Substance Abuse Flashcards
What is caution with admin of venlafaxine in alcohol and substance abuse?
Venlafaxine is an SRNI
Effexor is brand name
given very cautiously in alcohol and opioid abuse because can cause CNS depression
What is cross-tolerance?
Exposure/use of one drug builds up a tolerance for other drugs that are in same class and work similarly
Ex. A person who drinks heavily may need more of a CNS depressant med to achieve therapeutic effect.
What are autonomic symptoms of alcohol withdrawal?
Autonomic hyperactivity:
Tachycardia
Diaphoretic
High BP
Fever
N/V/diarrhea
What are motor symptoms of alcohol withdrawal?
Hand tremors
Jerky movements
Quivering (tremulousness)
Ataxia (loss of muscle control/coordination)
Easily startled
Irritable
Seizures
What are some psych symptoms of alcohol withdrawal?
Hallucinations
Fluctuating LOC
Delusions
Mood labile
Anxiety
Disturbed sleep
Combative
How serious are DT’s and alcohol withdrawal delirium?
Medical emergency
Can result in death if left untreated
Peaks in 2-3 days and lasts up to 5 days
What is CIWA?
A scale used to assess alcohol withdrawal symptoms
What vitamin deficiencies are common in alcoholics?
Thiamine
Folic Acid
Cyanocobalamin (b12)
Why is thiamine deficiency dangerous?
Can develop a syndrome called Wernicke-Korsakoffs
This is a thiamine (B1) deficiency usually related to chronic alcoholism
Can develop into encephalopathy and permanent damage to brain.
What is treatment for alcohol withdrawal aimed at?
Substituting other CNS depressants and then gradually tapering dose.
What is most commonly used medication in alcohol withdrawals?
What anticonvulsant may be ordered?
What med may be used for the autonomic hyperactivity?
Benzodiazepines
Phenobarbital
Clonidine (an antihypertensive med)
What medication is used to treat alcoholism by making the alcohol’s effect unpleasant?
Disulfiram (Antabuse)
This is very dangerous if alcohol is consumed while medication is on board.
What med is used to treat alcoholism/opioid abuse by blocking the endorphins released when alcohol/opioids are consumed?
Naltrexone (ReVia, Vivitrol)
What med is used to reduce unpleasant effects of alcohol abstinence?
Acamprosate (Campral)
What is the triad of opioid overdose symptoms?
Pinpoint pupils
Respiratory depression
Decreased LOC
What are symptoms of opioid withdrawal?
Low energy, irritability, anxiety, agitation, insomnia
Yawning
Flu like
Runny nose, teary eyes
Hot/cold sweats/ goosebumps
Severe muscle pain
Abdominal cramping, N/V/diarrhea
What is COWS?
Clinical Opiate Withdrawal Scale
Used to rate severity of withdrawal symptoms
How is methadone used in opiate withdrawal?
Substituted and slowly tapered off
Longer acting opiate that enables the person to function better IRL
What med is used to alleviate cravings in opiate withdrawal?
Buprenorphine hydrochloride
(Buprenex, Subutex, Suboxone)
Suboxone is same med but with naloxone mixed in.
What are some commonly abused CNS stimulants?
Cocaine
Meth
What are OD symptoms of cocaine/meth?
Respiratory distress/arrest
Ataxia
Fever
Convulsions
Stroke
MI
Coma/death
What is treatment for OD of meth/cocaine?
Benzos
Supportive measures to treat symptoms
What are withdrawal treatments for meth/cocaine?
Modanfinil
Benadryl
Benzos/sedatives
What is a common cause of drug:drug interaction that causes death?
Alcohol and cocaine
Liver can’t handle both
