E4: Drug Abuse/Addiction Part II Old People & EtOH

Question 1

WHHAAAA???The number of adults aged 50+years with substance abuse disorders is expected to _______ by 2020

Answer 1

DOUBLE

Question 2

SAY WHAT?! Nearly ____% of adults aged 65 and older drink alcohol

Answer 2

40%

Question 3

What is the most commonly abused substance in older adultS?

Answer 3

weed

Question 4

Which population is increasing in seeking treatment youth or older people?

Answer 4

old people

Question 5

What are the 3 main factors leading to Dependency on EtOH and Rx Drugs in the older population?

Answer 5

1. chronic pain 2.psychological problems 3.loneliness/boredom

Question 6

What are the 4 main meds (drugs) being abused by older adults?

Answer 6

1.Opiods 2.Benzos 3.EtOH 4.Sleeping pills

Question 7

What is the trend for Cocaine and Heroine use in the older population?

Answer 7

use declines after 60

Question 8

What is the most common class of CNS depressants abused?

Answer 8

Opioid analgesics

Question 9

Non-medical use of ______ abused more often than cocaine, heroin, hallucinogens and inhalants COMBINED

Answer 9

prescription drugs

Question 10

IN GENERAL, what is the most frequently abused drug?

Answer 10

EtOH

Question 11

Quick BIOCHEM: Ethyl alcohol is rapidly and completely absorbed from the _____….______ in the liver to ________, which is then metabolized to CO2 (carbon dioxide) and H2O (water)….Excreted in _____ and _____

Answer 11

GI tract… Oxidized to acetaldehyde…lungs and urine

Question 12

EtOH is eliminated by ___ order kinetics

Answer 12

Zero

Question 13

Since EtOH is 0 order kinetics-a _______ amount of alcohol is metabolized and eliminated per unit of time regardless of how much alcohol has been ingested….___ gram(s) per hour

Answer 13

constant..1 gm/hr

Question 14

What is a UNIQUE indication that someone has had a HIGH amount of EtOH?

Answer 14

NySTAGMUS (eye vibrations)

Question 15

Which drug will cause dilated pupils?

Answer 15

EtOH

Question 16

Which drug will cause pinpoint pupils? What is the official name for this?

Answer 16

Opiods…MIOSIS (not the same as sperm/egg miosis)

Question 17

Physiologic Considerations of Alcohol Use in Older Adults: Decreased body _____ and lean body _____

Answer 17

water…mass

Question 18

Physiologic Considerations of Alcohol Use in Older Adults: Decline in _____ and kidney function (Unexplained elevations of ________ indicate chronic alcohol abuse)

Answer 18

liver… liver enzymes

Question 19

Physiologic Considerations of Alcohol Use in Older Adults: Older people develop problems with alcohol even if ________ have not changed

Answer 19

drinking habits

Question 20

Consequences of Chronic Alcoholism in Elderly Individuals: Simple withdrawal, Delirium tremens (DTs), Seizures, Organic hallucinations, Psychosis, Dementia…all fall under the category:

Answer 20

biological brain disorder

Question 21

Consequences of Chronic Alcoholism in Elderly Individuals: Liver damage/cirrhosis, Peripheral neuropathies, Damaged: Pancreas, Heart, Muscles, Bone marrow, Bone, Increased risk for certain cancers and immune system disorders..all fall under the category:

Answer 21

Systemic Health Problems

Question 22

Consequences of Chronic Alcoholism in Elderly Individuals: ________/________ caused by: Cirrhosis, Heart disease, Pancreatitis, Pancreatic CARCINOMA

Answer 22

Fatigue/Weightloss

Question 23

Consequences of Chronic Alcoholism in Elderly Individuals: Worsening of _________: Diabetes, Hypertension, Congestive heart failure, Liver problems, Memory problems

Answer 23

existing conditions

Question 24

Consequences of Chronic Alcoholism in Elderly Individuals: _________: Isolation, Depression, Anxiety, Suicide

Answer 24

Psychological

Question 25

Consequences of Chronic Alcoholism in Elderly Individuals: Other: _______ burnout…Legal problems…_____ (same as younger people)…Criminal behavior (

Answer 25

Caregiver…DUI

Question 26

_________ + alcohol = GI bleeding

Answer 26

Aspirin/NSAIDS

Question 27

__________ + alcohol = liver damage

Answer 27

Acetaminophen

Question 28

________ + alcohol = drowsiness, impaired judgment/reaction time/coordination

Answer 28

Cold/Allergy Meds and antihistamines

Question 29

________ + alcohol = sleepiness, poor coordination, dyspnea, tachycardia, memory problems

Answer 29

CNS drugs

Question 30

Withdrawal from EtOH: How does it progress?

Answer 30

Occurs in stages

Question 31

Withdrawal from EtOH: ______ nervous system hyperactivity

Answer 31

Autonomic

Question 32

DTs = delirium tremens = shaky tremor movements can occur from withdrawal of what drug?

Answer 32

EtOH

Question 33

What are two of the main things to be aware of when treating an alcoholic?

Answer 33

1.Bleeding problems (c/o liver damage) 2.Cancer (oropharyngeal)

Question 34

What are the 3 main consequences of fetal alcohol syndrome?

Answer 34

1.Patterned Facial Features 2.Growth deficiency 3.CNS dysfunction

Question 35

What do you use to treat Alcoholism and how does it work?

Answer 35

DI-SUL-FIR-AM (Antabuse)….inhibits aldehyde dehydrogenase. build up of acetylaldehyde causes VOMITING. Its a deterrent

Question 36

Alcoholics in the Dental Office: _______ from neglect

Answer 36

Poor oral hygiene

Question 37

Alcoholics in the Dental Office: Bilateral enlarged __________

Answer 37

parotid glands

Question 38

Alcoholics in the Dental Office: _______ = abdomen filled with fluid

Answer 38

ASC-ITE-S

Question 39

Alcoholics in the Dental Office: Difficulty metabolizing drugs, including _________

Answer 39

local anesthetics!!!

Question 40

KNOW THESE Oral Complications of Alcoholism!!! (7) GET IT!

Answer 40

GLLA-BOF 1.Glossitis 2. Loss of Tongue Papillae 3.Leukoplakia on lateral borders of tongue 4.Angular Chelitis 5.Bleeding (from liver damage) 6.Oral Cancer (squamous cell) 7.Fungal Infections