substance use/withdrawal Flashcards
alcohol testing
breathalyzer and blood/urine
cocaine testing - and how many days
urine screen: positive for 2-4 days
amphetamine testing- how manny days
urine positive for 1-3 days
most will not be sensitive enough to detect
PCP testing and days
urine- 3-8 days
CPK and AST will be elevated
Barbituates- testing and days(short and long)
short acting - 24 hrs
long acting - 3 wks
Benzo. testing and days
short- 3 days
long - 30 days
opioids testing and days
urine- positive for 2-3 days
methodone and oxycodone will be negative on general screen - need to test separately
marijuana testing and days
heavy users 4 wks
single use - 3 days
bal of 100-150
ataxic gate and poor balance
bal of 150-250
lethargy, difficulty siting up, difficulty with memory
bal of 300
coma
bal of 400
respiratory depression and death is possible
naloxone
can reverse overdose if given alcohol and opioids together
what to use in alcohol withdrawal
librium
earliest symptom of alcohol withdrawl - begins when?
6-24 hrs
6-48hrs after last alcohol drink
seizures
alcohol withdrawal symptoms
mild - irritable, insomnia, tremor
mod - diaphoresis, hypertension, tachy, fever, disoriented
severe - tonic-clonic seizure, DTs and hallucinatiosn
48-72 hrs from last drink
DTs
DTs - what is it?
hallucination, tremor, autonomic instability, fluctuating taunting levels of psychomotor activity
how to treat DTs
benzo
antabuse
blocks aldehyde dehydrgoenase in the liver causing flushing, headache, vomit, and palitations, sob
disulfiram (contraindications)
anatbuse
cardiac disease, pregnancy and psychosis
naltrexone
opioid receptor blocker
decrease craving and “high” associated with alcohol
campral (MOA and indication/contraindication
similar to GABA - inhibits glutamatergic system -
post-detox for relapse prevention if stopped drinking
can use if liver disease - contraindicated in severe renal disease