Substance Abuse Disorders Flashcards
CAGE
Cut down on drinking?
Annoyed by criticism of your dirnking?
Guilty feelings about your drinking?
Ever had an Eye opener?
Moderate drinking
2 or less drinks/day men
1 or less for women
Heavy drinking
> 14 drinks/wk for men
>7 drinks for women
Binge drinking
More than 5 drinks in a row for men and 4 for women
ADH
Alcohol dehydrogenase
Converts alcohol to acetaldehyde.
ALDH
Aldehyde Dehydrogenase.
Converts acetaldehyde to acetate
Wernicke’s Encephalopathy
Acute sx reversible with high dose thiamine.
Ataxia, vestinular dysfxn, confusion, ocular abnormalities.
Korsakoff’s Syndrome
Chronic condition where 20% of pts recover.
Impaired recent memory and anterograde amnesia.
Cocaine
Serotonin, norepenephrine, dopamine reuptake inhibitor.
Adrenergic stimulation.
Methamphetamine
2nd to cannabis as most abused substance.
Meth intoxication tx
Sedation
Protect airway
Control temp and BP
Watch for cardiovascular collapse.
Is cannabis dependence inherited?
Yes. 60%
LSD
Lysergic acid diethylamide
Capsule, pill or liquid
Neuropsych sx, but alert and aware of situation
Dextromethorphan (DXM)
Codeine analog
OTC in cold and cough prep.
Mescaline
Active ingredient of cactus.
“bromo”
Gentler than LSD
PCP
Phencyclidine
Similar to ketamine
Varenicline
Chantix
Agonist of nicotinic acth receptors
1st line smoking cessation
Watch for neuropsych!
Drinking withdrawls
Begin within 6 hrs
Start to resolve within 24-48 hrs
Withdrawl seizures
Occur within 48 hrs after last drink
Treat w/ benzos
Alcoholic hallucinosis
Develop within 12-24 hrs from last drink, resolve within 24-48 hrs.
Usually visual
Delirium Tremens (DT’s)
5% of pts in withdrawl Hallucinations, disorientation, tachycardia HTN Agitation Can be fatal
When do DT’s begin?
48 - 96 hrs after last drink.
Last 1-5 days
Mortality rate of 5%
What should be given during moderare to severe withdrawals?
Benzos, thiamine
What should not be used to treat withdrawal?
Antipsychotics (lower seizure threshold)
Naltrexon
Mu-opioid receptor antagonist
Blunts pleasurable effects of etoh
Follow LFT’s
Also used in opioid abuse.
Acamprosate
Used for etoh relapse prevention.
Not as effective as naltrexon
Disulfiram (antabuse)
Causes hypersensitivity to etoh.
Unpleasant effect
Inhibits ALDH
Methadone
Method of long term tx
Schedule II
Single daily dose, controlled setting
Clonidine
Alpha II Adrenergic receptor agonist.
May decrease W/D sx
