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z S15 HEHI 4 > chemical dependency > Flashcards

chemical dependency Flashcards

(96 cards)

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1
Q

dependence

A

state in which normal function only occurs in the presence of a drug; manifested as physical disturbance when drug is removed (withdrawal)

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2
Q

biological theory of addiction

A

specific effects on selected neurotransmitters

DOPAMINE especially!

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3
Q

psychological theory of addiction

A

defense mechanism against anxious impulses; self-medication for depression and other chronic stressors

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4
Q

behavioral theory of addiction

A

positive reinforcement

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5
Q

sociocultural theory of addiction

A

social and cultural norms; socioeconomic stress

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6
Q

abuse

A

pattern of use that results in negative consequences

  • inability to fulfill role expectations
  • participation in hazardous activities while impaired
  • recurring legal, personal problems
  • continued use despite problems
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7
Q

dopamine significance in addiction

A

regulates pleasure and pain, plays a major role in all addictions

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8
Q

psychological dependence

A

SUBJECTIVE experience of need for drug to experience “normal” functioning

ALL drugs/events that are mood altering have potential for psychological dependence.

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9
Q

physical dependence

A

an event occurs when TOLERANCE DEVELOPS in response to use of a psychoactive substance and upon cessation results in WITHDRAWAL sequela

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10
Q

tolerance

A

greatly increased amounts of substance needed to achieve intoxication or desired effect

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11
Q

withdrawal

A

SUBSTANCE SPECIFIC SYNDROME that follows cessation or reduction in intake of a psychoactive drug on which an individual is physiologically dependent

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12
Q

polysubstance abuse

A

abuse of more than one substance at a time

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13
Q

dual diagnosis

A

coexistence of major psychiatric disorder and substance related disorder (at least 50% addictions w/ mental illness)

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14
Q

chemical dependence phase I: prodromal

A
  • increase of tolerance
  • temporary loss of memory
  • sneaking chemical(s)
  • preoccupation with use of chemical
  • avoidance of reference to personal use

more frequent loss of memory –> phase II

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15
Q

chemical dependence phase II: crucial (basic)

A
  • loss of control, morning use of chemical(s), change in use pattern, periodic abstinence
  • alibis and excuses, protecting supply
  • reproof by significant others, loss of friendships, position
  • extravagance, escape
  • aggression, resentment, persistent remorse
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16
Q

chemical dependence phase III: chronic

A
  • more or less continuous use
  • ethical deterioration
  • inconsistent, inappropriate thinking
  • indefinable fears
  • tremors, psychomotor inhibitions
  • decrease of tolerance if ALCOHOL
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17
Q

common personality traits of chemically impaired

A
  • avoidance: emotional, physical
  • grandiosity
  • impulsiveness: craving/anxiety = act without thinking
  • manipulation: rationalizing, intellectualizing, projecting, excuses
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18
Q

associated personal factors of chemically impaired people

A
  • decreased tolerance for frustration
  • risk taking
  • low self-esteem, lack of success and meaningful relationships

can be good at appearing fine outwardly

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19
Q

cardinal symptom/most common defense mechanism*

A

DENIAL!*

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20
Q

family roles: codependence

A

dysfunctional behavioral patterns characterized by excessive focus on emotional, social, physical needs of another

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21
Q

codependent person: characteristics

A
  • develops unhealthy pattern of relating to others
  • low self-esteem, willingness to suffer
  • needs to be needed
  • strong urge to change, control others

codependent needs treatment if addict gets treatment or role will be screwed up

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22
Q

family roles: hero

A

exceeds at whatever he/she does to avoid dysfunctional feelings through the praise of others

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23
Q

family roles: mascot/clown

A

makes everything all right through humor and showing off

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24
Q

family roles: scapegoat

A

gets into trouble, takes focus off dysfunction in the family by bringing it onto him/herself

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25
family roles: lost child
avoid family turmoil by being so quiet he/she is never noticed
26
alcoholism
primary, chronic disease with genetic psychosocial and environmental factors influencing its development and manifestations - often progressive, fatal - affects dopamine in brain enough to force adaptation because not working correctly
27
alcoholism: characteristics*
- impaired control over drinking - preoccupation with alcohol - use despite adverse consequences - distortions in thinking; DENIAL*
28
alcoholism: specific s/s
- gulping drinks - drinks alone - use as medicine - blackout - non-premeditated use
29
alcohol pharmacokinetics: absorption
20% stomach | 80% small intestine
30
alcohol pharmacokinetics: distribution
all tissues and body fluids
31
alcohol pharmacokinetics: metabolism
PRIMARILY LIVER 90% | - consistent rate of metabolism
32
blood alcohol level
can be used to assess level of intoxication and level of tolerance - as tolerance develops, discrepancy seen between BAL and expected behavior
33
ascites
?
34
alcohol withdrawal
early signs a few hours after decreasing alcohol (depends on how dependent and how much used) signs peak after 24-48 hours then rapidly disappear
35
alcohol withdrawal: s/s
- hyperalertness - jerky movements - irritability - easily startled - "shaking inside"
36
delirium tremens
aka DT aka alcohol withdrawal delirium - medical emergency that can result in death - delirium peaks at 2-3 days after cessation, lasts 2-3 days
37
delirium tremens: s/s
- tachycardia, diaphoresis, elevated bp - disorientation, clouding of consciousness - visual, tactile hallucinations - hyperexcitability through lethargy (extremes) - paranoid delusions, agitation - fever (100 - 103F) - SEIZURES!
38
red flag of possible alcohol withdrawal
tactile hallucinations (not frequently seen in psychotic disorders!)
39
delirium tremens: pharm intervention
PRIORITY: long acting benzodiazepine - thiamine: prevent encephalopathy - folic acid/multivitamins: correct deficiencies - magnesium sulfate: reduce seizures - anticonvulsants: control seizures
40
delirium tremens: thiamine
prevent encephalopathy
41
delirium tremens: folic acid/multivitamins
correct deficiencies
42
delirium tremens: mag sulfate
reduce seizures
43
delirium tremens: anticonvolsants
control seizures
44
delirium tremens: benzodiazepine
long acting; PRIORITY! act on the benzodiazepine-GABA-chloride receptor complex, having a similar GABA-potentiating effect as alcohol
45
cocaine/stimulant abuse: health issues
- extreme weight loss - malnutrition - myocardial infarction - stroke
46
intravenous drug use: health issues
infections, sclerosing of veins
47
intranasal drug use: health issues
sinusitis, perforated nasal septum
48
smoking substance: health issues
respiratory issues
49
cns depressants: intoxication s/s
- euphoria - sedation, unsteadiness - decreased: bp, hr, rr - cognitive decline - BARBS: cardiac, respiratory depression
50
cns depressants: abrupt withdrawal s/s
seizures, coma, death | taking patient off benzo? WEAN
51
taking patient off benzo?
WEAN!!!!
52
cns depressants: withdrawal s/s
- n, v - tachycardia - tremors - pupil dilation - severe insomnia
53
pupil dilation cardinal sign of
cns depressant withdrawal
54
cns depressant: therapeutic management of withdrawal
titrate with similar drug
55
cns depressant: therapeutic management of overdose
- induce vomiting, activated charcoal - gastric lavage - fluid support - seizure precautions
56
stimulants: intoxication s/s
- restless, agitated, anxious, increased vital signs - paranoia - absence of appetite
57
stimulants: overdose s/s
myocardial infarction, stroke, collapse
58
stimulants: withdrawal s/s
DEPRESSION, suicide, paranoia, n/v
59
stimulant: therapeutic management of withdrawal
- antidepressant | - dopamine agonist
60
stimulant: therapeutic management of overdose
- treat sx | - maintain body systems
61
opioid drugs: common effects
- euphoria - relaxed - lethargic - pupil CONSTRICTION
62
pupil constriction cardinal sign of
opioid drug use!
63
opioid drugs: intoxication effects
depressed vital signs, lethargy, coma leading to death
64
opioid drugs: withdrawal s/s*
U N C O M F O R T A B L E!!!!!!!* - n, d, muscle cramps - chills - runny nose/eyes
65
opioid drugs: therapeutic management of withdrawal
tapering, substitution
66
opioid drugs: therapeutic management of overdose
narcotic antagonist (naloxone/Narcan)
67
hallucinogens: common effects
- altered thoughts, perceptions - diverse effects - intense, profound mood swings
68
hallucinogens: toxic effects
- acute panic reactions | - "flashbacks"
69
hallucinogens: therapeutic management of toxic effects
- decrease stimuli - LSD: no pharm - PCP: Haldol and/or Valium
70
marijuana: physiological effect
cns depressant, also has hallucinogenic properties
71
opioids: physiological effect
suppresses cns
72
hallucinogens: physiological effect
inactivates some 5HT receptor sites and decreases GABA, which permits increased dopamine activity resulting in altered thoughts, perceptions
73
marijuana: common/toxic effects
- euphoria - time distortion - increased appetite - dry mouth, red eyes - may cause anxiety reactions long term: memory loss
74
caffeine: physiological effect/withdrawal
cns stimulant | - withdrawal: severe ha, irritability
75
nicotine: physiological effect/withdrawal
cns stimulant of ne (nicotinic receptors) | - withdrawal: ha, anxiety, irritability
76
inhalants: physiological effect
cns depressant | - prolonged use: toxic to brain
77
steroids: mechanism & psych effect
alter genetic material to produce new proteins | - psych: psychotic symptoms
78
therapeutic management of chemically impaired individual
- acute treatment - rehabilitation - group treatment
79
alcoholism: cns early effects
cns depression!: decreased inhibitions, judgment, memory, concentration, self-control
80
alcoholism: cardiac early effects
increased hr, hypotension (common), hypertension, cutaneous dilation
81
alcoholism: respiratory early effects
aspiration risk
82
alcoholism: renal early effects
diuretic (inhibits adh)
83
alcoholism: gi early effects
stimulates acid secretion, production; mucosal irritation
84
alcoholism: pancreas early effects
epigastric pain, vomiting
85
alcoholism: hepatic early effects
accumulation of fat, protein in liver
86
alcoholism: hematological early effects
decreased wbc and platelet production, anemia, increase infection risk
87
alcoholism: sexual early effects
decreased capacity for responsiveness, menstrual cycle changes
88
alcoholism: cns late effects
seizures, atrophy, wernicke-korsakoff syndrome
89
alcoholism: cardiac late effects
hyperlipidemia + chf, cad, cardiomyopathy
90
alcoholism: respiratory late effects
risk: aspiration, ineffective breathing, ineffective airway
91
alcoholism: gi late effects
gastritis, hemorrhagic ulcer and gi bleeds, nutritional and vitamin deficiency (damaged tract, malabsorption problems)
92
alcoholism: pancreas late effects
pancreatitis, increased activity of enzymes = autodigestion of pancreas tissue
93
alcoholism: hepatic late effects
vitamin b depletion, coagulation problems, necrosis, cirrhosis + associated secondary illnesses*, liver failure *esophageal varices, portal hypertension, ascites, hepatic encephalopathy, hepatic coma
94
alcoholism: hematological late effects
bone marrow depression, prolonged clotting (decrease in bile synthesis prevents absorption of fat soluble vitamins -> lack of vitamin K = insufficient clotting factors0
95
alcoholism: sexual late effects
impotence, impaired fertility, sterility, gynecomastia
96
wernicke-korsakoff syndrome
wernicke encephalopathy (damage to thalamus, hypothalamus) + korsakoff psychosis (permanent damage to areas controlling memory) brain damage caused by a lack of vitamin B1 (common in alcoholics)

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