Substance Use Addictive Disorders

Question 1

tolerance vs dependence

Answer 1

tolerance: needing more and more to get same result
dependence: body needs substance to function normally

Question 2

intoxication occurs at blood alc btwn?

Answer 2

100-200mg/dl

Question 3

death can occur at rangin from?

Answer 3

400 to 700mg/dl

Question 4

standard drink of beer

Answer 4

12 fl oz

Question 5

standard drink of malt liquor

Answer 5

8-9 fl oz

Question 6

standard drink wine

Answer 6

5 fl oz

Question 7

standard drink of distilled spirits

Answer 7

1.5 fl oz

Question 8

s/s of alc w/draw

Answer 8

Tremors, N/V, malaise or weakness, tachycardia, diaphoresis, elevated BP, anxiety, irritability, headache, insomnia, risk of seizure, and death
delirium

Question 9

what is delirium tremens
s/s?
precautions and meds?

Answer 9

LOC change begins within 48-72 hours of last drink or heavy use.
Symptoms
Restlessness, coarse tremor, fear, confusion/ clouded sensorium, agitation, visual hallucinations, illusions, fever, sensory hyperactivity, sleeplessness, delirium, seizure
Life threatening
Medical intensive care admission required; CIWA-Ar/CAM-ICU (Confusion Assessment Method-ICU)
Calm environment
Seizure precautions
Lorazepam drip
Intubation

Question 10

what does lorazepam do for alc w/draw

Answer 10

calms down neurons wanting alc
tx anxiety
prevent seizures
going to have tolerance
taper
sliding scale based on CIWA

Question 11

vitamin replacement

Answer 11

Alcohol interferes with absorption of vitamins.
Increased excretion of vitamins by kidney
Deficient in thiamine and folic acid
Folic Acid
Produces and maintains new cells
Makes normal RBC and prevents anemia
Thiamine
PROTECTIVE OF NEURONS (nystagmus)
Carbohydrate metabolism
Central and peripheral nerve cell function
Prevent Wernicke-Korsakoff encephalopathy

Question 12

opioid w/draw symptoms

Answer 12

Dysphoria
muscle aches
nausea/vomiting
lacrimation or rhinorrhea
pupillary dilation
piloerection
sweating
abdominal cramping
diarrhea
yawning
fever
insomnia

Question 13

tx mild w/draw

Answer 13

acetaminophen, aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
Plenty of fluids and rest are important.
loperamide can help with diarrhea, dicyclomine for abdominal cramping, and hydroxyzine may ease nausea.

Question 14

tx severe w/draw

Answer 14

a combination of a milder opioid (buprenorphine) that does not produce many of the addictive effects of other opioids and an opioid blocker (naloxone). The opioid blocker works mostly in the stomach to prevent constipation. (Suboxone)
Clonidine can help reduce the intensity of withdrawal symptoms by 50-75%. Clonidine is especially effective at reducing anxiety, cramping, muscle aches, restlessness, sweating, tears, runny nose
Methadone: an opioid agonist

Question 15

agonist v antagonist

Answer 15

agonist increases effects
antagonist blocks effects

Question 16

what is suboxone

Answer 16

partial agonist

Question 17

disulfiram what is antabuse

Answer 17

given for alcolhism, makes your violently ill if you drink while on antabuse

Question 18

how to treat alc wi/draw babies

Answer 18

morphine taper

Question 19

codependency

Answer 19

Codependency is a dynamic that often occurs between two people when one has an addiction. In the relationship, one person has an unhealthy reliance on the other, while the other person has a need to be needed and will do whatever it takes to try to please their loved one

Question 20

enabling behavior

Answer 20

Sometimes family members help, rescue, support, or protect their loved one from facing the negative consequences of their substance use. For example, giving them money, lying for them, or paying their bills