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Psych > Chapter 7 pt 1 > Flashcards

Chapter 7 pt 1 Flashcards

1
Q

what are substance use disorders

A

cognitive, behavioral, and physiological symptoms indicating continuing use of a substance despite significant substance-related problems

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2
Q

what is the DSM-5 criteria for substance use disorder

A

problematic pattern of substance use w. impairment or distress manifested by at least tow of the following within a 12-month period

  1. using substance more than originally intended
  2. persistent desire or unsuccessful efforts to cut down on use
  3. significant time spent in obtaining, using, or recovering from substnace
  4. craving to use substance
  5. failure to fulfill obligations at work, school, or home
  6. continued use despite social or interpersonal problems due to the substance use
  7. declined social, occupational, or recreational activities because of substance use
  8. use in dangerous situations (driving)
  9. continued use despite subsequent physical or psychological problem
  10. tolerance
  11. withdrawal
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3
Q

what is prevalence of substance use disorder

A

8%

more common n men than women

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4
Q

what are most commonly used substances

A

alcohol and nicotine

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5
Q

what is withdrawal

A

development of a substance-speficied syndrome due to the cessation (or reduction) of substance use

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6
Q

what is tolerance

A

need for increased amounts of the substance to achieve the desired effect or diminished effect if using the same amount of substance

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7
Q

what testing can be done for PCP use

A

UDS positive for 4-7 days

CPK and AST often elevated

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8
Q

how long are barbiturates in the system

A 
short acting (pentobarbital): 24 hours
long acting (phenobarbital): 3 weeks
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9
Q

how long are benzos in the system

A 
short acting (lorazepam): up to 5 days
long acting (diazepam): up to 30 days
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10
Q

what opioids require a separate panel

A

methadone and oxycodone (come up negative on general screen)

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11
Q

what should be part of every substance use disorder treatment

A

behavioral counseling

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12
Q

how does alcohol work

A

activates GABA, dopamine, and serotonin receptors

inhibits glutamate and voltage-gated calcium channels

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13
Q

what is the most common co-ingested drug in overdose

A

alcohol

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14
Q

how is alcohol metabolized

A

alcohol to acetaldehyde (alcohol dehydrogenase)
acetaldehyde to acetic acid (aldehyde dehydrogenase)
-upregulation of these enzymes in heavy drinkers

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15
Q

most adults show signs of intoxication with BAL over what

A

BAL > 100 mg/dL

obvious signs with BAL > 150 mg/dL

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16
Q

what causes flushing and nausea in asians who drink

A

lack of aldehyde dehydrogenase

17
Q

what affects the presentation of alcohol intox

A

age, sex, body weight, chronic nature of use, duration of consumption, food in stomach, state of nutrition, liver health

18
Q

how is alcohol intoxication treated

A

monitor: ABCs, glucose, electrolytes, acid-base status
THIAMINE and FOLATE
NALOXONE (reverse effects of co-ingested opioids)

19
Q

households where the male is involved in some kind of substance use disorder are more likely to experience what

A

spousal abuse

20
Q

what are the clinical effects of alcohol intoxication

A

decrease in fine motor control (BAL 20-50)
impaired judgement and coordination (BAL 50-100)
ataxic gait and poor balance (BAL 100-150)
lethargy, difficulty sitting upright, difficulty with memory, nausea/vomiting (150-250)
coma in the novice drinker (300)
respiratory depression, death possible (400)

21
Q

when is GI evacuation indicated for EtOH overdose

A

significant amount ingested within the preceding 30-60 minutes

22
Q

what is the issue with alcohol withdrawal

A

it can be fucking LETHAL

23
Q

what are signs and symptoms of alcohol withdrawal

A 
insomnia (mild)
anxiety (mild)
hand tremor (mild)
irritability (mild)
anorexia
nausea
vomiting
autonomic hyperactivity (diaphoresis, tachycardia, hypertension) (MODERATE)
psychomotor agitaiton
fever (MODERATE) 
seizure (SEVERE)
hallucinations (SEVERE)
delirium (SEVEREE)
24
Q

when do EtOH withdrawal symptoms start and how long they last

A

start 6-34 hours

last 2-7 days

25
Q

when does one see generalized tonic clonic seizures due to alcohol withdrawal

A

12-48 hours after cessation of drinking
peak at 12-24 hours

1/3 of people with seizures develop DTs

26
Q

what is delirium tremens (DTs)

A

most serious form of alcohol withdrawal
begins 48-96 hours after last drink

physical illness predisposes the condition

afre over 30 and prior DTs increase the risk

27
Q

what is seen in delirium tremens (DTs)

A 
delirium
hallucinations (visual most common)
agitation
gross tremor
autonomic instability
fluctuating levels of psychomotor activity
28
Q

how ate DTs treated

A

benzos

Psych (35 decks)

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