Clinical Approach to Substance Abuse Disorders (Hill) Flashcards
The National Institute of Alcohol Abuse and Alcoholism (NIAAA) defines moderate drinking in men as?
In women and people over 65?
1) 2 drinks or fewer per day
2) As 1 or fewer drinks per day
What are some withdrawal symptoms of alcohol use disorder?
1) Autonomic hyperactivity
2) Increased hand tremor
3) Insomnia
What is the clinical presentation of alcohol abuse?
1) Daily or frequent drinking to function
2) Violence
3) Neglect of food intake and hygiene
4) N/V
How is alcohol abuse screened for?
CAGE questions:
1) Have you ever felt you ought to Cut Down on your drinking?
2) Do you get Annoyed at criticism of your drinking?
3) Do you ever feel Guilty about your drinking?
4) Do you ever take an Early-Morning drink?
At what blood alcohol level are you legally intoxicated?
Can cause coma?
Can cause death?
1) 0.08
2) 0.40-0.50
3) Greater than 0.50
Tremulousness, delusions, hallucinations, and seizures can occur due to?
Alcohol withdrawal (Delirium Tremens)
In the treatment of alcohol withdrawal, what should be given with fluids?
What vitamins should be given?
1) Magnesium, potassium, glucose
2) Thiamine, folic acid
Why is IV thiamine given to alcoholics that present in the ER?
Thiamine deficiency can result in Wernicke’s encephalopathy and eventually Korsakoff’s syndrome (permanent)
What medication is used to maintain abstinence in alcoholics following withdrawal?
Acamprosate
Acamprosate reduces the voluntary ingestion of alcohol by?
Inhibiting GABA
What opioid antagonist is used to treat alcohol dependence by cutting cravings?
Naltrexone
What is used to control alcohol intake as a deterrent because it produces unpleasant adverse effects if the patient drinks?
Disulfiram
In the initial management of alcohol dependence, what vitals should be checked?
What do you want to look at on CBC?
On BMP?
1) Elevated BP and HR
2) MCV and platelets
3) Hyponatremia
What substances are seen with Stimulant-Related Disorders?
Amphetamines and Cocaine
What symptoms can be seen due to stimulant withdrawals?
1) Increased sleep
2) Nightmares
3) Increased appetite
4) Suicide attempts
What is the treatment for stimulant withdrawal?
Antidepressants and Hospitalization
With Stimulant-Related Disorders, you would use phentolamine to treat?
You would use haloperidol to treat?
1) HTN and hyperthermia
2) Psychotic Symptoms
What substances are seen with Sedatives/Hypnotics/Anxiolytics-Related Disorders?
Benzodiazepines and Barbituates
What is the treatment regimen for Sedatives/Hypnotics/Anxiolytics-Related Disorders?
1) Oxygen
2) Prevent loss of body heat
3) Forced diuresis with alkalization of urine
4) Hemodialysis
What should be taken into consideration with Sedatives/Hypnotics/Anxiolytics withdrawal?
Can be fatal
What symptoms can be seen due to Sedatives/Hyponotics/Anxiolytics withdrawals?
1) Orthostatic hypotension
2) Delirium
3) Seizures
What is the treatment for Sedatives/Hyponotics/Anxiolytics withdrawal?
Phenobarbital (used to wean patients off)
What substances are seen with Hallucinogen-Related Disorders?
LSD and PCP
What can be given to treat Hallucinogen-Related Disorders?
1) Diazepam
2) Sedation with haloperidol if violent
Agitation with blank stare, anxiety, stupor, aggression, panic, bizarre behavior are psychiatry symptoms seen with what Substance-Induced Mental Disorder?
Phencyclidine (PCP)
Agitation with persecutory delusions or euphoria with irritability are psychiatry symptoms seen with what Substance-Induced Mental Disorder?
Amphetamine/Cocaine
Sensory distortion, hypersensitivity of senses, euphoria, hallucinations are psychiatry symptoms seen with what Substance-Induced Mental Disorder?
LSD
What substances are seen with Opioid-Related Disorders?
Morphine, Heroin, Codeine, Methadone
What can be given for opioid treatment?
Naloxone
Naloxone has what effects?
1) Reverse Coma and Apnea
2) Cause vomiting
What can be used to treat withdrawal symptoms of opioids?
1) Buprenorphine w/ or w/out naloxone
2) Methadone
What is the treatment regimen for MDMA “Molly” intoxication?
1) Hypertonic saline solution
2) Hyperthermia ice bath for rapid cooling
3) Benzodiazepines
