substance use/withdrawal Flashcards

1
Q

alcohol testing

A

breathalyzer and blood/urine

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2
Q

cocaine testing - and how many days

A

urine screen: positive for 2-4 days

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3
Q

amphetamine testing- how manny days

A

urine positive for 1-3 days

most will not be sensitive enough to detect

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4
Q

PCP testing and days

A

urine- 3-8 days

CPK and AST will be elevated

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5
Q

Barbituates- testing and days(short and long)

A

short acting - 24 hrs

long acting - 3 wks

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6
Q

Benzo. testing and days

A

short- 3 days

long - 30 days

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7
Q

opioids testing and days

A

urine- positive for 2-3 days

methodone and oxycodone will be negative on general screen - need to test separately

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8
Q

marijuana testing and days

A

heavy users 4 wks

single use - 3 days

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9
Q

bal of 100-150

A

ataxic gate and poor balance

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10
Q

bal of 150-250

A

lethargy, difficulty siting up, difficulty with memory

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11
Q

bal of 300

A

coma

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12
Q

bal of 400

A

respiratory depression and death is possible

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13
Q

naloxone

A

can reverse overdose if given alcohol and opioids together

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14
Q

what to use in alcohol withdrawal

A

librium

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15
Q

earliest symptom of alcohol withdrawl - begins when?

A

6-24 hrs

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16
Q

6-48hrs after last alcohol drink

A

seizures

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17
Q

alcohol withdrawal symptoms

A

mild - irritable, insomnia, tremor
mod - diaphoresis, hypertension, tachy, fever, disoriented
severe - tonic-clonic seizure, DTs and hallucinatiosn

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18
Q

48-72 hrs from last drink

19
Q

DTs - what is it?

A

hallucination, tremor, autonomic instability, fluctuating taunting levels of psychomotor activity

20
Q

how to treat DTs

21
Q

antabuse

A

blocks aldehyde dehydrgoenase in the liver causing flushing, headache, vomit, and palitations, sob

22
Q

disulfiram (contraindications)

A

anatbuse

cardiac disease, pregnancy and psychosis

23
Q

naltrexone

A

opioid receptor blocker

decrease craving and “high” associated with alcohol

24
Q

campral (MOA and indication/contraindication

A

similar to GABA - inhibits glutamatergic system -
post-detox for relapse prevention if stopped drinking
can use if liver disease - contraindicated in severe renal disease

25
topomax
anticonvulsant - potentiaties GABA and inhibits glutamate receptors - reduces alcohol craving
26
cocaine intoxication
euphoria, high or low BP, tachy, or brady, nausea, dilated pupils, sweating dangerous: respiratory depression, seizure, arrhythmia, paranoia, hallucination deadly - vasoconstriction might lead to MI
27
what meds for cocaine dependence?
disulfiram and aripirazole
28
cocaine withdrawal -
not life threatning malaise, fatiue, hypersomnolence, depression, hunger, constricted pupils, vivid dreams, psychomotor agitation or retardation, resolve within 18 hrs if mild user if heavy user- resolve within weeks - peak in several days
29
substituted amphetamines - MOA
release dopa, NE, and serotonin from nerve ending
30
amphetamine intoxication
hyperthermia, dehydration --> rehydrate --> hyponatremia | rhabdo --> renal failure
31
amphetamine withdrawal
prolonged depression - can treat psychosis
32
PCP and ketamine intoxication
agitation, depersonlization, hallucination, synesthesia, impaired judgmenet, memory impairment, assaultiveness, nystagmus, ataxia Overdose- seizure, coma, death
33
how to treat PCP intoxication
benzo for agitation, anxiety, muscle spasms, seizure | antipsychotics- control severe agitation, or psychotic symptoms
34
pcp withdrawal
none- but they get flashbacks, as the substance is released and stored in lipid stores
35
benzo intoxication
confusion, hypotension, slurred speech, incoordination, lability, impaired judgement, nystagmus, respitratory depression, coma, death
36
benzo overdose treatment
activated charcoal if ingested within 4-6 hr benzo: flumazenil barbituates: alkalinize urine and sodium bicarb
37
benzo withdrawal
can be life threatening | tonic clonic seizure might occur - similar withdrawal to alcohol
38
treatment for benzo
benzo taper | carbamazepine or valproic acid for seizure prevention
39
opioid intoxication
drowsiness, n/v, constipation, constricted pupils, seizures, respiratory depression, might lead to coma and death could lead to seretonin syndrome - hyerthermia, confusion, hyer or hyotension and muscle rigidity
40
treatment for opioid overdose
naloxone
41
opioid withdrawal
non life threatening dysphoria, insomnia, lacrimation, rhinorrhea, sweating, piloerection, n/v fever, dilated pupils, abdominal cramps, myalgia, hypertension, tachy
42
opioid treatment
symptomatic treatment with clonidine - NSAID, cicyclomine for abdmominal cramps severe- buprenorphine or methadone
43
hallucinogen intoxication
illusions, hallucinations, body image distortion, dilated pupils, tachy, hypertension, hyperthermia, tremor, sweating, palpitation