Substance Use Disorder Flashcards
What is the substance abuse triad?
psychological dependence or craving
physiologic dependence
tolerance
what is the NIAA consumption amount of alcohol that increases health risks?
Men under 65- 14 per week, 4 drinks a day
women and adults over 65- more than 7 standard drinks per week on average
how many criteria does a patient require to be classified as “mild” alcohol use disorder?
2-3 required for mild.
there is a strong association with alcoholism and what type of disorders?
psychiatric
what is CAGE?
screening tool for alcoholism.
Ever felt you should CUT down
Have people ANNOYED you by criticizing your drinking
Have you ever felt GUILTY about drinking
Have you ever taken a drink in the first thing in the morning (EYE OPENER)
What is a complication of alcohol use disorder due to thiamine deficiency?
Wernicke Encephalopathy
What is the triad of Wernicke Encephalopathy syndrome?
Encephalopathy (disorientation, inattentiveness)
OCC dysfunction
Gait ataxia
What is a late consequence of chronic WE?
Korsakoff syndrome
What does Korsakoff syndrome cause
anterograde/retrograde amnesia. long term memory and cognitive skill impairment is less common.
mild alcohol withdrawal symptoms usually being within how long?
6- 24 hrs. of last drink.
What are some sx of mild alcohol withdrawal
anxiety
restlessness
insomnia
diaphoresis
palpitations
headache
alcohol craving
what are some physical signs of alcohol withdrawal?
tachycardia, hypertension, tremor
within how many days will mild alcohol withdrawal sx resolve?
one to two days
within what time frame will you have severe sx of alcohol withdrawal such as hallucinations?
12-24 hours and resolves within another 1-2 days
if you were to have a seizure from alcohol withdrawal, what is the usual time frame for it to occur?
6-48 hrs.
what is the “kindling effect”?
risk of seizures increase with repeated withdrawals from alcohol
what is Delirium Tremens?
fluctuating disturbances in attention and cognition that may include hallucinations
delirium begins within what time frame for severe alcohol withdrawal?
72-96 hours after last drink
what is the leading preventable cause of mortality worldwide?
tobacco use disorder
What are the major causes of mortality due to tobacco use disorder?
cardiovascular
pulmonary
and cancers
clear evidence of less than how many minutes of counseling advice at each patient encounter can increase rates of quitting tobacco?
5 mins
what is the peak of nicotine withdrawal? and it subsides over the course of what time frame?
peaks in first three days and slowly subsides over the course of about one month.
what are some signs associated with nicotine withdrawal?
increased appetite, weight gain, depression, insomnia, irritability, anxiety, restlessness.
what is the long acting treatment of nicotine withdrawal?
nicotine patch
what is the short acting treatment of nicotine withdrawal?
gum or lozenge
what is a medication used for nicotine withdrawal?
buproprion (wellbutrin)
MOA of Buproprion (Wellbutrin)
Inhibits reuptake of norepinephrine and dopamine as well as act as nicotinic receptor antagonist.
What drug can be used for nicotine withdrawal that is a partial nicotine agonist, stimulates dopamine activity but to a much smaller degree than nicotine, and reduces cravings and withdrawal sx?
Varenicline (Chantix)
Effects of marijuana use occur within how many minutes and last what amount of time?
10-20 min, last 23 hrs.
number of days cannabis is detected in urine for short term and long term users
4-6 days and 20-50 days.
two phases of marijuana use with moderate users
mild euphoria followed by sleepiness
the increase in opioid users directly correlates with what?
prescribed opioids
ophthalmologic findings of acute opioid toxicity
miosis
what condition is not uncommon, rapidly correctable, and easily confused with acute opioid toxicity?
hypoglycemia
what is the clinical picture of acute stimulant intoxication?
diaphoresis
tachy
elevated BP
mydriasis
Hyperactivity
acute brain syndrome with confusion and disorientation
