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Acute Psych > FINAL - Substance abuse > Flashcards

FINAL - Substance abuse Flashcards

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1
Q

In substance abuse disorder, the substance interferes with __________

A

An individual’s ability to fulfill role obligations

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2
Q

In substance abuse disorder, the individual would ____________ but cannot

A

The individual would like to cut down or control use but cannot

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3
Q

In substance abuse disorder, there is an excessive time spent _______ or ___________

A

Excessive time procuring the substance or recovering from effects

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4
Q

Addiction

A

Tolerance develops and increased amounts are necessary

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5
Q

Intoxication

A

Development of a REVERSIBLE substance-specific SYNDROME due to the ingestion of a substance

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6
Q

Withdrawal

A

Occurs upon abrupt reduction or discontinuation of a substance

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7
Q

In Alcohol Use Disorder, there is a problematic pattern of alcohol use which leads to

A

Clinically significant impairment or distress

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8
Q

Alcohol Use Disorder is a cluster of behavioral and physical symptoms (3)

A

Tolerance, Craving, Withdrawal

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9
Q

Alcohol withdrawal develops _____ hrs after reduction of intake

A

4-12 hrs

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10
Q

Normal male alcohol intake

A

No more than 14 drinks/week

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11
Q

Normal female alcohol intake

A

No more than 7 drinks/week (no more than 3 in one sitting)

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12
Q

Underlying change in brain circuits causes _______ and ________

A

Repeated relapses and intense drug craving

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13
Q

General physiological effects of alcohol

A

General, nonselective reversible depression of CNS

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14
Q

Once ingested, alcohol is immediately

A

Absorbed into the blood stream and carried to the brain, tissues, organs, and body secretions

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15
Q

Absorption of alcohol is influenced by (3)

A

Food, rate of drinking, type of alcohol

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16
Q

Chronic alcohol abuse results in

A

Multi-system impairments

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17
Q

Toxic effects of alcohol results in

A

malabsorption of nutrients - especially vitamin B (Thiamine)

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18
Q

Treatment for Peripheral Neuropathy

A

Reversible with abstinence

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19
Q

11 categories of physiological effects of alcohol

A

1) peripheral neuropathy
2) myopathy
3) cardiomyopathy
4) Wernicke’s encephalopathy
5) Korsakoff’s psychosis
6) Esophagitis
7) Gastritis
8) Pancreatitis
9) Hepatitis
10) Hepatic Encephalopathy
11) Cirrhosis

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20
Q

Alcoholic Myopathy (6)

A
  • Muscle pain
  • Swelling
  • Weakness
  • Reddish urine from myoglobin breakdown
  • Elevated CPK, LDH, AST
  • Vitamin B deficiency
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21
Q

Myopathy treatment

A

Abstinence, nutrition, Thiamine supplement

22
Q

Most serious thiamine deficiency in alcoholics

A

Wernicke’s encephalopathy

23
Q

Wernicke’s encephalopathy

A
  • Paralysis of ocular muscles
  • Diplopia
  • Ataxia
  • Somnolence
  • Stupor
24
Q

Treatment of Wernicke’s encephalopathy

A

Thiamine replacement to avoid death

25
Q

Korsakoff’s Psychosis (3)

A
  • Confusion
  • Recent memory loss
  • Confabulation
26
Q

Which effect is seen in those recovering from Wernicke’s encephalopathy

A

Korsakoff’s psychosis

27
Q

Treatment of Korsakoff’s psychosis

A

Thiamine replacement - PN or oral

28
Q

How does alcohol effect myocardial cells? What odes it lead to? (3)

A

Accumulation of lipids in myocardial cells leads to enlargement, CHF, arrythmias

29
Q

Signs of cardiomyopathy

A
  • Enlargement, CHF, arrhythmias
  • Tachycardia
  • Dyspnea
  • Edema
  • Palpitations
  • Non-productive cough
  • Decreased exercise tolerance
  • Elevated CPK, LDH, AST, ALT
30
Q

Treatment of cardiomyopathy

A

Abstinence

31
Q

Alcohol Intoxication - levels, lethal

A

100-200 mg/dL, lethal if 400-700 mg/dL

32
Q

Intoxication symptoms (9)

A 
FUN IS MIDDI 
Flushed face
Unsteady gait 
Nystagmus 
Incoordination 
Slurred speech 
Mood lability 
Impaired social or occupational functioning 
Disinhibition 
Impaired judgment
33
Q

Alcohol Withdrawal symptoms (8)

A

Autonomic hyperactivity

  • Agitation
  • Visual, tactile, auditory hallucinations/illusions
  • Anxiety
  • Generalized tonic-clonic seizures
  • N/V
  • Insomnia
  • Sweating
  • Hand tremors
34
Q

Alcohol withdrawal, course of treatment

A

Benzos - Librium, Ativan

Start with high doses and reduce by 20-25% each day

35
Q

Tremor treatment

A

Libirum 25-100 mg q4-6 hrs

36
Q

Hallucination/agitation treatment

A

Libirum IV 0.5mg/kg at 12.5 mg/min until calm

37
Q

Withdrawal seizure, DT treatment

A

Libirium IV 0.1 mg/kg at 2.0 mg/min

38
Q

Individuals with liver disease should use…

A

Shorter acting Ativan

39
Q

Nutrition intervention

A

Thiamine replacement

40
Q

For breakthrough symptoms…

A

Monitor and give additional doses of benzos

41
Q 
Physiological effects of Opioids 
CNS (7):
GI:
Cardiovascular:
Sexual function:
A

CNS - euphoria, respiratory distress, mood changes, mental clouding, drowsiness, pain reduction, pupillary constriction
GI - diminished
CV - hypotension
Sexual function - decreased libido and function

42
Q

Opioid Overdose Triad

A

Pinpoint pupils + unconsciousness + respiratory depression

43
Q

Opioid Overdose signs (6)

A
  • O2 less than 86%
  • Bradycardia
  • Hypotension
  • Unresponsive
  • Loud Snoring
  • Triad
44
Q

Opioid overdose treatment

A

Narcan - IM, IV, SC, Nasal

-Takes 3-7 minutes so give assisted breathing until it takes effect

45
Q

Opioid Withdrawal symptoms (12)

A
  • Dysphoric mood
  • N/V
  • Muscle aches
  • Lacrimation (tearing) or rinorrhea (runny nose)
  • Diarrhea
  • Pupillary dilation, piloerection, sweating
  • Yawning
  • Fear
  • Insomnia
46
Q

When do opioid withdrawal symptoms occur?

A

6-8 hrs after last dose

47
Q

When does opioid withdrawal peak?

A

2nd or 3rd day

48
Q

When do opioid withdrawal symptom subside?

A

5-10 days

49
Q

Drug treatments for opioid withdrawal

A

Methadone substitution - daily maintenance

Buprenorphine - office supply via MD

50
Q

Methadone

A

daily opioid withdrawal treatment

51
Q

Which drug do you get a month supply of at the MD

A

Buprenorphine

52
Q

Drug for nicotine/tobacco abuse

A

Buproprion

Acute Psych (15 decks)

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