substance abuse Flashcards
What are the 3 C’s of an addiction
Craving
Consequences (use despite)
control (loss of control)
+ tolerance and withdrawal
Cage screening tool
Cut down
annoyed
guilty
early morning
alcohol use disorder can be diagnosed based on what criteria
loss of control
use with understanding of consequences
craving/compulsions
tolerance and withdrawal
what does alcohol withdrawal look like
hand tremor, insomnia, hallucinations, anxiety, seizures
alcohol intoxication/overdose symptoms
slurred speech, hand tremor with normal mental status
dilated pupil
(CNS depressant)
is alcohol withdrawal life threatening?
yes, wernicke encephalopathy and delirium tremens
what are the symptoms of delirium tremens
tremors, delusions, hallucinations, seizures
how do we treat alcohol withdrawal
prevent with a detox order set
benzodiazapens on a schedule
fluids and vitamins (IV thiamine def)
what screening do we use in alcohol withdrawal to determine benzodiazepine dose
CIWA-Ar
Korsakoff is damage to?
maxillary bodies (permanent)
what are some treatments/rehabilitation options for people with alcohol disorder
motivational interviewing, residential programs, AA, rehab programs
what drug can we use to treat alcohol use disorder to maintain abstinence and inhibit GABA in the CNS
acamprosate
what drug can we use in alcohol use disorder that improves abstinence and is an opioid antagonist
naltrexone
what medication can we use in alcohol use disorder as a deterrent and cause flushing of the skin, accelerated HR, shortness of breath, headache, mental confusion and more
disulfiram
in alcohol use disorders what are the labs
hyponatremia, microcytic anemia
elevated BP and HR
medications for withdrawal aside from the thiamine/fluids
Benzodiazepam
diazepam**
what Benzos should you use in alcohol withdraw if your patient has a known liver impairment
lorazepam
intoxication symptoms with amphetamines and cocaine
increased energy/alertness
anxiety irritability
seizures
elevated BP and pulse
dilated pupils
loss of appetite
delusions *, euphoria with irritability
how do you treat intoxication with stimulates
phentolamine for HTN and hyperthermia
haloperidol (for psychosis)
withdrawal of stimulant symptoms
depression, increased sleep, increased appetite, cravings, irritability
withdrawal treatment of amphetamines and cocaine (stimulants)
manage symptoms
intoxication of sedatives ( benzodiazepines and barbiturates)
increased seizure threshold, sedation, coma, hypotension, hypothermia, hypoxemia, respiratory depression, depressed reflexes
(CNS depression)
treatment of a benzodiazepine/barbituate overdose
flumazenil (opioid antagonist)
treatment of sedative intoxication
ABC
airway
breathing
circulation
prevent heat loss
diuresis
can withdrawal of sedatives be fatal?
yes
anxiety, hyperreflexia, delirium, seizures, sweating, weakness, orthostatic hypotension
sedative withdrawal treatment
phenobarbital
LSD/PCP intoxication
dilated pupils, increased HR, paranoia, hallucinations
muscular rigidity, violent behavior and nystagmus in PCP
treatment of LSD/PCP in intoxication
diazepam/haloperidol if violent
PCP/LSD withdrawal symptoms
flashbacks
Benzos
PCP psychiatric symptoms
agitation with blank stare
stupor
aggression
bizarre behavior (picking up a car)
LSD psychiatric symptom s
sensory distortion, hypersensitive of senses
substance induced mental disorders
mental health disorder developed within 1 month of substance intoxication
opioid related intoxication
pain relief with LOC
leathrgy
euphoria
itching
miosis (pinpoint pupils)
consipation
respiratory depression
hypotension
treatment of opioid intoxication
supportive care and NALOXONE (intranasally)
is opioid withdrawal fatal
symptoms
no, feels like it
sweating, lacrimation, dilated pupils, violent yawning, restlessness
opiote withdrawal scale
COWS
withdrawal treatment for opioids
buprenorphine or methadone
buprenorphine and naloxone
what drug can you use in opioid withdraw if there is elevated blood pressure
clonidine
what drug can you use in opioid withdrawal if there is itching and rhinorrhea
diphenhydramine
what drug can you use in opioid withdrawal with diarrhea
Imodium
Molly intoxication symptoms
hyperthermia, jaw clinching, nystagmus, tremors, psychogenic polydipsia, chills, nystagmus, dilated pupils, hyponatremia and cerebral edema, serotonin syndrome
treatment of Molly intoxication
hypertonic saline solution
hyperthermia ice bath
what drug do you give for signs of serotonin syndrome
cyprohetadine
