Substance Abuse Flashcards
“Risky drinking” is when Males <65yo drink >____ drinks per week or >___ drinks a day
OR
Females (all ages) and Males 65yo+ drink >___ drinks per week or >___ drinks per day
- Males <65yo drink >14 drinks per week or >4 drinks a day
- Females (all ages) and Males 65yo+ drink >7drinks a week or >3drinks a day
Binge drinking is when you drink so much within a 2hr period that your blood [alcohol] = ____g/dL
0.08
Binge drinking is usually when females have ____ drinks or males have ___ drinks within 2Hr and it raises their blood [alcohol] to 0.08g/dL
F = 4 drinks
M = 5 drinks
Tx for Mild ETOH use DO
Psychosocial therapy (motivational counseling, grp therapy)
Tx for Mod/Severe ETOH Use DO
- if NO opiod use?
- if Opiod use?
- Psychosocial + meds
- Naltrexone (can start while actively drinking but cannot be taken if using opiods)
- Opiod use -> Acomprosate
Tx for Refractory ETOH Use DO
Disulfiram, Topiramate
Tx for ETOH Intoxication
- Mild?
- Mod/Severe?
- ETOH Poisoning?
- Mild -> monitor
- Mod/Sev -> fluids, labs, glucose q 8hr
- poisoning -> RESPIRATORY, Fluids, Thiamine
Tx for Alcohol poisoning is based on which assessment?
CIWA-AR (Clinical Instutite Withdrawal Assessment for Alcohol, Revised)
Tx for VERY Mild vs Mild ETOH Poisoning based on the CIWA-AR
- VERY Mild -> GABA (anticonsulsant)
- Mild -> Long-acting Benzo
Tx for caffeine addiction
- Within 1hr?
- Within 2hr & has good mental status W/O Emesis
- within 1hr: NG tube aspiration/lavage
- within 2Hr: Activated Charcoal
Labs to order for caffeine intoxication?
[serum caffeine]
electrolytes
Glucose
CBC
EKG
Tx for Life-threatening dysrhythmia d/t caffeine intoxication?
SVT?
Ventricular?
- Life-threatening -> HEMODIALYSIS
- SVT -> Benzo or Cardioselective Beta-1 BB
- Ventricular -> ACLS/PALS
Caffeine intoxication Tx
- HypoTN?
- Vomiting?
- Hypokalemia?
- HypoTN -> IV Fluids, Vasopressors, B-1 BBs
- Vomiting -> Odansetron, Metoclopramide
- Hypokalemia -> K+ Supplmentation
Tx for Cannabis use DO
(NOTTTTTT INTOXICATION)
- set tx goals
- intervention, therapy
- NO MEDS BY FDA
Tx for Cannabis INTOXICATION in PEDS
Peds (CNS Depression) -> ABCs
Tx for Cannabis INTOXICATION in ADULTS
- CP?
- Cannabis Hyperemesis Syndrome?
- SEVERE Hallucinations?
- CP -> r/o other ET
- Vomiting -> IV Fluids, Antiemetics (Droperidol, Haloperidol)
- Severe Hallucinations -> Antipsychotic
Tx for Phencyclidine Intoxication
- violent/aggravated?
ABCs
+/- Activated Charcoal
Violent/aggravated -> SEDATION
Examples of Hydrocarbon-based Inhalants
Toluene
Gasoline
Toluene is found naturally in crude oil, and is used in oil refining and the manufacturing of paints, lacquers, explosives (TNT) and glues
Tx for opiod intoxication
- Mild?
- Mod/Sev?
- OVERDOSE?
- Mild -> Naltrexone (Long-acting inject). MUST HAVE BEEN OFF OPIODS
- Mod/Sev -> Buprenorphine or Methadone
- OVERDOSE -> Narcan (Naloxone)
Generally, Opiod intoxication causes pupilary _____
constrict/dilate
CONSTRICTION
Dilation if anoxia from severe overdose
Opiod withdrawal causes pupillary _____
constrict/dilation
DILATION
5 A’s approach for Tobacco DO
- Ask about tobacco use
- Advise quitting
- Assess readiness to quit
- Assist smokers ready to quit
- Arrange FU
Pharm Tx for Tobacco DO
- **Varenicline
- Combo Nicotine Replacement Therapy (NRT)
- Bupropion (Wellbutrin)**
3 Screens for alcohol use DO
AUDIT-C, AUDIT, CAGE
