Alcohol Disorders & Nicotine Flashcards Preview

Year 2 Psych exam2 > Alcohol Disorders & Nicotine > Flashcards

Flashcards in Alcohol Disorders & Nicotine Deck (45):
1

main component in alcohol

ethyl alcohol

2

fermentation stops at what percent alcohol

12-13%

3

50% of all alcohol consumed by

10% of all drinkers

4

how many gr of ETOH per drink

10-14 grams
1.5 oz whiskey
12 oz beer
4 oz wine

5

how is blood alcohol concentration BAC measured

g/dL or mg/dL
1-2 drinks is 0.25g/dL or 0.25%

6

enzymes for alcohol metabolism

alcohol dehydrogenase
aldehyde dehydrogenase

7

where is alcohol dehydrogenase ADH found

liver

8

what does AldDH do

acetaldehyde to acetic acid

9

acetic acid in normal metabolic pathway becomes

carbon dioxide and water

10

peak BAC occurs how

30 minutes when alcohol taken orally
longer if taken with food

11

primary site alcohol absorption

small intestine

12

why is BAC higher in females than males

smaller total body water distribution due to fat stores

13

effects of BAC 50-100 mg/dL

sedation
subjective sensation of high
reaction slowed
80mg/dL legally drunk

14

how many drinks to cause 50-100 BAC in nontolerant

2-4 drinks in short period of time

15

BAC 100-200 mg/dL signs

impaired speech
impaired motor function
gait disturbance, clumsiness, ataxia
increasingly disinhibited
blackouts, anterograde amnesia
disruption in REM sleep
snoring and sleep apnea

16

BAC 200-300 mg/dL signs

emesis and stupor

17

BAC 300-400 mg/dL signs

coma

18

BAC 500+ mg/dL

respiratory depression and death

19

management of acute alcohol intoxication

treat and prevent respiratory depression
monitor/prevent aspiration
give thiamine oral or IM
monitor labs for electrolytes, glucose, thiamine etc

20

use of thiamine in acute alcohol intoxication

reduce risk of Wernickes encephalopathy from lactic acidosis

21

management of chronic alcoholism

vital signs
monitor labs like BAC, CBC, LFT, CMP
vitamins thiamine benzo if withdrawal
vital signs again to monitor for deterioation

22

what benzo best for withdrawal of alcohol

long acting like clorazepate dipotassium or diazepam

23

chronic effects of alcohol on liver

cirrhosis in 25%
women>M
concurrent Hep C, liver effects more severe

24

chronic alcohol effects on GI

pancreatitis 3x likely
chronic gastritis and diarrhea
vit deficiency from malabsorption
weight loss

25

CNS effects chronic alcohol

peripheral neuropathy
cerebellar degeneration- gait and balance
wernickes encephalopathy- confusion
korsakoffs psychosis- memory problems and chronic confabulation

26

CV effects chronic alcohol

HTN in M>W
50% HTN 3-4 drinks a day
100% HTN 6-7 drinks.day

27

neoplastic risks of chronic alcohol

cancer 10x risk

28

uncomplicated alcohol withdrawal

shakes 12-18 hours after
peak 24-48 hr
no Tx subsides in 5-7 days

29

alcohol withdrawal seizures

7-48 hrs post
peak 24-48 hrs
status epilepticus rare

30

alcoholic hallucinosis

auditory visual or tactile hallucinations
48 hrs post
may last up to 7 days

31

delerium tremens

2-3 days post
Sx peak 4-5 days
last 3-5 days to weeks
mortality rates 15%

32

mangement alcohol withdrawal syndromes

long acting benzos
short acting benzos if liver disease (lorazepam of oxazepam)
thiamine oral or IM once
folic acid 1 mg daily
haloperidol or risperidone for hallucinosis

33

CAGE test

-tried to Cut down?
- felt Annoyed by questions?
- felt Guilty about drinking?
- needed Eye opener in morning?

34

Tx options for alcohol disorders

AAA
structured detox
inpatient alcohol Tx
physician support
family support and interventions

35

Antabuse

disulfiram
inhibits AldDH causeing accumulation acetaldehyde causing nausea, vomiting, hypotension and palpitations

36

Naltrexone

mu opioid antagonist
reduce pleasurable effects and craving for alcohol

37

campral (acmprosate)

reduce craving for alcohol via glutamate R modulation
reduces physical and emotional discomfort in alcohol cessation

38

what % of Americans public smoke

25%

39

major psychoactive substance in tobacco

nicotine

40

half life nicotine

2 hours

41

effects nicotine

inc HR, BP , RR
dizziness, lightheadedness
tremor
nausea

42

nicotine withdrawal effects

craving nicotine
irritability, anger, frustration
anxiety
difficulty concentrating
restlessness
dec HR
increased appetite/weight gain
HA
sleep disturbance

43

Nicotine replacement Tx

transdermal patches
nicotine gum
nicotine lozenges
nicotine inhaler
electronic cigarette

44

tx options for nicotine dependence

acupuncture
hypnosis
bupropion
varenicline (chantix)
combination therapy!!!

45

health issues with smoking

lung disease like COPD asthma and cancer
CV: MI PVD stroke
HA
impotence in males!!