Module 6: Substance Use Disorders Flashcards
What are the signs and symptoms of alcohol withdrawal?
- delirium tremens (sudden and severe mental or nervous system changes)
- elevated temperature, pulse, and blood pressure
- seizures
- tremors
What are the mild symptoms of alcohol withdrawal?
- temperature ↑
- heart rate ↑
- systolic blood pressure normal/slightly ↑
- slight diaphoresis
- mild anxiety and restlessness
- shakes
- hand tremors
- restless sleep
- impaired appetite
- nausea
What are the moderate symptoms of alcohol withdrawal?
- temperature ↑
- heart rate 100-120 BPM
- systolic blood pressure ↑
- obvious diaphoresis
- intermittent confusion
- transient visual and auditory hallucinations
- illusions (mostly at night)
- painful anxiety
- motor restlessness
- visible tremulousness
- rare convulsions
- insomnia and nightmares
- anorexia, N/V
What are the severe signs of alcohol withdrawal?
- temperature ↑
- heart rate, 120 - 140 BPM
- systolic and diastolic blood pressures ↑
- marked diaphoresis
- marked disorientation and confusion
- disturbing visual and auditory hallucinations
- delusions related to the hallucinations
- delirium tremens
- consciousness agitation
- misidentification of objects
- extreme restlessness
- uncontrollable tremors and convulsions
- panic state unable to sleep
- rejecting all fluid and food
What are signs to assess for in alcohol withdrawal?
- anxiety
- agitation
- auditory disturbances
- visual disturbances
- tactile disturbances
- headache, fullness in head
- N/V
- orientation, clouding senses
- paroxysmal sweats
- tremor
What medications are used to treat alcohol withdrawal?
- Long-acting benzodiazepines
- Chlordiazepoxide (Librium)
- Diazepam (Valium)
- Short acting benzodiazepine
- Lorazepam (Ativan)
How do benzodiazepines help with alcohol withdrawal?
- bind to the GABA-benzodiazepine receptor
- depress the CNS
- imitate mechanism of action of alcohol
What are signs of chronic Alcohol Use Disorder (AUD)?
- Alcohol-induced psychotic disorder
- delusions and auditory hallucinations
- Delirium tremens (CNS irritability)
- life threatening
- hallucinations
- shaking
- altered Mental Status
- Tonic clonic seizures (gran mal)
- aspiration
- death
What are medications used for AUD? (NOT withdrawal)
- Acamprosate calcium
- Disulfiram (Antabuse)
- Naltrexone hydrochloride (ReVia)
What medication is first in line for alcoholism?
Naltrexone hydrochloride (ReVia)
What is Naltrexone hydrochloride used for?
- treat narcotic dependence
- approved for treatment of alcohol dependence
When is Acamprosate calcium used?
when abstinence started but not while the person is still drinking
How is Disulfiram used?
- an aversive medication
- patient knows that they will get sick if they drink alcohol with this medication
What drugs are used for maintenance and MAT (opioids)?
- Buprenorphine (MAT)
- Methadone (MAT)
- Naltrexone
- Suboxone: Buprenorphine + Naloxone
- Subutex: only contains Buprenorphine (safe in pregnancy)
What is psychoeducation of AUD?
providing those in recovery with knowledge and information as it pertains to successful and long-term sobriety
- group therapy settings through reading, lectures, video series, presentations or seminar-style discussions?
What is Wernicke-Korsakoff Syndrome?
- Alcohol toxic to the brain – causes atrophy to frontal cortex and chronic brain syndrome
- Poor dietary intake can lead to deficiencies of folic acid, thiamine and other B vitamins.
- Wernicke encephalopathy – degenerative brain disorder caused by thiamine deficiency
What is Korsakoff amnestic syndrome?
- involves the heart, vascular and nervous system
- inability to acquire new information and retrieve memories
What are signs of Korsakoff amnestic syndrome?
- amnesia
- attention deficit
- confabulation
- disorientation
- visual impairment
What’s the difference between medications for recovery treatment and medication assisted treatment (MAT)?
- Recovery treatment medications address mental health and support wellness overall, while MAT specifically targets substance use disorders
What are some medication assisted treatment (MAT) drugs (alcohol & opioids)?
- Acamprosate Calcium
- Disulfiram
- Naltrexone hydrochloride (ReVia)
- Buprenorphine
- Methadone
What are the screening tools for Substance Use Disorder (SUD)?
- CAGE: 4 question screening
- AUDIT – C: 3 question screening
- AUDIT: 10 question screening
What 4 questions are asked for CAGE?
C – Have you ever felt the need to cut down on your drinking?
A – Have people annoyed you by criticizing your drinking?
G – Have you ever felt guilty about drinking?
E – Have you ever felt you needed a drink first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)?
What primary neurotransmitters are associated with SUD?
- acetylcholine
- dopamine (rewarding effect)
- endorphins
- GABA
- glutamate
- norepinephrine
- serotonin
What medication is used for suspected opioid overdose?
Naloxone (Narcan)
