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Psych Exam 1 > SUD > Flashcards

SUD Flashcards

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1
Q

social components of SUD

A

social stigma/controversy
environmental factors
peer influence
dysfunctional family dynamics
abusive hx
social maladaptation
family hx addiction
peer pressure
lack of family involvement
difficult family situations: lack of bond with parents or siblings; lack of bond with parents or siblings; lack of parental supervision

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2
Q

psychological aspects of addiction

A

STRESS
• DEPRESSION
• LOW SELF-ESTEEM
• INCREASED NEED FOR SUCCESS/POWER
• INABILITY TO COPE
• ANXIETY
• LONELINESS.

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3
Q

biological components of addiction

A

genetic predisposition
increased dopamine
immature brain development
function of acetate
having other mental health disorder
males

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4
Q

cocaine

A

stops molecules that mop up excess dopamine

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5
Q

amphetamines

A

push dopamine out of sacs where it is stored

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6
Q

heroin

A

makes dopamine neurons fire more

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7
Q

alcohol

A

helps release more dopamine

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8
Q

excess of dopamine

A

feeling high

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9
Q

immature brain development

A

early experiences affect brain development
early stress and trauma change brain responses
brain develops until age 24
adolescent brain develops back to front

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10
Q

back of brain

A

emotion, memory, impulse, psychomotor activity

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11
Q

front of brain

A

areas of executive function, planning, problem solving, judgement, impulse control, organization

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12
Q

biological alcohol craving and acetate

A

etoh breaks down into acetate
acetate triggers craving
liver and pancreas of addicted person processes alcohol slower than normal
normal drinkers acetate moves quicker and exits
in addicted person after 1st drink body craves more, after second drink they want more and more and cant stop
control is lost and the craving cycle has began
acetate accumulates in alcoholics body after only 1 drink and this never changes

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13
Q

The addicted brain

A

repeat use leads to tolerance and withdraw via changes in neurotransmitters
decreased dopamine receptors and decreased dopamine release resulting in compulsive behaviors, decreased inhibition, increased impulsivity, impaired regulation of intentional action

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14
Q

what do alcohol and nicotine metabolize down into?

A

acetate

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15
Q

substance intoxication

A

symptoms are drug specific
recent overdose/ excessive use of a substance such as acute alcohol intoxication, that results in a reversible substance-specific syndrome
judgement is impaired
CNS changes occur; disruption in physiological and psychological functioning
can happen with one time of use

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16
Q

substance withdraw

A

happens when substance is removed after heavy and prolonged use

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17
Q

symptoms of substance withdraw

A

anxiety
irritability
restlessness
insomnia
fatigue
symptoms differ and are specific to substance type

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18
Q

Medications for alcohol withdraw

A

chlordiazepoxide (librium)
Diazepam (valium)
Lorazepam (ativan)
Thiamine daily replacement
other meds: PHENOBARBITAL, INDERAL, CLONIDINE (goal to keep BP and HR low, MAGNESIUM SULFATE, MVI,
ANTIPSYCHOTICS

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19
Q

Opioid Withdraw: COWS

A

increased resting pulse (observe client being quiet for 5 min before checking)
sweating
restlessness
pupil size (3mm normal)
bone and joint aches
runny nose or tearing
GI upset
tremors
yawning
anxiety or irritability
gooseflesh skin (hallmark sign of severe w/d)
max score 48

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20
Q

treating opioid withdraw non medication

A

nausea (provide crackers, ginger ale, tea, flat warm coke)
muscle aches: (hot shower, warm compress, tylenol)
Anxiety reduction: (distraction, relaxation and talk therapy)

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21
Q

what do you give to reduce nausea and vomiting in opioid withdraw?

A

ondansetron, phenergan (oral or rectal, avoid IM gives pt a rush)

22
Q

what do you give to reduce anxiety, lacrimation, and rhinorrhea in opioid withdraw?

A

Atarax or Hydroxizine

23
Q

what meds do you avoid in opioid withdraw?

A

benzos

24
Q

what do you give for insomnia in opioid withdraw?

A

desyrel
trazorel (trazodone)
Myalgiastyloneol (use caution in patients with esophageal varices or ulcers)

25
Q

what do you give for diarrhea in opioid withdraw?

A

Kaopectate is preferred choice
AVOID lomotil (loperamide) causes sedative effect sought by patient

26
Q

important facts about naltrexone

A

cannot use any opioids 10-14 days before starting
if pt uses opioids they will get very sick and will cause fast withdraw
blocks opioid receptors and blocks the feelings of
ETOH and decreases cravings
injection every 28 days
Vivtrol, Revia

27
Q

Disulfiram (Antabuse)

A

prevents breakdown of acetyladohyde
can make pt very sick if they drink, decreases cravings
Pts cannot be close to alcohol, paint thinner, perfume, or anything containing alcohol or they will become very sick
vomiting profusely

28
Q

clonidine

A

anti-HTN
helps to calm pt by lowering BP and HR

29
Q

campral

A

decreases ETOH cravings

30
Q

methodone

A

opioid to help with opioid withdraw
pts can be addicted to methadone

31
Q

suboxone

A

Subutex and naloxone combo drug

32
Q

subutex

A

reduced withdraw from opiods

33
Q

emergency treatment of heroin overdose

A

nalaxone kits
narcan can be delivered by injection or nasal mist
quickly reverses the effects of heroin withdraw
can get free kits at UK ER or health departments
INSTANT withdraw

34
Q

long term methadone maintenance for pregnant women

A

decreases variability of illicit drug effect on fetus
newborns have predictable outcomes
doses may need to be adjusted upward as pregnancy progresses
decreases cravings and withdraw
blocks effects of other opioids
maintained until delivery, then withdraw
infant can experience symptoms of withdraw that may be 2/3x as intense as mom

35
Q

tolerance

A

must use increased amounts of drug over time to achieve the same effect

36
Q

causes of wernicke’s encephalopathy

A

vitamin b1: Thiamine deficiency that directly intereferes with glucose production
caused by chronic alcoholism

37
Q

other causes of thiamine deficiency

A

gastric carcinoma
starvation
chronic gastritis
hemodialysis in end stage renal disease

38
Q

classic symptoms of Wernicke’s encephalopathy

A

mental confusion
ataxia
mental status changes
ophthalmoplegia (paralysis or weakness of the eye)

39
Q

treatment of wernicke’s encephalopathy

A

reversible with thiamin replacement
improve nutritional status
without treatment may advance to korsakoff psychosis

40
Q

korsakoff psychosis

A

not reversible
persistent learning and memory problems
chromic and debilitating syndrome
ataxia
disorientation
delirium/ psychosis
confabulation
neuropathy

41
Q

wernicke-korsakoff syndrome

A

combination of both processes
requires long term care/institutionalization
BP and temp low
pule rate elevated
symptoms mirror intoxication even after BAC=0

42
Q

prevention as a tx stragtegy

A

change in norms
form/join community/school coalitions
reduce access
limit exposure
enforce laws and policies
family involvement
access to behavioral health services

43
Q

how many drinks are considered high risk?

A

women: 7 drinks per week
Men: 14 drinks per week

44
Q

BAC levels

A

.02 for under 21
.8 for 21 and over
0.50 and greater = death
tolerance can result in a pt having a higher BAC and not showing many symptoms

45
Q

typical effects of a BAC 0.8

A

decreased muscle coordination
harder to detect danger
judgement, self control, reasoning, and memory are impaired
impaired perception
short term memory loss

46
Q

blackouts

A

not same as passing out, client functions as normal and cannot remember several hours

47
Q

relapse

A

recurrence of alcohol or drug dependent behavior in an individual who previously achieved abstinence

48
Q

dual diagnosis

A

co-occurring mental illness with substance abuse or addictive disorder

49
Q

forms of denial

A

refusing outright- its not a problem
minimizing- no big deal im fine
rationalizing- everyone else is doing it
intellectualizing- i can stop if i want to
blaming/projecting- if you were stressed you would drink too
bargaining- just one more time
passivity- i cant do anything about it anyway
hostility-demanding- ill drink if i want too

50
Q

nursing interventions for SUD

A

honest expression of feelings
listen to what the individual is really saying
express caring
monitor your reactions
hold the individual responsible
communicate the treatment plan to pt and team

Psych Exam 1 (10 decks)

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