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alcohol and substance abuse Flashcards

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1
Q

what are the most commonly abused drugs?

A

alcohol
nicotine
caffeine

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2
Q

most common age group to be affected by alcohol and substance abuse

A

18-34 but occurs at all ages

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3
Q

what is moderate drinking for men?

A

Fewer than 14 drinks/ week

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4
Q

What is moderate drinking for women?

A

fewer than 7 drinks/ women

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5
Q

what is a little intoxication drinking

A

fewer than 4 drinks per occasion for men and fewer than 3 drinks per occasion for women

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6
Q

what is “at risk” or hazardous use for drinking?

A

more than moderate drinking but don’t have consequences yet

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7
Q

what constitutes at risk prescription drug users?

A

patients on mood altering drugs or prescription (Rx) pain medications for more than 3 months

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8
Q

what are problems related to Rx drug use

A

falls, oversedation, drug interactions, overdoses, or symptoms of dependence

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9
Q

Development of a reversible substance-specific syndrome due to recent ingestion of or exposure to a substance
Intoxication even without abuse or dependence, has risks

A

substance intoxication

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10
Q

nonspecific, nonmedical term referring to psychological and/or physical dependence that results in substance seeking behavior

A

Addiction

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11
Q

physiological changes that occur with drug or alcohol use and result in withdrawal symptoms when use is stopped
It may or may not be associated with substance seeking behavior

A

Physical dependence

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12
Q

craving or desire for the substance (can occur with or without physiological dependence)

A

Psychological dependence

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13
Q

DSM IV described abuse how?

A

substance abuse and substance dependence

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14
Q

DSM V describes substances problems as what?

A

substance use

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15
Q

A maladaptive pattern of use
Doesn’t meet criteria for dependence
Causes recurrent and significant adverse consequences
E.g., legal problems
Work problems
Problems at home
Person keeps using the substance despite the negative consequences

A

Substance abuse

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16
Q

A maladaptive pattern of use
Causes significant impairment or distress
Often has tolerance for the substance
Often has withdrawal when doesn’t take the substance
Tries unsuccessfully to cut down

A

substance dependence

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17
Q

two ways in which substance dependence can occur

A
  1. With physiological dependence (if tolerance or withdrawal are present)
  2. Without physiological dependence (if neither tolerance nor withdrawal are present)
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18
Q

what is remission for substance dependence?

A

Remission is defined as no longer meeting any of

the criteria for substance abuse or dependence for at least a month.

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19
Q

what are the substance use severities?

A

2-3 symptoms mild
4-5 symptoms moderate
6 or more symptoms severe

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20
Q

what are common causes of death from alcohol?

A

suicide
cancer
heart disease
hepatic disease

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21
Q

what increases risk of alcohol use disorders?

A

childhood hx of ADHD or conduct disorder

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22
Q

what metabolizes alcohol

A

liver by metabolism, small amount through kidney and lungs

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23
Q

what is higher in heavy drinkers w/ alcohol metabolism?

A

enzymes for alcohol so metabolism is more rapid

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24
Q

what inhibits aldehyde dehydrogenase?

A

antabuse (disulfiram) making the person sick

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25
what is one drink of 80 proof liquor?
1.25 oz
26
what is one drink of table wine?
5 oz
27
what channel is alcohol associated w/
GABA
28
what should you not take w/ alcohol
barbiturates benzodiazepines depress respiratory drive
29
what is the leading cause of mental retardation?
fetal alcohol syndrome
30
what is the presentation of fetal alcohol syndrome?
Characterized by microcephaly, craniofacial malformations, limb and heart defects, short stature, cognitive problems
31
what are lab tests are helpful for alcoholism
brethalyzer or blood alcohol level GGT- gamma-glutamyl transpeptidase MCV is high uric acids, TG, AST, and ALT can be high
32
what sign of alcohol withdrawal develops after 6-8 hours?
tremulousness
33
when do seizures develop from alcohol withdrawal?
12-24 hours
34
when do psychotic and perceptual disturbances happen w/ alcohol withdrawal?
8-12 hours
35
when do DTs occur w/ alcohol withdrawal? these can cause death
develop w/i 72 hours but can occur up to a week after drinking has stopped
36
signs of delirium tremens
delirium appearing within a week of stopping drinking or “cutting down,”, autonomic hyperactivity, perceptual distortions, fluctuating levels of psychomotor activity
37
when do DTs typically appear?
after 5-15 years of heavy drinking, typically binge
38
what does CAGE stand for?
C: Have you ever felt that you should Cut down on your drinking? A: Have people Annoyed you by criticizing your drinking? G: Have you ever felt bad or Guilty about your drinking? E: Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover? ( Eye opener)
39
what is Al-Anon?
support group for family members of someone who abuses alcohol
40
drug tx for alcohol withdawal
benzodiazepines carbamezapine thiamine, folic acid beta blockers, clonidine
41
what happens is someone drinks while taing disulfiram?
flushing, nausea, burning sensation in stomach due to buildup of aldehyde can involve danger HTN
42
what is an opioid antagonist that decreases alcohol craving or blunts the pleasurable effects of alcohol.
naltrexone
43
Mechanism of action not certain, but believed to act on NMDA and GABA receptors. given in patients who are already abstinent. works best w/ good family support. thought to reduce the pleasurable effects of alcohol. taken TID
Acamprosate
44
All drugs of addiction increase DA in the _______ __________(part of the brain associated with pleasurable response and motivation to repeat the experience)
nucleus accumbans
45
Includes Rx medications such as methylphenidate and dexedrine, ephedrine, pseudoephedrine, as well as methamphetamine
amphetamines
46
what does withdrawal w/ amphetamines involve
"crash" with depression, rebound REM sleep and nightmares, cramps, hunger
47
what can amphetamiens cause?
psychotic disoder that looks like schizophrenia MI, THN, ischemic colitis, twtiching, seizures powerful cravings
48
what can be used to treat agitation from amphetamine withdrawal
anxiolytics or neuroleptics
49
Blocks dopamine reuptake by the DA transporter Used by inhaling “snorting”, sub-q, IV, smoking Highly addictive Causes intoxication, withdrawal similar to amphetamine “crash”, abuse, dependence
Cocaine
50
ADRs of cocaine
``` transient ischemic attacks nonhemorrhagic cerebral infarctions seizures MIs and arrhythmias cardiomyopathy syncope or chest pain leading to death ```
51
are there drugs to decrease craving of cocaine?
No, management is similar to amphetmaines propranolol can help w/ withdrawal symptoms baclofen can be used as a muscle relaxant
52
what are part of the opioid family?
Includes opium, morphine, heroin, codeine, oxycontin, fentanyl, etc.
53
what does opiates affect?
opioid receptors, which regulate analgesia, respiratory depression, constipation, sedation, diuresis
54
withdrawal symptoms of opioids?
``` muscle cramps, bone aches diarrhea, abodminal cramps rhinorrhea, lacrimation pilorection yawning, fever pupillary dilation, HTN, tachycardia, temp dysreg ```
55
do people often die of opioid withdrawal?
no, unless they are in poor health
56
how is heroin taken?
IV, smoke, snort
57
treatment for opioid addiction
methadone | buprenoprhine
58
what will reverse the effect of any opioid?
naloxone
59
what blocks euphoria from opiates?
naltrexone
60
what control the autonomic x of withdrawal?
clonidine (alpha 2 agonist)
61
what can help muscle cramping w/ opiate withdrawal?
baclofen
62
a partial opioid agonist, can be given 3x/week, appears to reduce heroin use Methadone: a synthetic opioid
buprenorphine
63
what is a syntheic opioid?
methadone
64
do most users develop dependence from inhalants?
No
65
ADRs from inhalants
death from respiratory depression, arrhythmias, asphyxiation, aspiration, accident irreversible hepatic or renal damage, muscle damage, heavy metal poisoning, decreased IQ, brain atrophy, GI sx, other neurological sx
66
what are sedative hypnotics and anxiolytics
Includes: Benzodiazepines: diazepam, lorazepam Barbiturates: secobarbital, etc. Barbiturate-like substances(methaqualone: Quaalude, meprobamate:Equanil.)
67
withdrawal symptoms from sedative-hynpotics
seizures, similar to alcohol withdrawal | can occur after a month w/ use at prescribed doses
68
do barbituates or benzos cause more respiratory depression
barbituates
69
tx of barbituate OD?
gastric lavage | activated charcoal
70
what is a benzodiazepine antagonist that can be used for OD
flumazenil

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