SUD Lecture Flashcards

1
Q

All addicting substances and behaviors
directly or indirectly affect the ? pathways,

A

dopamine

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2
Q

As ? is the
primary neurotransmitter associated with the reinforcing effect of the substance.

A

dopamine

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3
Q

DSM criteria for alcohol use disorder (at least ? of the following occurring in a ?-month
period)

A

2

12

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4
Q

Screening of substance use disorders

Diagnostic Tools - ?

A

None

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5
Q

Screening of substance use disorders

3 Screening Tools

A

CAGE
AUDIT – C
AUDIT

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6
Q

CAGE: ? question screening

A

4

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7
Q

AUDIT – C: ? question screening

A

3

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8
Q

AUDIT: ? question screening

A

10

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9
Q

Have you ever felt the
need to cut down on
your drinking?

CAGE

A

C

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10
Q

Have people annoyed you by
criticizing your drinking?

CAGE

A

A

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11
Q

Have you ever
felt guilty about drinking?

CAGE

A

G

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12
Q

Have you ever felt you
needed a drink first thing
in the morning to steady
your nerves or to get rid
of a hangover (eye-
opener

CAGE

A

E

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13
Q

What do each C mean

CAGE

A

Cut

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14
Q

What do A mean

CAKE

A

Annoyed

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15
Q

What does G mean

CAGE

A

Guilt

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16
Q

What does E mean

CAGE

A

Eye opener

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17
Q

AUDIT-C

A score greater than ? for men is at risk

A

4

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18
Q

AUDIT-C

A score greater than ? for women is at risk

A

2

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19
Q

Pharmacokinetics of Alcohol

Primarily metabolized in the ?
leading to ?

A

Liver
Cirrhosis

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20
Q

Pharmacokinetics of Alcohol

?% is excreted in sweat, breath and urine

A

10

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21
Q

Pharmacokinetics of Alcohol

? is the chemical name for alcohol

A

Ethanol

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22
Q

10% is excreted in 3?

A

sweat, breath and urine

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23
Q

Responsible for “rewarding” effect

A

Dopamine

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24
Q

The inability to withhold a prepotent response or suppress an inappropriate or unwanted behavior which is casue d by alcohol ingestion

A

Disinhibition

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25
Q

Alcohol effects

S
D
R
D
S
N

A

Sedation,
Disinhibition,
Relaxation,
Decrease coordination
Slurred speech
Nausea

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26
Q

Alcohol Overdose

R
C

A

Respiratory depression
Cardiac arrest

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27
Q

Alcohol Withdrawal

T
S
E
D

A

Tremors,
seizures,
elevated temperature pulse blood pressure
Delirium tremens

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28
Q

Alcohol

Prolonged use : Effects or systems of the body. Can lead to other ? 2

A

dependencies, and malnutrition

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29
Q

Causes agitation, restlessness, anxiety, and sweating.

Alcohol Withdrawal vs. Alcohol Effects/overdose

A

Alcohol Withdrawal

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30
Q

Can lead to slowed brain function, cognitive impairment, coma.

Alcohol Withdrawal vs. Alcohol Effects/overdose

A

Alcohol Effects/overdose

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31
Q

VS:
elevated HR,
elevated temp,
normal or slightly elevated systolic BP

Mild, Moderate, Severe AWS

A

Mild

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32
Q

Ranges for normal temp in F

A

97 to 99

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33
Q

Ranges for normal temp in C

A

36.1 to 37.2

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34
Q

With alcohol withdrawal syndrome is ? of BP is priorty

A

Systolic

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35
Q

VS:
Heart rate 100-120 BPM elevated systolic BP
Elevated temperature

Mild, Moderate, Severe AWS

A

Moderate

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36
Q

VS
Heart rate 120 - 140 BPM; Elevated Systolic and Diastolic BP
Elevated temperature

Mild, Moderate, Severe AWS

A

Severe

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37
Q

Mild AWS
Diaphoresis :?

A

Slight

38
Q

Moderate AWS
Diaphoresis :?

A

Obvious

39
Q

Severe AWS
Diaphoresis :?

A

Marked

40
Q

No confusion no hallucinations

Mild, Moderate, Severe AWS

A

Mild

41
Q

-Intermittent confusion; transient visual
-Auditory hallucinations and
illusions (mostly at night)

Mild, Moderate, Severe AWS

A

Moderate

42
Q

-Marked disorientation
-confusion
-disturbing visual and auditory
hallucinations

Mild, Moderate, Severe AWS

A

Severe

43
Q

-Misidentification of objects delusions related to the hallucinations

Mild, Moderate, Severe AWS

A

Severe

44
Q

Delirium tremens

Mild, Moderate, Severe AWS

A

Severe

45
Q

disturbances and consciousness agitation

Mild, Moderate, Severe AWS

A

Severe

46
Q

-Extreme restlessness and panic state unable to sleep
-Gross uncontrollable tremors
-Convulsions

Mild, Moderate, Severe AWS

A

Severe

47
Q

mild anxiety and restlessness
restless sleep

Mild, Moderate, Severe AWS

A

Mild

48
Q

hand tremors; shakes

Mild, Moderate, Severe AWS

A

Mild

49
Q

no convulsions

Mild, Moderate, Severe AWS

A

Mild

50
Q

Convulsions

Mild, Moderate, Severe AWS

A

Severe

51
Q

Painful anxiety and motor restlessness

Mild, Moderate, Severe AWS

A

Moderate

52
Q

insomnia and nightmares

Mild, Moderate, Severe AWS

A

Moderate

53
Q

Visible tremulousness

Mild, Moderate, Severe AWS

A

Moderate

54
Q

Rare convulsions

Mild, Moderate, Severe AWS

A

Severe

55
Q

-Gross uncontrollable tremors

Mild, Moderate, Severe AWS

A

Severe

56
Q

GI: impaired appetite, nausea

Mild, Moderate, Severe AWS

A

Mild

57
Q

GI: anorexia, nausea and vomiting

Mild, Moderate, Severe AWS

A

Moderate

58
Q

GI: rejecting all fluid and food

Mild, Moderate, Severe AWS

A

Severe

59
Q

The following is what?

Determine if patient is at risk of withdrawal

A

Main Priority due to safety

60
Q

Clinical Institute Withdrawal Assessment for
Alcohol Scale, Revised (CIWA-Ar)

V
N
V
T
A
H
P
C

A

Vital sign changes
Nausea
Vomiting
Tremors
Agitation
Headache
Perspiration
Change in mental status

61
Q

Perspiration

A

the process of sweating

62
Q

Diaphoresis

A

Sweating

63
Q

What medication suppresses the CNS with give a sedative affect similar to alcohol?

A

Benzodiazepines (BENZOS)

64
Q

Short acting Benzos for AWS

A

Lorazepam (Ativan)

65
Q

Long-acting Benzos for AWS

A

Chlordiazepoxide (Librium)
Diazepam (Valium)

66
Q

Benzos are the other drugs for ?

A

alcohol withdrawal not abuse

67
Q

First line treatment of alcoholism

a. Naltrexone hydrochloride (ReVia)
b. Acamprosate calcium
c. Disulfiram (Antabuse)

A

a. Naltrexone hydrochloride (ReVia)

68
Q

An opioid receptor antagonist initially used to treat narcotic
dependence and is approved for treatment of alcohol dependence.

a. Naltrexone hydrochloride (ReVia)
b. Acamprosate calcium
c. Disulfiram (Antabuse)

A

a. Naltrexone hydrochloride (ReVia)

69
Q

increases abstinence and reduces alcohol cravens

a. Naltrexone hydrochloride (ReVia)
b. Acamprosate calcium
c. Disulfiram (Antabuse)

A

a. Naltrexone hydrochloride (ReVia)

70
Q

monthly injection

a. Naltrexone hydrochloride (ReVia)
b. Acamprosate calcium
c. Disulfiram (Antabuse)

A

a. Naltrexone hydrochloride (ReVia)

71
Q

won’t stop the individual from drinking but extends periods of sobriety

a. Naltrexone hydrochloride (ReVia)
b. Acamprosate calcium
c. Disulfiram (Antabuse)

A

a. Naltrexone hydrochloride (ReVia)

72
Q

Use when abstinence started but not while the person is still drinking.

a. Naltrexone hydrochloride (ReVia)
b. Acamprosate calcium
c. Disulfiram (Antabuse)

A

b. Acamprosate calcium

73
Q

Can be used in conjunction with other medications to support but the outcome of recovery

a. Naltrexone hydrochloride (ReVia)
b. Acamprosate calcium
c. Disulfiram (Antabuse)

A

b. Acamprosate calcium

74
Q

an aversive medication, the patient is aware that they will get sick if they drink alcohol while taking this this medication.

a. Naltrexone hydrochloride (ReVia)
b. Acamprosate calcium
c. Disulfiram (Antabuse)

A

c. Disulfiram (Antabuse)

75
Q

This medication is not recommended unless the
patient is in full awareness of the side effects.

a. Naltrexone hydrochloride (ReVia)
b. Acamprosate calcium
c. Disulfiram (Antabuse)

A

c. Disulfiram (Antabuse)

76
Q

Inhibits the breakdown of acetaldehyde because acetaldehyde is toxic if a
person drinks?
a. Naltrexone hydrochloride (ReVia)
b. Acamprosate calcium
c. Disulfiram (Antabuse)

A

c. Disulfiram (Antabuse)

77
Q

they will become ill with the following symptoms

a. Naltrexone hydrochloride (ReVia)
b. Acamprosate calcium
c. Disulfiram (Antabuse)

A

c. Disulfiram (Antabuse)

78
Q

This medication is most effective in patients with
moderate motivation for long term recovery and sobriety

a. Naltrexone hydrochloride (ReVia)
b. Acamprosate calcium
c. Disulfiram (Antabuse)

A

c. Disulfiram (Antabuse)

79
Q

Disulfiram symptoms

D
f
H
N
V
P
T
T
W
D
M
S
D
A

A

Diaphoresis
flushing of the neck and face
Hypotension
Nausea
Vomiting
Palpitations
Tachycardia
Tremor
Weakness
Dyspnea
MI
Seizures,
Death cardiac failure Arrhythmias

80
Q

With Disulfiram pt should avoid

W
N
M
B
A
L

A

Wine
None alcoholic beer
Malt vinegar
Baked goods
Aftershaves
Lotions

81
Q

Alcohol toxic to the brain – causes ? to frontal cortex and ? brain syndrome

A

atrophy

chronic

82
Q

Poor dietary intake can lead to deficiencies or insufficiencies of 3

A

folic acid, thiamine and other B vitamins.

83
Q

Degenerative brain disorder caused by thiamine deficiency

Wernicke vs Korsakoff

A

Wernicke

84
Q

Involves the heart, vascular and nervous system. Inability to acquire new information and retrieve memories

Wernicke vs Korsakoff

A

Korsakoff

85
Q

Wernicke

C
H
V
U
C

A

Confusion
hypotension
visual impairment
unsteady gait
Coma

86
Q

Korsakoff

A
D
A
V
C

A

Attention deficit
Disorientation
Amnesia
Visual impairment
Confabulation

87
Q

A neuropsychiatric disorder wherein a patient generates a false memory without the intention of deceit?

A

Confabulation

88
Q

Wernicke encephalopathy -degenerative brain disorder caused by ? deficiency

A

Thiamine

89
Q

Chronic AUD (Alcohol Use Disorder)
D
? after last intake of alcohol
Life threatening
A
S
A
A
D

A

Delirium tremens
48-72
A/V Hallucinations
Shaking
Altered Mental Status (Confusion)
Aspiration
Death

90
Q

Chronic AUD (Alcohol Use Disorder)
? after last intake of alcohol

A

48-72 after last intake of alcohol