Exam 5 - Substance Abuse Flashcards
define substance abuse
use of psychoactive drug that poses a risk to health
define addiction
chronic relapsing brain disease that is characterized by constant seeking
define tolerance
the response from a specific dose that is smaller than the initial
what is cross tolerance
tolerance to one drug confers tolerance to another drug in the same class
psychological dependence
the intense subjective need for a drug
what is abstinence syndrome
withdrawal; signs and symptoms when they discontinue physical use of drug
physical dependence
a state in which abstinence syndrome will occur if the drug is discontinueD
what are biological factors that affect addictive behaviors
genetics and biochemical(reward center wants more)
what are psychological factors that affect addictive behaviors
developmental factors
personality factors
last part of brain to develop is impulse control
what are sociocultural factors that affect addictive behavior
modeling and imitation
conditioning
cultural and ethnic influences
what are the common prescriptions that are abused?
opioids
CNS depressants
stimulants
early signs of opioid withdrawal
(AADIIMY) agitation anxiety muscle aches increased lacrimation insomnia rhinorrhea diaphoresis yawning
late signs of opioid withdrawal
abdominal cramping diarrhea mydriasis (dilated pupils) piloerection nausea vomitting
withdrawal medications for opioids
clonidine
antiemetics
antidiarrheals
buepinephrine
what does clonidine do?
decrease anxiety, agitation, muscle aches, diaphoresis, running nose and cramping
how do you assess severity of symptoms for withdrawal of opioids?
COW scale
meant for buepinephrine
what are complications that can occur during opioid withdrawal
dehydration
electrolyte imbalance
aspiration
what are the alcohol intoxication stages?
euphoria lethargy confusion stupor coma death
BAC for euphoria
0.3 to .12
BAC for lethargy
.09 to .25
BAC for confusion
.18 to .30
BAC for stupor
.25 to .40
BAC for coma
.35 to .50
BAC for death
.5 and above
signs of alcohol euphoria
shortened attention span
flushed
poor judgement
troubles with fine movement
signs of lethargy alcohol
sleepy trouble understanding and remembering slow reaction uncoordinated movements blurry vision decreased sensory reception
signs of confusion for alcohol
confusion dizzy uncoordinated highly emotional cannot see clear slurred speech no pain
signs for stupor alcohol
can barely move cannot stand or walk cannot respond to stimuli may vomit in and out of consciousness
signs for coma alcohol
unconsciousness decreased reflex decrease body temp slow shallow resp HR slow death can occur
signs for death alcohol
CNS fails
breathing stops
what are short term effects of alcohol
gi irritation increase blood flow to skin aches swelling weakness inhibit antidiuretic hormone increase urinary excretion of magnesium
why is it important to keep a close eye on the intoxicated patient?
prevent falls and injury and aspiration
why is hydration important during alcohol intoxication?
to prevent dehydrated effects of alcohol
how is thiamine used during alcohol intoxication?
prevent wernicke-korsakoff syndrome
how is thiamine administered?
PO or IV
what is wernickes korsakoff?
wern –> encephalapthy from thiamine def
kors –> memory issue r/t thiamine(b12) def
what are the physical effects of chronic alcohol abuse?
myopathy peripheral neurapthy malnutrition wernicke korsakoff cardiomyopathy pancreatitis sexual dysfunction
when might pancreatitis occur?
1 to 2 days after binge drinking
what are the medications used for alcohol withdrawal?
benzodiazepines
lorazepam (ativan)
librium
thiamine, folic acid, multivitamin
how does benzos help alcohol withdrawal
sedate to help anxiety and agitation
what are treatments for alcohol withdrawal
medications IV fluids physical environment reorientation observation
what is the scale to use for alcohol withdrawal severity?
CIWA
what questions do we ask to assess for alcohol abuse and misuse?
CAGE questions
- CUT DOWN
- ANNOYED
- GUILT
- EYE OPENER
what are drugs used for alcohol treatment
reviva (naltrexone)
campral
antabuse
what is reviva or naltrexone?
opioid receptor antagonist
what is campral?
reduced symptoms of post acute alcohol withdrawal
what is antabuse?
acute sensitivity to alcohol
what are the 3 levels of prevention of substance abuse
primary
secondary
tertiary
what is primary prevention of substance abuse
school and community based
what is secondary substance abuse prevention
assess and intervene
what is tertiary prevention of substance abuse
monitor withdrawal and relapse prevention
