Change and Drugs - Sheet1 Flashcards
What is precontemplation
Not yet acknowledging there is a problem
What is contemplation:
acknowledging there is a problem but not ready or willing to make a change
What is preparation/determination:
getting ready to change behaviors
What is action/willpower:
changing behaviors
What is maintenance:
maintaining the behavior changes
What is relapse:
Returning to old behaviors and abandoning new changes
What are 4 depressants
ETOH, Opioids, Barbs, BZDs
This presents with emotional lability, slurred speech, taxi, coma, blackouts and elevated GGT can be an indicator with AST 2x ALT
Alcohol intoxication
This can present as autonomic hyperactivity and Delirium tremens if a pt is hospitalized for an extended period of time with known chronic ETOH use
ETOH Withdrawal
This presents with euphoria, respiration and CNS depression, decreased GAG reflex, pupil constriction is key, seizures if taken too much
Opioids
How do you treat Delirium tremens seen in ETOH withdrawal
BZDs
This withdrawal presents with excessive sweating, dilated pupils, piloerection (cold sweat), fever, rhinorrhea, yawning, nausea, stomach cramps, diarrhea with flue like symptoms
Opiods
How do you treat opioid withdrawal:
long term support with methadone or buprenorphine
This OD presents with acute marked respiratory depression
Barbituates
This withdrawal presents with delirium and life-threatening CV collapse
Barbiturates
What is treatment for OD on Barbiturates
-symptom management, respiratory assistance if necessary
This intoxication presents with ataxia and minor respiratory depression
BZDs
This withdrawal presents withs keep disturbances, depression and rebound anxiety, with potential for seizures
BZDs
How do you treat BZD intoxication
Flumazenil
This life threatening alcohol withdrawal syndrome peaks 2-4 days after last drink is characterized by hyperactivity of autonomic systems: Tachycardia, tremors, anxiety, seizures
Delirium tremens
Alcoholic hallucinosis is a distinct condition characterized by what type of hallucinations 12-48 hrs post sat drink:
Visual
Intoxication with these presents as euphoria, grandiosity, pupillary dilation, prolonged wakefulness and attention, HTN, tachycardia, anorexia, paranoia and fever. If severe can manifest as cardiac arrest or seizures
Amphetamines
How do you treat Amphetamine intoxication
BZDs for agitation and seizures
This intoxication presents with impaired judgement, pupillary dilation, hallucinations (including tactile), paranoid ideations, angina, sudden cardiac death
Cocaine
How do you treat cocaine OD
Alpha-blockers, BZDs, (don’t give b-blockers)
This OD presents with restlessness, increased diuresis, and muscle twitching with withdrawal symptoms of headache, difficulty concentrating, flu-like symptoms
Caffeine
This presents with OD of restlessness and withdrawal symptoms of irritability, anxiety, restlessness, difficulty concentrating
Nicotine
Intoxication with this substance presents with violence, impassivity, psychomotor agitation, nystagmus, tachycardia, HTN, analgesia, psychosis, delirium, and seizures.
PCP
How do you treat PCP OD
BZDs and/or rapid-acting antipsychotic
What is the most common complication from PCP OD:
trauma
Intoxication with this results in peripheral distortion both visual and auditory, depersonalization, anxiety, paranoia, psychosis, and possible flashbacks
Lysergic acid diethyl amide (LSD)
Intoxication with this substance presents with Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgement, social withdrawal, increased appetite, dry mouth, maybe hallucinations and conjunctival injection
Marijuana
This is medical form of a recreational drug useful as an antiemetic in chemotherapy and appetite stimulant in AIDS
Dronabinol-tetrahydrocannabinol isomer
Withdrawal of this drug can present as irritability, anxiety, depression, insomnia, restlessness, decreased in appetite with positive UA up to 1 month
Marijuana
Intoxication with this substance shows hallucinogenic stimulant euphoria, disinhibition, hyperactivity. With potential fatal effects including HTN, tachycardia, hyperthermia, hyponatremia, and serotonin syndrome
MDMA (ecstasy)
Severe Depression, fatigue, change in appetite, difficulty concentrating, anxiety are withdrawal effects of this drug
MDMA (ecstasy)
Users of this drug are at increased risk for hepatitis, HIV, abscesses, bacteremia, right-heart endocarditis
Heroin
What do you use for heroin detoxification or long-term maintenance
Methadone
MOA of Naloxone and buprenorphine for heroin addiction:
naloxone: antagonist not oral available - Buprenorphine: partial agonist (will precipitate withdrawl)
This is a long acting opioid antagonist used for relapse prevention once detoxified form heroin
Naltrexone
What can be given to condition an alcoholic pt to abstain from alcohol use:
disulfiram
This presents as a triad of confusion, opthalmoplegia, ataxia
Wernicke encephalopathy from B1 (thiamine) deficiency
This presents following Wernicke encephalopathy with irreversible memory loss, confabulation, and personality changes, and is associated with periventricular hemorrhage/necrosis of the mammillary bodies
Korsakoff syndrome
This is a partial thickness tear at the gastroesophageal junction caused by excessive/forceful vomiting often presents with hematemesis and misdiagnosed as esophageal varicose rupture
Mallory-weiss syndrome
