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Shelf psych > First Aid Substance Related Disorders I > Flashcards

First Aid Substance Related Disorders I Flashcards

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1
Q

Abuse

A

impairment or distress for at least 12 mo with 1+:

  • failure to fulfill obligations at work, school, or home
  • use in dangerous situations
  • recurrent substance-related legal problems
  • continued use despite social or interpersonal problems due to the substance abuse
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2
Q

dependence

A

impairment or distress manifested by at lease 3+ in 12 mo period

  • tolerance
  • withdrawal
  • using substance more than originally intended
  • persistent desire or unsuccessful efforts to cut down use
  • significant time spent on getting/recovering from substance
  • dec social occupational or rec activities
  • continued use despite problems
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3
Q

withdrawal

A

development of substance specific syndrome due to the cessation of substance use that has been heavy and prolonged

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4
Q

tolerance

A

increased amounts of substance to achieve the desired effect or diminished effect if using the same amount of the substance

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5
Q

treatment of substance abuse

A

behavioral counseling
psychosocial treatments with motivational intervention and CBT
contingency management and group therapy
AA and narcotics anonymous

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6
Q

how long is cocaine in your system

A

2-4 days

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7
Q

how long are amphetamines in your system

A

1-3 days

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8
Q

how long is PCP in your system

A

3-8

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9
Q

how long are sedatives/hypnotics in your system

A

short acting barb 24 hrs
long acting barb 3 weeks
short acting benzo 3 days
long acting benzo 30 days

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10
Q

how long are opiates in your system

A

2-3 days

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11
Q

how does alcohol work in CNS

A

activates GABA inhibits glutamate R and VCaCh

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12
Q

how is alcohol metabolized

A

to actaldehyde by alcohol dehydrogenase

to acetic acid by aldehyde dehydrogenase

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13
Q

treatment of alcohol intoxication

A

monitor ABCs, glucose, electrolytes and acid base
give thiamine
naloxone if opioids too
CT for subdural hematoma or brain injury

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14
Q

at what BAL do most patients have ataxic gait

A

100-150

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15
Q

BAL lethargy and difficult sittin guprigth

A

150-250

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16
Q

coma BAL level

A

300

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17
Q

respiratory depression BAL level

A

400

18
Q

clinical presentation of alcohol withdrawal

A

insomnia, anxiety, hand tremor, irritability, anorexia, nausea, vomiting, autonomic hyperactivity (diaphoresis, tachycardia and HTN), psychomotor agitation, fever, seizures, hallucinations and delerium

19
Q

Sx according to time in withdrawal from alcohol

A 
6-24 hours earliest
tonix clonic seizures between 6 and 48 hours, peak around 24
DTs happen in 1/3 people
hypoMg predispose to seizures
treated with benzo taper
20
Q

Sx DT

A

delerium, hallucinations, gross tremor, autonomic instability and fluctuating levels psychomotor activity

21
Q

treatment DTs

A 
benzo
carbamazepine and valproate taper can be used
antipsychotics for severe agitation
thiamine, folic acid and MVI
electrolyte and fluid abnormalities corrected
monitar with CIWA scale
watch consciousness
check signs for hepatic failure
22
Q

CAGE questionnaire

A 
2+ = positive screen
ever wanted to Cut down
ever felt Annoyed by criticism
felt Guilty about drinking
taken a drink as an Eye opener (to prevent shakes)
23
Q

Disfulfiram

A

Antabuse
blocks enzyme aldehyde dehydrogenase in liver and auses aversive reaciton to alcohol like flushing HA nausea vomiting, sob
CI in those with severe cardiac disease, pregnancy and psychosis

24
Q

naltrexone

A

opioid R blocker
dec craving of alcohol
if have physical opioid dependence it will cause withdrawal

25
Q

give what before glucose in alcohol withdrawal

A

thiamine to prevent wernicke korsakoff syndrome

26
Q

acamprosate

A

campral
similar to GABA thought to inhibit glutamatergic system
started post detox for relapse prevention
can be used in those with liver disease
CI in severe renal disease

27
Q

topiramate

A

topomax
anticonvulsant that potentiates GABA and inhibits glutamate R
reduces craving for alcohol

28
Q

wernickes encephalopathy

A

caused by thiamine, vit B1 deficiency resulting from poor nutrition
acute and can be reversed with thiamine therapy
ataxia, confusion, ocular abnormalities
can progress to korsakoff syndrome

29
Q

korsakoff syndrome

A

chronic amnestic syndrome
reversible in only 20%
impaired recent memory, anterograde amnesia, compensatory confabulation (unconscious)

30
Q

how does cocaine work

A

blocks dopamine reuptake from synaptic cleft, causing a stimulant effect

31
Q

effects of cocaine

A

euphoria, heightened self esteem, inc or dec BP, tachycardia or bradycardia, nausea, dilated pupils, weight loss, psychomotor agitation or depression, chills and sweating

32
Q

dangerous effects of cocaine

A

respiratory depression, seizures, arrhythmias, paranoid and hallucinations
the vasoconstriction effect can lead to MI or stroke

33
Q

management of cocain intoxication

A

benzos, severe psychosis give antipsychotics

34
Q

signs of cocaine withdrawal

A

malaise, fatigue, hypersomnolence, depression, hunger, constricted pupils, vivid dreams, psychomotor agitation or retardation

35
Q

Sx of amphetamine avuse

A

dilated pupils, increased libido, perspiration, respiratory depression and chest pain

36
Q

how do amphetamines work

A

block reuptake and facilitate release of DA and NE from nerve endings

37
Q

what are the substituted amphetamines

A

MDMA ecstasy and MDEA eve

release DA NE and erotonin

38
Q

signs of chronic amphetamine use

A

acne and accelerated tooth decay

39
Q

don’t want to mix cocaine with what

A

anything really

SSRI

40
Q

OD amphetamines Sx

A

hyperthermia, dehydration and rhabdomyolysis

41
Q

treatment of amphetamine OD

A

rehydrate, correct electrolyte imbalance and treat the hyperthermia

42
Q

Sx of special K

A

ketamine

tachycardia, tachypnea, hallucinations and amnesia

Shelf psych (6 decks)

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