Alcohol & Substance Use D/O Flashcards

Question

Epidemiology of Cocaine use?

Answer 1

Men > women 18-25 y/o ~10% have tried cocaine No difference in SES/race

Answer 2

Psychosis, anxiety, talkativeness, pressured speech, paranoid ideation, grandiosity, increased sexual interest, restlessness, insomnia

Answer 3

Intense cocaine craving is most prominent sign | Fatigue, guilt, anxiety, feeling helpless, hopeless, worthless, suicidal

Answer 4

``` Agitation If acute and harmful to self/others Ativan Physical restraints w/psychosis Antipsychotic (Haldol) ```

Answer 5

Prevalence ~5%, over use is highest among Whites Most common abused “illicit” drug Routes Usually smoked, can be eaten, but action is delayed Massachusetts passed the legal use of medical marijuana effective 1/1/13

Answer 6

Euphoria, anxiety, suspiciousness, inappropriate laughter, time distortion, impaired judgment Can cause depersonalization, mild persecutory delusions Signs: injected conjunctiva, increased appetite, tachycardia, hypothermia, mild sedation Very high doses: mild delirium w/panic symptoms

Answer 7

``` Fatigue Irritability Anxiety Depression hyperinsomnia Psychomotor retardation ```

Answer 8

Anxiety d/t acute intoxication: anxiolytics Psychosis from acute intoxication: (hallucinations/delusions): antipsychotics

Answer 9

diazepam Alprazolam ketamine

Answer 10

``` Deadly with EtOH Confusion Irritability Exhaustion Coma ```

Answer 11

Treatment Airway, Breathing, Circulation Antidote: Flumazenil IV

Answer 12

``` Paralysis, numbness Distortion of sounds and objects Sedation Anterograde amnesia with “black-outs” “K-hole” Near death experience Depersonalization Paralysis ```

Answer 13

ABCs | Supportive care, IV hydration

Answer 14

Releases Dopamine into cortex via reward pathway (mesolimbic) producing psychotic like sxs when taken in high doses. Effects are similar to Cocaine

Answer 15

Neuropsychiatric Effects: Euphoric, anorectic, paranoid psychosis Cardiovascular Effects: Hypertension, CVA, MI, seizures, coma, death Intoxication: Pupillary dilation, sweating, chills, wt loss, N/V, confusion, seizures, coma

Answer 16

Dysphoria, fatigue, nightmares, increased appetite, psychomotor agitation/retardation

Answer 17

benzodiazepines Maintenance: Antidepressants Drug counseling

Answer 18

``` Hallucinations, delusions, paranoia Extreme aggression, combativeness, homicidal Hyperthermia Hyper-dynamic Cardiovascular state Respiratory depression Stroke MI Coma ```

Answer 19

``` IV Lorazepam or diazepam every 3 minutes until calm Restraints No antipsychotics Increased QTc interval Increased hyper-thermia Increased seizures ```

Answer 20

``` Used for: ADHD Nacrolepsy Depression (off label use) Weight loss (not FDA approved) ``` ``` Effects: Extreme agitation, Arrhythmias MI Hyper-thremia Seizures MI ```

Answer 21

``` Solvents Gasoline paint thinners cleaning products lighter fuel aerosol sprays ``` Acts quickly Inhalants go directly to the cardio-pulmonary system and into the cerebral circulation Nicotine, cannabis also

Answer 22

``` One inhalation can cause immediate death Anesthesia Unconsciousness Heart failure Suffocation--hypoxia Seizures Coma and death ``` Treatment ABCs Anti-arrhythmics

Answer 23

- -Narcotics, stimulants, and sedatives are the common prescription drugs of abuse - -cold medicines containing dextromethorphan, can also be abused and lead to significant CNS effects including a dissociative state

Answer 24

(1) assessment of the need for treatment (2) placement into appropriate treatment (3) determination of physical suitability for treatment (medical clearance)

Answer 25

``` T olerance (2 points): How many drinks can you hold? (Six or more indicates tolerance.) W orried (2 points): Have close friends or relatives worried or complained about your drinking in the past year? E ye openers (1 point): Do you sometimes take a drink in the morning when you first get up? A mnesia (1 point): Has a friend or family member ever told you about things you said or did while you were drinking that you could not remember? [K] Cut down (1 point): Do you sometimes feel the need to cut down on your drinking ```

Answer 26

``` Complete history Head to toe physical exam CBC, lytes, BUN, Creatinine, Glucose Urine HCG for women of child bearing age Urine drug screen (opiates, THC, cocaine, amphetamines, etc…) Serum drug screen ```

Answer 27

U/A Yields detectable concentration for most drugs than other sample sites (blood) Does not measure impairment

Answer 28

``` All chronic alcoholics in the ED get a “banana bag” - Thiamine 200 mg - Folate 1 mg - Multivitamin Ativan 1-2 mg po for agitation ```

Alcohol & Substance Use D/O Flashcards

(52 cards)