Substance-Related Disorders 2 Flashcards
When does alcohol abuse become dependence?
When withdrawal symptoms develop or tolerance
What is considered a positive CAGE screen?
Greater than or equal to two points
What are the components of a CAGE screen?
Cutdown (ever felt need to cut down)
Annoyed (have people ever said they were annoyed when you drink?)
Guilt
Eye opener (ever needed to start your day?
What is non-pharm treatment for alcohol dependence?
Psychotherapy
Inpatient and residential tx programs
What are pharm tx options for alcohol dependence?
-Disulfiram (Antabuse)
-Naltrexone
-Gabapentin
-Topiramate
What is the MOA of Disulfiram?
inhibits aldehyde dehydrogenase > increased acetaldehyde and illness with alcohol consumption
Disulfiram same same
Antabuse
When is Disulfiram contraindicated?
-CV dx
-DM
-Hypothyroidism
-Epilepsy
-Kidney or liver disease
How is Naltrexone useful in treatment of alcohol dependence?
Opioid antagonist, reduces alcohol cravings and alcohol related euphoria
What is the mechanism of cocaine?
Stimulant effect via inhibition of reuptake of dopamine, norepinephrine and epinephrine
What is the presentation of cocaine intoxication?
-Elevated or euphoric mood
-Psychomotor agitation
-Pressured speech
What are the PE findings of cocaine use?
Sympathetic hyperactivity:
-Increased motor activity
-Tremor
-Flushing
-Hyperthermia
-Cold Sweats
-Pupillary dilation
What happens in severe cocaine intoxication?
-Respiratory depression
-Arrhythmias
-HTN
-Seizures
-Repetitive behaviors
-Agitation
-Aggression
-Hallucinations
-Paranoia
What are deadly complications of cocaine use?
-MI
-Stroke
-ICH
What is the management of mild cocaine intoxication?
Reassurance and benzos
