Substance Use Disorders

Question 1

what are some of the immediate withdraw symptoms from alcohol?

Answer 1

GI distress, sweating, autonomic instability, hand tremor, insomnia

Question 2

what happens to LFTs in alcohol use?

Answer 2

AST, ALT, GGT elevated

Question 3

what is the characteristic pattern of alcohol use in AST and ALT labs?

Answer 3

AST up more than ALT

Question 4

what is the serum indicator of alcohol use?

Answer 4

gamma glutamyltransferase (GGT)

Question 5

what is Rx for alcohol withdraw?

Answer 5

benzos

Question 6

when does delirium tremens occur?

Answer 6

2-4 days after last drink

Question 7

what happens in DT?

Answer 7

altered mental status…hallucination, autonomic hyperactivity, seizures tremors, insomnia

Question 8

what is Rx for DT?

Answer 8

benzos

Question 9

what is wernickes encephalopathy triad?

Answer 9

confusion
ataxia
ophthalmoplegia

Question 10

what causes wernickes encephalopathy?

Answer 10

decreased thiamine

Question 11

how to treat wernickes encephalopathy

Answer 11

thiamine IV

Question 12

what is korsakoff syndrome?

Answer 12

impaired memory in patient who is otherwise alert and responsive…

Question 13

what type of memory loss in korsakoff syndrome?

Answer 13

retrograde and anterograde

Question 14

in alcoholic hallucinations, which type is more common, visual or auditory?

Answer 14

visual

Question 15

aside from visual hallucinations what other type is common in alcoholics?

Answer 15

tactile

Question 16

if alcoholic patient has hepatic failure, which benzo do we give and why?

Answer 16

loarzepam because it has less hepatic matabolism

Question 17

what is the drug used for alcohol stop that discourages patients from drinking because of effect of drug?

Answer 17

disulfiram

Question 18

what is the drug to use for alcohol cessation that reduces cravings associated with rewarding effects of alcohol?

Answer 18

naltrexone

Question 19

what is the main effect sedatives have on people?

Answer 19

mood elevation, lower anxiety, behavioral disinhibition, sedation, respiratory depression

Question 20

what are the three main types of sedatives?

Answer 20

barbituates, alcohol and benzos

Question 21

what is Rx for benzo OD?

Answer 21

flumazenil

Question 22

what is withdrawal like from benzos and barbituates?

Answer 22

can lead to delirium tremens like alcohol use

Question 23

what are the main effects of opioids that people seek?

Answer 23

mood elevation, decreased anxiety, sedation, analgesia,

Question 24

what are adverse effects of opioids to look for in clinical setting?

Answer 24

constipation/nausea, respiratory depression, pupil constriction

Question 25

do pupils dilate or constrict with opioid use?

Answer 25

constrict

Question 26

with opioid withdrawal, what happens to pupils?

Answer 26

get really dilated

Question 27

what are symptoms of opioid withdrawal?

Answer 27

sweating, dilated pupils, piloerection, cramps, diarrhea, flu like illness, yawning

Question 28

what to give for OD on opioids?

Answer 28

naloxone

Question 29

what is Rx for withdrawal of opioids?

Answer 29

mainly symptom management

Question 30

what med can you give to help someone wean off opioids?

Answer 30

methadone

Question 31

name the four meds that can be given to opioid addicts to help

Answer 31

naltrexone methadone naloxone | buprenorphine

Question 32

what is the combo of buprenorphine and naloxone called? where must it be given? what is it used for?

Answer 32

suboxone, office based treatment for opioid abuse

Question 33

what are the four classes of stimulants

Answer 33

caffeine nicotine amphetamines cocaine

Question 34

what are the effects of cocaine?

Answer 34

mood elevation, psychomotor agitation, anxiety, decreased appetite, increased BP and pulse,

Question 35

are pupils constricted or dilated with cocaine use?

Answer 35

dilated

Question 36

what are withdrawals from stimulants like?

Answer 36

depression, irritable, lethargic, fatigued, headaches, decreased BP and pulse

Question 37

what is Rx for stimulant overdose?

Answer 37

benzo

Question 38

what are the four hallucinogens to know?

Answer 38

LSD Ecstasy (MDMA) Cannabis Phenycyclidine

Question 39

what are effects of hallucinogens?

Answer 39

hallucinations, hyperalertness, euphoria

Question 40

what are examples of inhalants?

Answer 40

fuels, paints, amyl nitrite, anesthetics, NO

Question 41

what are examples of dissociative substances?

Answer 41

PCP ketamine dextromethorphan NO

Question 42

are hallucinations with hallucinogenic drugs more auditory or visual?

Answer 42

more visual

Question 43

marijuana withdrawal has what symptoms?

Answer 43

anxiety, irritability, loss of appetite, insomnia

Question 44

what are the five stages of recovery from substance abuse?

Answer 44

``` pre contemplative contemplative preparation action maintenance ```

Question 45

during what stage of substance abuse recovery does relapse often happen?

Answer 45

maintenance