Substance Abuse

Question 1

Define the characteristics of abuse:

Answer 1

take it during hazardous behaviors
failure to fulfill obligations
recurrent legal problems
continued use despite social problems

Question 2

Define the characteristics of dependence.

Answer 2

tolerance
withdrawal
use > intended
unsuccessful cut down
alot of time getting and using
decreased activities
continued use despite physical/psychological symptoms

Question 3

What doesnt show up on a UDS?

Answer 3

methadone, fentanyl, meperidine

Question 4

Alcohol OD:

Answer 4

breath and body odor, rhinophyma, ascites, jaundice, spiderangioma, ataxia and unsteady gait

Question 5

How do we treat alcohol OD?

Answer 5

ABCs, thiamine, naloxene, diazepam, disulfram

Question 6

Alcohol WD:

Answer 6

irritable, disoriented, seizures, hallucinations, tremor, panic attacks

Delerium tremens

Question 7

What is delerium tremens?

Answer 7

VT hallucinations, gross tremor, autonomic instability.

HIGH MORTALITY

Question 8

What complication is associated with alcohol OD?

Answer 8

weirnikes encephalopathy- ataxia, confusion, nystagmus and gaze palsies

Question 9

How do we treat alcohol WD?

Answer 9

BZD and thiamine

Question 10

Cocaine OD

Answer 10

euphoria, decreased BP, tachy or brady, dilated pupils, T hallucinations, teeth grinding

vasoconstiction - MI

Question 11

How do we treat cocaine OD?

Answer 11

mild= benzo
severe= haloperidol

Question 12

Cocaine WD

Answer 12

not life threatening, “crash”, hunger, constricted pupils, vivid dreams

Question 13

How do we treat cocaine WD?

Answer 13

sleep it off, supportive therapy

Question 14

Sedative hypnotics OD

Answer 14

drowsiness, slurred speech, impaired judgement, resp depression, relaxation, euphoria

Question 15

How do we treat acute sedative OD?

Answer 15

flumazenil

Question 16

Sedative hypnotics WD

Answer 16

abrupt stop = life threatening

autonomic hyperinstability, tremor, delirium, hallucinations and system rebound

Question 17

How do we treat sedative WD?

Answer 17

long acting BZD- diazepam (taper)

Question 18

Opiate OD:

Answer 18

constipation, pupil constriction, resp depression, altered mental status, and skin infections

Question 19

What is associated with opiate OD?

Answer 19

serotonin syndrome- hyperthermia, hypo/hypertension, muscle rigidity

Question 20

How do we treat opiate OD?

Answer 20

naloxene to reverse OD, abc’s, methadone if severe

Question 21

Opiate WD:

Answer 21

diarrhea, dilated pupils, yawning, goose bumps (pilorection), fever, rhinorrhea, lacrimation
IF IT LEAKS ITS OPIATE WD

Question 22

How do we treat opiate WD?

Answer 22

mathadone for severe, clondine/buprenorphine

Question 23

What is the CAGE test?

Answer 23

cut down
annoyed
guilty
eye-opener