Lecture 3: Substances of Abuse Flashcards
What is the top drug abused?
What is the first organ affected in abuse of this substance?
ALCOHOL
BRAIN
effects of alcoholism?
management?
affects vision, depth of concentration, is a depressant
banana bag, supportive care, ABC, Benzos
DUI level?
acute alcohol intoxication level?
DUI - BAL > 0.080 g/dl
acute alcohol intoxication - BAL > 100
alcohol withdrawal syndrome
occurs after …. ;
is a phenomenon of … ;
AWS
occurs after cessation of alcohol intake after prolonged and heavy use
is a phenomenon of a concomitant loss of inhibition and increased excitation
mild - anxiety/tremor
mod - hallucinations/seizures
severe - after 3-5 days !
What is Delirium tremens???
signs and symptoms
management
2-3 days after last drink, a sever form of AWS; a rapid onset of confusion in chronic alcohol pts
-- tachycardia, HTN, dangerous dehydration
-- confusion, disorientation, stupor, sweats, sleep
issues
-- **wernicke-korsakoff**: **thiamine deficiency** characterized by **confusion, ataxia, ophthalmoplegia, memory issues** (AOA = AMS, ophthalmoplegia, ataxia)
-- calm, well lit environment
how do BENZOs play into AWS?
benzos bind to GABA
GOLD STANDARD FOR AWS TX –> seizure prophylaxis
benzodiazepine - used for agitation, AWS and seizures
What is given in the case of an iatrogenic overdose of benzodiazepine?
flumazenil
OPIOIDS
opiates vs opioids
and their complications
opiATEs = natural
opiOIDs = synthetic
ATEs —-> Morphine + Codeine (or cocaine?)
–miosis,CNS/Resp depression
OIDs —-> Demerol + Methadone + Fentanyl
–mydriasis, CNS/Resp depression, arrhythmia, seizures
What to use when pt is in Opioid Withdrawal Syndrome?
life threatening!
use buprenorphine or naloxone/naltrexone
the latter for overdose too
What is something Florida set in place to combat national opioid epidemic?
Who is it NOT for?
Florida’s Controlled Substance Prescription Law: Chp 2018-13 (House Bill 21)
new requirements for prescribing controlled substances
NOT for chronic pts; cancer, terminal illness, incurable dz a/w pain, palliative care, serious trauma
What does the Controlled Substance Prescription Law states in regard to physicians?
law states that all licensed physicians registered w DEA and authorized to prescribe controlled substances must take a board approved 2 hours CE course on controlled substances !!
