Substance Use Disorder Flashcards

1
Q

What is the “Substance Abuse Triad”?

A

1) Psychological dependence or craving (Mental)
2) Physiologic dependence (Physical)
3) Tolerance

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2
Q

How many deaths per year are directly attributable to alcohol use?

A

85,000

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3
Q

___ in ___ deaths in working age adults results from excessive drinking?

A

1 in 10

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4
Q

What is the 3rd leading preventable cause of death in the United States?

A

Alcohol Use Disorder

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5
Q

What is the NIAAA?

A

National Institute of Alcohol Abuse and Alcoholism

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6
Q

What are the estimated consumption amounts of alcohol that would increase health risks for a man?

A

1) More than 14 drinks/week

2) More than 4 drinks on ANY day

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7
Q

What are the estimated consumption amounts of alcohol that would increase health risks for a woman?

A

1) More than 7 drinks/week

2) More than 3 drinks on ANY day

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8
Q

What is a “standard drink” of wine?

A

5 oz

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9
Q

What is a “standard drink” of beer?

A

12 oz beer

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10
Q

What are the criteria used to diagnose an alcohol use disorder?

A

LW-STACK-SHOT

1) Drinking in LARGER amounts for longer periods than intended
2) Evidence of alcohol WITHDRAWAL or use of alcohol for relief or avoidance of withdrawal
3) Persistent desire or unsuccessful attempts to STOP or reduce drinking
4) Great deal of TIME spent obtaining, using, or recovering from alcohol
5) Important ACTIVITIES given up or reduced because of drinking
6) Alcohol CRAVING
7) Continued drinking despite KNOWLEDGE of problems caused
8) Continued drinking despite alcohol-related SOCIAL or interpersonal problems
9) Recurrent drinking in HAZARDOUS situations
10) Recurrent drinking resulting in failure to fulfill role OBLIGATIONS
11) Evidence of TOLERANCE

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11
Q

What are the Medical Complications of alcohol use?

A

1) HTN
2) Cardiovascular disease
3) Liver disease
4) Pancreatitis
5) Gastritis
6) Esophagitis
7) Neuropathy

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12
Q

What are physical exam findings of withdrawal?

A

Tremors and Agitation

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13
Q

What are the features of liver disease from alcohol abuse?

A

1) Hepatic/splenic enlargement
2) Icterus/jaundice
3) Spider angiomata
4) Palmar erythema

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14
Q

What are the CAGE questions?

A

1) Have you ever felt you should CUT down on your drinking?
2) Have people ANNOYED you by criticizing your drinking?
3) Have you ever felt bad or GUILTY about your drinking?
4) Have you ever taken a drink first thing in the morning (EYE OPENER) to steady your nerves or get rid of a hangover?

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15
Q

Wernicke Korsakoff syndrome is a complication of what?

A

Alcohol Use Disorder

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16
Q

If you were dealing with a patient that has an Alcohol Abuse disorder, What is a possible complication if you noticed Nystagmus, wide/short steps and Disorientation during your physical exam?

A

Wernicke Encephalopathy

Direct damage to the brain caused by thiamine deficiency

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17
Q

Wernicke Korsakoff Syndrome is caused by a deficiency in what?

A

Due to a deficiency of Thiamine (Vitamin B1)

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18
Q

A deficiency of Thiamine (Vitamin B1) is caused by what?

A

Alcohol Abuse

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19
Q

What is the triad for Wernicke encephalopathy?

A

1) Encephalopathy (Confused)
2) Oculomotor dysfunction (Nystagmus)
3) Gait ataxia (Wide short gait)

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20
Q

MILD Withdrawal Symptoms generally begin within ___ to ___hours of last drink and last __ to __ days.

A

6-24 hours

1-2 days

21
Q

Alcohol Hallucinosis begins within ___ - ___ hours and last ___ - ___ days

A

12-24 hours

1-2 days

22
Q

Seizures due to alcohol withdrawal occur within ___ - ___ hours.

A

6-48 hours

23
Q

True or False:

Risk of seizures increases with repeated Alcohol Withdrawals.

A

True

Its called “Kindling effect”

24
Q

What is the leading preventable cause of mortality worldwide?

A

Tobacco Use Disorder

25
Q

What are the stages of quitting tobacco?

A

1) Pre-contemplation
2) Contemplation
3) Preparation
4) Action
5) Maintenance

26
Q

What is the most important risk factor for COPD?

A

Smoking

27
Q

When does nicotine withdrawal peak?

A

First three days

28
Q

When does nicotine withdrawl subside?

A

1 month

29
Q

What is an example of a long acting nicotine replacement therapy?

A

Nicotine Patch

30
Q

What is an example of short acting nicotine replacement therapy?

A

Nicotine gun or lozenges

31
Q

What medications can be used for tobacco cessation?

A

1) Buproprion (Wellbutrin)

2) Varenicline (Chantix)

32
Q

What is the Mechanism of Action for Buproprion?

A

It is a Dopamine and Norepinephrine reuptake inhibitor

33
Q

What is the treatment of choice for a patient that is suffering from seizures due to alcohol withdrawal?

A

Diazepam

34
Q

How long can THC be detected in the urine for a long term and short term user?

A

Short term = 4 - 6 days

Long term= 20 - 50 days

35
Q

What is a negative effect of marijuana usage?

A

You go to heck

36
Q

What is the most widely used treatment for cannabis dependence?

A

Cognitive behavioral therapy

37
Q

Where are 55% of abused opioids obtained from?

A

Friends and Family

38
Q

What are the effects of opioid abuse on a patients vitals?

A

+/- Heart Rate
Hypo-tension
Bradycardia
Hypothermia

39
Q

What physical exam findings would be present in a patient that has abused opioids?

A

Hypo-active bowel sounds (That’s why you get constipated)
Neurological Sedation or Seizures
Miosis (Constricted pupils)

40
Q

What should be ruled out when suspecting a patient has abused opiods?

A

Hypoglycemia

41
Q

What is the treatment of choice for acute opioid intoxication?

A

Naloxone

You should also pay attention to airway management

42
Q

What are the physical findings in an acute stimulant intoxication patient?

A

1) Sweating
2) Tachycardia
3) Elevated blood pressure
4) Mydriasis (dilated pupils)
5) Hyperactivity
6) Acute brain syndrome with confusion and disorientation.

43
Q

What should be a clinical concern for patients presenting with unexplained nasal bleeding, headaches, fatigue, insomnia, anxiety, depression, and chronic hoarseness?

A

Cocaine use

44
Q

Bipolar disorder is a mood disorder that is characterized by what three mood states?

A

1) Mania *
2) Hypomania
3) Major Depression *

45
Q

What is defined as a distinct period of abnormally or persistently elevated, expansive, or irritable mood and persistently increased activity or energy, lasting at least one week.

A

Mania

46
Q

What are the symptoms that need to be present for a person to be considered Manic?

(3+ symptoms must be present)

A

DIG FAST

D - Distractibility
I - Indiscretions
G - Grandiosity
F - Flight of ideas
A - Activity increase
S - Sleeplessness
T – Talkativeness
47
Q

What are the symptoms that need for be present for a person to be considered to have “Major Depression”?

(5+ symptoms must be present)

A

* SIG-E-CAPS*

S- Suicide

I- Loss of intersts

G- Guilt (for unknown reasons)

E- Energy decreased

C- Concentration loss

A- Appetite (Increased or decreased)

P- Psychomotor Retardation

S- Sleep disturbances

48
Q

How does an IDC manage a patient with Bipolar disorder?

A

1) Immediately refer and manage acute symptoms while awaiting referral
2) Haloperidol and MEDEVAC if for an acute manic episode

49
Q

What is the maintenance therapy for bipolar disorder?

A

(Prescribed by a psychiatrist)

a) Lithium
b) Valproic acid
c) Lamotrigine (Lamictal)
d) Quetiapine (Seroquel)