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PSYCH > TOPIC 10 - substance abuse > Flashcards

TOPIC 10 - substance abuse Flashcards

1
Q

cross tolerance

A

developing tolerance for more than one drug in the same class
includes intense rush followed by intense lows

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2
Q

difficulty of success with nicotine cessation attempts

A

abstinence syndrome :
strong cravings, irritability, impatience, increased appetite

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3
Q

risk of marijuana use

A

long term effects = lethargy, anhedonia, difficulty concentrating, loss of memory, amotivational syndrome

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4
Q

current US substances most often used

A

alcohol, marijuana, nicotine, opioids, prescription abuse

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5
Q

common classes of prescription drugs

A

painkillers, sedatives, stimulants

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6
Q

common classes of prescription drugs

A

painkillers, sedatives, stimulants

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7
Q

opioid examples

A

hydrocodone, oxycodone, hydromorphone, morphine, codeine

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8
Q

hydrocodone uses

A

commonly prescribed for variety of painful conditions

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9
Q

morphine uses

A

before and after surgical procedures to alleviate severe pain

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10
Q

codeine uses

A

mild pain, relieve coughs and diarrhea

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11
Q

heroin overdoses

A

suppression of breathing (decrease amount of oxygen reaching brain = hypoxia)

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12
Q

feelings after injection of heroin

A

euphoria
dry mouth
warm flushing of skin
heaviness of extremities
clouded mental functioning

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13
Q

what follows the feeling of euphoria after heroin injection

A

alternating wakeful and drowsy state

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14
Q

what happens in the brain with dependence and addiction

A

the brain tricks itself into believing that the drug is as necessary for survival as basic needs

“turns volume down” to compensate for vicious highs and lows that occur during repeated opioid use and opioid withdrawal by reducing the number of opioid receptors in the brain

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15
Q

physical dependence s/s

A

restless, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes, involuntary leg movements

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16
Q

what happens to white matter of the brain due to heroin use

A

affects decision making abilities, ability to regulate behavior, and responses to stressful situation

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17
Q

influences and risk factors

A

psychological, societal, cultural, gender, religious and societal

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18
Q

difference in men and women with substance use

A

men have higher tolerance than women but women can get addicted quicker

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19
Q

4 C’s of addiction

A

craving, compulsive behavior, chronic relapsing, cognitive impairment

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20
Q

what receptor is involved in the feelings of euphoria that patients are likely to keep seeking and lead to addiction

A

dopamine

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21
Q

alcohol and CNS depressants act on

A

GABA

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22
Q

assessment for substance abuse

A

Clarify presenting signs
Assess for withdrawal
Assess for overdose
Assess for self-harm potential
Evaluate physiologic response
Explore individual’s interest in taking action
Assess knowledge of community resources
Med History
Psychiatric History
Psychosocial Issues

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23
Q

what are patients who abuse substance and have other mental illnesses likely to suffer from

A

depression and suicidal ideation

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24
Q

what age poses clients at a greater risk for addiction if they started drinking at this age

A

under 14 (since the brain is not developed - affects brain development)

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25
Q

alcohol use and pregnancy

A

alcohol is the most teratogenic
FAS - long lasting effects both physically and mentally
breastfeeding considerations
impairs fetus ability to receive oxygen

26
Q

alcohol use and aging

A

tolerance is decreased due to slowed gastric emptying, slower metabolism, increased sensitivity, decline mass, liver damage

changes in response to alcohol include : headache, reduction in mental abilities, memory loss, feelings of malaise

27
Q

antidepressants and alcohol

A

ingestion of both together = affects are potentiated and toxicity of other drugs is enhanced by alcohol associated malnutrition and reduced stores of detoxifying substances

28
Q

do older adults have a higher or lower BAL than younger people

A

higher

29
Q

physiologic effects of alcohol

A

change in motor coordination, temp regulation, sleep, mood, cognitive impairment, sleep disturbance, anxiety, depression, short attention span, coma

30
Q

how to treat hepatic encephalopathy

A

lower ammonia levels

31
Q

comorbid medical issues with alcoholism

A

hepatic encephalopathy, fetal alcohol syndrome, cardiomyopathy, arrhythmia, stroke, hypertension, cirrhosis, jaundice, ascites, varices, hepato or splenomegaly, edema, anemia, pancreatitis

32
Q

wernickes enecephalopathy

A

confusion, abnormal eye movements and unsteady gaits

33
Q

korsakoffs psychosis

A

chronic condition
consequence of untreated wernickes
inability to learn new information, short and long term memory loss

34
Q

wernicke - korsakoff syndrome

A

thiamine deficient
need B1, mag sulfate, and folic acid, and multivitamin supplement

35
Q

how long does it take the liver to detoxify 1 oz of alcohol

A

1 hr

36
Q

what is BAL

A

determines level of intoxication tolerance

37
Q

effects of 1-2 drinks

A

change in mood and behavior, impaired judgement

38
Q

effects of 5-6 drinks

A

Legal level of intoxication in most states. Clumsiness in voluntary motor activity

39
Q

effects of 10-12 drinks

A

Depressed function of entire motor area of the brain, causing staggering and ataxia; emotional lability

40
Q

effects of 15-19 drinks

A

confusion and stupor

41
Q

effects of 20-24 drinks

A

coma

42
Q

effects of 25-30 drinks

A

death by resp depression

43
Q

mild alcohol withdrawl stages

A

Anxiety
Tremors (feeling ‘shaky’)
Insomnia
Headache
Palpitations
Gastrointestinal disturbances (cramping)
Orientation remains intact

44
Q

moderate and severe alcohol withdrawl stages

A

Diaphoresis
Elevated systolic blood pressure
Tachypnea
Tachycardia
Confusion
Mild hyperthermia
Hallucinations (visual, tactile, and or auditory)
Orientation remains intact

45
Q

delirium tremens stage of alcohol withdrawl

A

Disorientation to time, place, and person
Impaired attention
Agitation
Hallucinations (visual, tactile, and or auditory)
Potential seizures

46
Q

time of peak for alcohol withdrawl symptoms

A

24-48 hr after last drink

47
Q

screening tools

A

CAGE, AUDIT

48
Q

withdrawl delirium peak

A

2-3 days after cessation or reduction of alcohol intake

49
Q

CAGE

A

cut down
annoyed
guilty
eye opener

50
Q

CIWA-AR

A

used to assess need for alcohol detoxification

51
Q

medications for alcohol withdrawl

A

benzos, anticonvulsants, beta blockers, mag sulfate, thiamine, folic acid, multivitamins

52
Q

first line med for sedation and seizure prevention

A

benzos

53
Q

examples of benzos

A

chlordiazeproxide
dizepam

54
Q

considerations for benzos

A

gradually taper off once detox is complete

55
Q

other drugs for seizure prevention and control

A

carbamazepine (Tegretol)
valproic acid (Depakote)
magnesium sulfate

56
Q

use of naltrexone

A

reduce or eliminate alcohol craving

57
Q

acamprosate

A

reduce alcohol craving, reduce unpleasant symptoms of abstinence, prolong withdrawl symptoms

58
Q

when do you see benefits of acamprosate

A

30-90 days

59
Q

disulfiram use

A

alcohol ingestion with disulfiram = unpleasant physical effects (nausea, vomiting, headache, flushing)

60
Q

when would there not be a disulfiram reaction if someone had alcohol

A

14 days

61
Q

types of treatment

A

psychotherapy, group therapy, CBT, motivational incentives, motivational interviewing, 12 step program, SMART, program types (residential, intensive outpatient, outpatient drug free, employee assistance)

62
Q

what do AA 12 step programs focus on related to spirituality

A

sense of purpose, gratitude, forgiveness

PSYCH (15 decks)

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