Substance Abuse Flashcards
Define the characteristics of abuse:
take it during hazardous behaviors
failure to fulfill obligations
recurrent legal problems
continued use despite social problems
Define the characteristics of dependence.
tolerance withdrawal use > intended unsuccessful cut down alot of time getting and using decreased activities continued use despite physical/psychological symptoms
What doesnt show up on a UDS?
methadone, fentanyl, meperidine
Alcohol OD:
breath and body odor, rhinophyma, ascites, jaundice, spiderangioma, ataxia and unsteady gait
How do we treat alcohol OD?
ABCs, thiamine, naloxene, diazepam, disulfram
Alcohol WD:
irritable, disoriented, seizures, hallucinations, tremor, panic attacks
Delerium tremens
What is delerium tremens?
VT hallucinations, gross tremor, autonomic instability.
HIGH MORTALITY
What complication is associated with alcohol OD?
weirnikes encephalopathy- ataxia, confusion, nystagmus and gaze palsies
How do we treat alcohol WD?
BZD and thiamine
Cocaine OD
euphoria, decreased BP, tachy or brady, dilated pupils, T hallucinations, teeth grinding
vasoconstiction - MI
How do we treat cocaine OD?
mild= benzo severe= haloperidol
Cocaine WD
not life threatening, “crash”, hunger, constricted pupils, vivid dreams
How do we treat cocaine WD?
sleep it off, supportive therapy
Sedative hypnotics OD
drowsiness, slurred speech, impaired judgement, resp depression, relaxation, euphoria
How do we treat acute sedative OD?
flumazenil
Sedative hypnotics WD
abrupt stop = life threatening
autonomic hyperinstability, tremor, delirium, hallucinations and system rebound
How do we treat sedative WD?
long acting BZD- diazepam (taper)
Opiate OD:
constipation, pupil constriction, resp depression, altered mental status, and skin infections
What is associated with opiate OD?
serotonin syndrome- hyperthermia, hypo/hypertension, muscle rigidity
How do we treat opiate OD?
naloxene to reverse OD, abc’s, methadone if severe
Opiate WD:
diarrhea, dilated pupils, yawning, goose bumps (pilorection), fever, rhinorrhea, lacrimation
IF IT LEAKS ITS OPIATE WD
How do we treat opiate WD?
mathadone for severe, clondine/buprenorphine
What is the CAGE test?
cut down
annoyed
guilty
eye-opener
