms indicating that
the individual continues using despite
significant substance-related problems

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2
Q

Tolerance

A

The need for a larger dose of a drug to obtain the original effects

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3
Q

Relief craving

A

The intense desire for a
substance, usually experienced after decreased use

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4
Q

Reward craving

A

Occurs in the presence of
people, places, or things associated with
substance taking

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5
Q

Relapse

A

Returning to substance use after a
period of abstinence

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6
Q

Urgent care regarding alcohol use

A

Intoxication responses usually last less than 24 hours and are directly related
to the ingestion of alcohol

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7
Q

Overdose priority

A

First priority of care is ABCs (airway, breathing, and circulation)

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8
Q

____ % of the population
aged 15 years and older drink alcohol

A

78 (most widely consumed substance)

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9
Q

Indigenous people and alcohol

A

experience increased
harm related to alcohol use
 Interrelated dependence factors (genetic,
psychosocial, cultural–environmental)

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10
Q

BAC

A

Concentration can be determined by
assessing the blood alcohol concentration

 BAC is affected by the amount consumed,
drinking rate, drink concentration, body
size and composition, and hormones.

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11
Q

Alcohol primarily affects the

A

central nervous system (CNS)

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12
Q

Screening using the CAGE questions

A

C (cut-down) - Have you felt you ought to
cut down on your drinking/drug use?
 A (annoyed) - Have people annoyed you
by criticizing your drinking/ drug use?
 G (guilt) - Have you felt bad or guilty
about your drinking/drug use?
 E (eye opener) - Have you ever had a
drink or used drugs first thing in the
morning to steady your nerves or get rid
of a hangover or to get the day started?

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13
Q

Alcohol withdrawal length (start to end)

A

Most alcohol-dependent patients
experience a minor withdrawal syndrome
in the first 6–12 hours after the last drink.
 May last 3–5 days

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14
Q

Symptoms of Alcohol withdrawal

A

 Tremulousness
 Anxiety
  Heart rate
  Blood pressure
 Sweating
 Nausea
 Hyperreflexia
 Agitation
 Insomnia
 Hallucinations

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15
Q

Severe signs of withdrawal

A

Hallucinations, Seizures and delirium tremens.

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16
Q

Delirium Tremens

A

Anticipated within 48- 72 hours of alcohol withdrawal (last drink)
 Severity depends on how much alcohol was ingested and for how long
 Symptoms:
 Anxiety, uncontrollable fear
 Tremor
 Irritability
 Agitation
 Insomnia
 Visual, auditory, tactile, olfactory hallucinations
 Autonomic over-activity- dilated pupils, profuse perspiration, elevated Vital
signs
 DTs is a life threatening condition, with high mortality rate
 Death may be caused by hyperthermia, peripheral vascular collapse, or cardiac
failure.

17
Q

Complications of Chronic
Alcohol Abuse

A

Wernicke’s encephalopathy, Korsakoff syndrome, nutritional deficiencies, HF, Hypertension

18
Q

Wernicke’s encephalopathy

A

a life-threatening condition caused by chronic thiamine deficiency
 affects CNS and PNS
 Nystagmus, ataxia, confusion

19
Q

Korsakoff syndrome

A

 Condition that results from chronic thiamine deficiency
 Damage to nerve cells in the brain and spinal cord
 Memory issues

20
Q

Diagnostic labs re Nutritional
Deficiencies/other medical
problems

A

 CBC
 chemistry with pre-albumin
 lipid profile
 Thiamine
 Folate (folic acid)
 B12
 Iron, magnesium levels
 Hepatitis screen
 Urinalysis

21
Q

Ethanol (Blood Alcohol, Blood
ET0H) level (critical values)

A

Critical Level > 64.8 mmol/L OR >
300 mg/dL

22
Q

Interprofessional
Care of a Patient
with Alcohol Use
Disorder

A

 Initial treatment is
withdrawal management.
 Supportive measures to
promote ventilation and
circulation until alcohol is
metabolized
 Medications to decrease
symptoms, increase level
of comfort, and decrease
risk of seizures and DTs
 disulfiram, acamprosate

23
Q

Disulfiram (Antibuse)

A

: Aversive therapy causing severe
reactions if alcohol is consumed ( even up to 14 days
after last drink ; small amounts of alcohol- mouthwash,
aftershave, cough medicine can cause a reaction
 Reactions- flushing, seating, headache, neck pain,
palpitations, dyspnea, tachycardia, hypotension, confusion,
CONVULSIONS, DEATH- activate EMS; may give Benadryl to
treat reaction

24
Q

Acamprostate (Campral)

A

after detox of 7 days and opiate
free 10 days; recommended for 1 year- used in US
 Side effects- GI upset, myalgia, headache, rash, syncope,
palpitations, edema, Impotence

25
Q

Special considerations for Perioperative care

A

 If delirium tremors occurs in the post-operative phase
significant mortality rate is associated with cardiac
dysrhythmias, cardiomyopathy, and bleeding tendencies
seen in long–term alcohol abuse
 Screen ALL patients for alcohol use
 Some patients may deny alcohol use - suspect alcohol
withdrawal in patients who develop symptoms (tremors,
diaphoresis, anxiety etc.) after a period of
hospitalization

26
Q

6-12 hours after alcohol withdrawal

A

Minor withdrawal symptoms: insomnia, tremors, anxiety, gastro-intestinal upset, headache, diaphoresis, palpitations, anorexia, nausea, tachycardia, hypertension

27
Q

12–14 hours after alcohol withdrawal

A

Visual, auditory, or tactile hallucinations

28
Q

24–48 hours after alcohol withdrawal

A

Withdrawal seizures: generalized tonic–clonic seizures

29
Q

48–72 hours after alcohol withdrawal

A

Alcohol-withdrawal delirium (delirium tremens): hallucinations (predominantly visual), disorientation, agitation, diaphoresis

30
Q

Example of a screening tool with withdrawal severity

A

Clinical Institute Withdrawal Assessment for Alcohol (CIWA)

31
Q

Mild withdrawal symptoms

A

Anxiety, tremors (shaking), insomnia, headache, nausea, and irritability. Typically lasts 24-48 hours

32
Q

Moderate Alcohol Withdrawal:

A

In addition to mild symptoms, moderate withdrawal may involve increased heart rate, elevated blood pressure, sweating, and confusion. It lasts 48-72hours

33
Q

Severe Alcohol Withdrawal

A

Severe symptoms may include hallucinations, severe confusion, seizures, fever, and agitation. Delirium tremens (DT) lasts 48-72 hours but DT can last for up to a week

HC (9 decks)

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