Ch 14: Drug Abuse Flashcards by Christina Stafstrom

Need for increasing amounts to produce the desired effects

physical dependence

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Overwhelming desire to repeat the use of a particular drug to produce pleasure or avoid discomfort

psychological dependence

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describe substance abuse disorder

Use of the substance interferes with ability to fulfill role obligations
Attempts to cut down or control use fail
Intense craving for the substance
Excessive amount of time spent trying to procure the substance or recover from its use

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Development of a reversible syndrome of symptoms following excessive use of a substance
Direct effect on the central nervous system
Disruption in physical and psychological functioning
Judgment is disturbed and social and occupational functioning is impaired.

substance intoxication

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Development of symptoms that occurs upon abrupt reduction or discontinuation of a substance that has been used
Symptoms are specific to the substance that has been used.
Disruption in physical and psychological functioning

substance withdrawal

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Classes of Psychoactive Substances

Alcohol, Caffeine, Cannabis, Hallucinogens, Inhalants, Opioids, Sedatives/hypnotics, Stimulants, Tobacco

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biochemical factor of alcohol addiction

Alcohol may produce morphine-like substances in the brain that are responsible for alcohol addiction.

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is alcoholism genetic

yes

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psychological factors for addiction/alcoholism

Punitive superego

Fixation in the oral stage of psychosexual development

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sociocultural factors of addiction

social learning, conditioning, cultural influences

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phase one of alcohol use disorder

Prealcoholic phase: Characterized by use of alcohol to relieve everyday stress and tensions of life

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phase two of alcohol use disorder

Early alcoholic phase: Begins with blackouts—brief periods of amnesia that occur during or immediately following a period of drinking; alcohol is now required by the person.

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phase three of alcohol use disorder

The crucial phase: Person has lost control; physiological dependence is clearly evident.

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phase four of alcohol use disorder

The chronic phase: Characterized by emotional and physical disintegration. The person is usually intoxicated more often than sober

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Peripheral neuropathy, characterized by

Peripheral nerve damage
Pain
Burning
Tingling
Prickly sensations of the extremities

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Thought to result from same B vitamin deficiency that contributes to peripheral neuropathy

alcoholic myopathy

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Sudden onset of muscle pain, swelling, and weakness; reddish tinge to the urine; rapid rise in muscle enzymes in the blood

acute myopathy

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Gradual wasting and weakness in skeletal muscles

chronic myopathy

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Most serious form of thiamine deficiency in alcoholic patients

Wernicke’s encephalopathy

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Syndrome of confusion, loss of recent memory, and confabulation in alcoholic patients

Korsakoff’s psychosis

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Effect of alcohol on the heart is an accumulation of lipids in the myocardial cells, resulting in enlargement and a weakened condition.

alcoholic cardiomyopathy

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Inflammation and pain in the esophagus

esophagitis

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Effects of alcohol on the stomach include inflammation of the stomach lining characterized by epigastric distress, nausea, vomiting, and distention

gastritis

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Usually occurs 1 or 2 days after a binge of excessive alcohol consumption. Symptoms include constant, severe epigastric pain; nausea and vomiting; and abdominal distention.

acute pancreatitis

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Leads to pancreatic insufficiency resulting in steatorrhea, malnutrition, weight loss, and diabetes mellitus

chronic pancreatitis

Caused by long-term heavy alcohol use Symptoms: Enlarged, tender liver; nausea and vomiting; lethargy; anorexia; elevated white blood cell count; fever; and jaundice. Also ascites and weight loss in severe cases

alcoholic hepatitis

end-stage of alcoholic liver disease and is believed to be caused by chronic heavy alcohol use. There is widespread destruction of liver cells, which are replaced by fibrous (scar) tissue

Cirrhosis of the liver

Complications of cirrhosis of the liver can include

Portal hypertension Ascites Esophageal varices Hepatic encephalopathy

Impaired production, function, and movement of white blood cells

leukopenia

Platelet production and survival are impaired as a result of the toxic effects of alcohol

thrombocytopenia

Alcohol use during pregnancy can result in

fetal alcohol spectrum disorders (FASDs)

what can fetal alcohol syndrome cause

Problems with learning, memory, attention span, communication, vision, and hearing Alcohol-related neurodevelopmental disorder Alcohol-related birth defects

Alcohol intoxication

Occurs at blood alcohol levels between 100 and 200 mg/dL

when does alcoholic withdrawal occur

Occurs within 4 to 12 hours of cessation of or reduction in heavy and prolonged alcohol use

what substances are used in Sedative/hypnotic use disorder

Barbiturates Nonbarbiturate hypnotics Antianxiety agents Club drugs

effects of sedative/hypnotic use disorder

``` Effects on sleep and dreaming Respiratory depression Cardiovascular effects Renal function Hepatic effects Body temperature Sexual functioning ```

With these central nervous system (CNS) depressants, effects can range from disinhibition and aggressiveness to coma and death (with increasing dosages of the drug).

intoxication

Severe withdrawal from CNS depressants...

can be life threatening

substances used in stimulant use disorder

``` Amphetamines Synthetic stimulants Non-amphetamine stimulants Cocaine Caffeine Nicotine ```

stimulant use disorder effects

CNS, cardiovascular, pulmonary, renal/GI, sexual

Amphetamine and cocaine intoxication produce

euphoria, impaired judgment, confusion, and changes in vital signs (even coma or death, depending on amount consumed).

Caffeine intoxication usually occurs following

consumption in excess of 250 mg (causes restlessness and insomnia)

Amphetamine and cocaine withdrawal may result in

dysphoria, fatigue, sleep disturbances, and increased appetite.

Withdrawal from caffeine may include

headache, fatigue, drowsiness, irritability, muscle pain and stiffness, and nausea and vomiting

Withdrawal from nicotine may include

dysphoria, anxiety, difficulty concentrating, irritability, restlessness, and increased appetite

symptoms of inhalant disorder

Dizziness, ataxia, muscle weakness Euphoria, excitation, disinhibition, slurred speech Nystagmus, blurred or double vision Psychomotor retardation, hypoactive reflexes Stupor or coma

when does intoxication of inhalants occur

shortly after use of or exposure to inhalant

Severe opioid intoxication can lead to

respiratory depression, coma, and death

withdrawal From short-acting drugs (e.g., heroin)

Symptoms occur within 6 to 8 hours, peak within 1 to 3 days, and gradually subside in 5 to 10 days

withdrawal From long-acting drugs (e.g., methadone)

Symptoms occur within 1 to 3 days, peak between days 4 and 6, and subside in 14 to 21 days.

withdrawal From ultra-short-acting meperidine

Symptoms begin quickly, peak in 8 to 12 hours, and subside in 4 to 5 days

symptoms of opiod withdrawal

Dysphoria, muscle aches, nausea/vomiting, lacrimation or rhinorrhea, pupillary dilation, piloerection, sweating, abdominal cramping, diarrhea, yawning, fever, and insomnia

physiological effects of hallucinogens

NV, pupil dilation, increased BP and pulse, loss of appetite, insomnia, increased blood sugar, decreased respirations

Symptoms of phencyclidine intoxication

belligerence and assaultiveness, and may proceed to seizures or coma.

how long does impairment of motor skills following cannabis last

8-12 hrs

symptoms of cannabis intoxication

conjunctival injection, increased appetite, dry mouth, tachycardia

what is the legally intoxicated level

0.08 % BAL

when does alcohol withdrawal occur

4-12 hours after cessation

this is an excellent tool that is used by many hospitals to assess risk and severity of withdrawal from alcohol used for initial assessment as well as ongoing monitoring of alcohol withdrawal symptoms

Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA)

these are another screening tool to determine if an individual has problem with substances some psychiatric units administer this to all clients to determine if there is a dual diagnosis

CAGE Questionnaire and Michigan Alcoholism Screening Test (MAST)

what are the four main parts of the CAGE

Cut down? Annoyed you? Guilty? Eye opener?

Clients with a coexisting substance disorder and mental disorder may be assigned to a special program that targets the dual diagnosis. Program combines special therapies that target both problems.

dual diagnosis

It is estimated that 10 to 15 percent of nurses suffer from

disease of chemical dependency

_______ is the most widely abused drug, followed closely by ________

alcohol; narcotics

state board response to chemically impaired nurse

May deny, suspend, or revoke a license based on a report of chemical abuse by a nurse

allow impaired nurses to avoid disciplinary action by agreeing to seek treatment.

diversionary laws

Defined by dysfunctional behaviors that are evident among members of the family of a chemically dependent person, or among family members who harbor secrets of physical or emotional abuse, other cruelties, or pathological conditions

codependency

Keeps feelings in control, and often releases anxiety in the form of stress-related illnesses, or compulsive behaviors such as eating, spending, working, or use of substances

codependency

classic characteristics of codependent nurse

Caretaking Perfectionism Denial Poor communication

recovery process of codependence

Survival stage Re-identification stage Core issues stage Reintegration stage

A major self-help organization for the treatment of alcoholism

alcoholics anyonymous

what is AA based on

Peer support Acceptance Understanding from others who have experienced the same problem

pharmacology for alcoholism

``` Disulfiram (Antabuse) * Acamprosate (Campral) * Naltrexone (ReVia) Nalmefene (Revex) Selective serotonin reuptake inhibitors (SSRIs) ```

what is used in substitution therapy

activan and valium

psychopharmacology for alcohol

Benzodiazepines Anticonvulsants Multivitamin therapy Thiamine

pharmacology for opiods

Narcan and Clonidine and Methadone

psychopharmacolgy for stimulants

Minor tranquilizers Major tranquilizers Anticonvulsants Antidepressants

Ch 14: Drug Abuse Flashcards

(77 cards)