Substance Disorders Flashcards
This is the term to describe “helping” addicts to make it easier for them to continue the progression of the disease.
Enabling
This is the term to describe addicts focusing on other tissues other than the substance beign their real problem.
Denial.
This is being overly involved with and/or assuming responsibility for another persons problems, needs, and wishes who is also dysfunctional and/or addicted.
Co-dependence
What 2 structures cause blackouts in alcoholics, so that they cant consolidate new memories?
Hippocampus and related temporal lobe structures
THis is the condition where there is tremor, tachycardia, fever, diaphroresis, and global confusion 3-4 days after the last drink.
Delirium tremens
What is the lifespan of delirium tremens?
2-3 days even if treated
What are the 4 steps of gateways?
1- legal drugs like alcohol/cigarettes
2- marijuana
3- ilicit drugs, hallucinogens, inhalants, opioids
4- prescription drugs
This is the process where there is a desire to ease physical or emotional pain –> drugs taken to help –> mesolimbic system signals reward from that shit –> drug starts being used improperly –> down the rabbit hole.
Cycle of Addiction (dependence)
This is the condition where there is ataxia, horzontal nystagmus, gaze palsy, confabulation, and memory disturbances.
Wernicke-Korsakoff syndrome
Deficiency of what vitamin causes Wernicke-Korsakoff syndrome ?
B1 (thiamine)
What % of Korsokoff’s syndrome is reversible?
Only 20%
What is the BAC characterized by normal behavior, feeling mildly relaxed, and there is some determent in judgement?
0.01-0.05
What is the BAC characterized by legal intoxication, slurred speech, poor muscle coordination, short term memory loss, and delayed reaction time?
0.08-0.10
In addition to difficulty walking/standing and getting aggressive, what other Sx might start happening at a BAC of 0.11-0.15?
Blackout
What is the BAC characterized by cofusion, disorientation, exaggeration, emotional stages (girls), and an increased pain threshold (come on bro, u can totally crack that beer bottle over my head)?
0.18-0.20
What is the BAC characterized by stupor, decreased response to stimuli, inability to stand/walk, and possible death?
0.25-0.40
At what BAC do you go into a coma and die?
> 0.40
What is the liver marker that shows heavy drinking?
GGT
What is the testing method that has a 60-95% sensitivity to identify a problem with alcohol?
CAGE testing
What is the question to ask for the “C” part of CAGE to assess drinking patterns?
“have you felt to need to Cut down on your drinking?”
http://www.southparkstudios.com/clips/155157/daddys-very-sick
What is the question to ask for the “A” part of CAGE to assess the consequences of alcohol?
“have people Annoyed you by criticizing your substance use?”
What is the question to ask for the “G” part of CAGE to assess the consequences of alcohol?
“have you ever felt Guilty about your drinking?”
What is the question to ask for the “E” part of CAGE to assess patterns and compulsiveness?
“have you ever needed an Eye opener the first thing in the morning?”
A 1/4 on the CAGE has what % chance of alcoholism?
25-33%
This is the need for markedly increased amounts of alcohol to achieve intoxication or desired effects.
Tolerance
After what time frame is there symptoms of withdrawal from alcohol after prolonged, heavy alcohol ingestion?
4-12 hours
Recent ingestion of alcohol behavioral/psyhological changes, and signs of slurred speech/incoordination/unstrady gait/nystagmus/imporment in attention/stupr describe what conditon?
Alcohol intoxication
This is the condition where there is autonomic hyperactivity, anxiety, and GI symptoms several hours to a few days after the cessation of alcohol.
Alcohol withdrawal
What might you be intoxicated with if you present with the following Sx?
Restlessness, nervousness, excitement, insomnia, flushed face, diuresis, GI disturbance, muscle twitching, rambling flow of thought, tachycardia, periods of inexhaustibility, and psychomotor agitation.
Caffeine
What are the Sx of caffeine withdrawal, typically seen within 24 hours following the cessation of caffeine use?
Headache, fatigue, dysphoric mood, difficulty concentrating, and flu-like Sx.
What is the name of the concentrated form of cannabis called?
Hashish
In addition to the psychological and behavioral Sx of weed, what are the 4 physical signs of use?
Conjunctival injection
Increased appetite
Dry mouth
Tachycardia
Irritability, anger, aggression, anxiety, sleep problems, decreased appetite, restlessness, depressed mood, and mild physical Sx are signs of withdrawal from what drug?
Cannabis
With regards to withdrawal from ANY substance, what is the time frame to define “early” remission?
from 3-12 months after cessation
With regards to withdrawal from ANY substance, what is the time frame to define “sustained” remission?
> 12 months after cessation
PCP “angel dust”, ketamine, cyclohexamine, and dizocilpine belong to what class of drugs?
Phencyclidines
Phenylalkylamines, MDMA, psilocybin, LSD, Salvia, and Jimsonweed belong to what category of drugs?
Hallucinogens.
Case: A pt presents with smoking some unknown substance at a party. His friends took him to the ER, stating that he wasnt “acting right” and stated that he punched some dude in the face. Examination shows horizontal nystagmus, HTN, ataxia, muscle rigidity, and diminished responsiveness to pain. What drug is he on?
Phencyclidine (PCP)
Case: A patient arrives to the ER via police, where they stated the man was walking down the street naked and looking up at the sky and yelling “But soft! What light through yonder window breaks? it the east and Unicorns are the sun.” PE shows mydriasis, tachycardia, diaphoresis, tremors, and ataxia. What drug class might they be on?
Hallucinogens
Case: pt presents to the ER after beating his pet cat for peeing on his girlfriends face. PE shows nystagmus, slurred speech, unsteady gate, tremor, weakness, lethargy, and diplopia. What drug class is the pt on?
Inhalants
Case: pt presents to the ER complaining of a 10/10 abdominal pain. CT and PE are unremarkable. When returning to the room, the pt is persistent about alleviating her pain. You notice miosis, slurred speech, impairment of attention, and slight aggressiveness. What drug could the pt be addicted to?
Opioids
An ER tech walking into the ER to start his shift has a car pull up right next to him. The driver jumps out and says “please help! get my boyfriend to a doctor!” She opens the passenger door revealing a man with vomitus covering his shirt, lacrimation, diaphoresis, yawning, and fever. What drug could this patient be in withdrawing from?
Opioids
true story btw
Case: you’re at a party and notice some guy making inappropriate sexual advances to the neighbors badger. When asking whether or not he’s alright, you ntoice slurred speech, incoordination, unsteady gait, nytagmus, stupor, and poor memory. You know he hasnt had any alcohol because he’s Korean and alcohol is a Koreans worst enemy. What drug class could he be on?
Sedative, hyponotic, or anxiolytics
The Korean guy ends up having a problem with sedative, hyponotics, or anxiolytics and you decide to help him through withdrawals. What Sx might be seen during the withdrawals?
Autonomic hyperactivity, hand tremor, insomnia, N/V, hallucinations, psychomotor agitation, anxiety, grand mal szrs.
Amphetamines, dextramphetamines, methamphetamines, and khat belong to what class of drugs?
Stimulants
Case: while at Tony Montana’s house, you see him snorting a mountain of cocaine. What Sx might been seen after he ingests this substance?
Tachycardia or bradycardia Mydriasis hypoTN or HTN perspiration or chills N/V chest pain confusion, szrs, respiratory depression, arrhythmias.
True or False: hallucinations, including auditor, visual, or tactile illusions, can be experience in stimulant use.
True
Fatigue, vivid unpleasant dreams, insomnia or hypersomnia, increased appetite, and psychomotor retardation are associated with withdrawal from what drug?
Stimulants.
Irritability, anxiety, problems concentration, icnrrased appetite, restlessness, depressed mood, and insomnia are Sx of withdrawal from what drug?
Tobacco
This is the coindition where there is risking something of value in the hopes of obtaining something of greater value.
Gambling disorder
