Exam 1 Flashcards
(47 cards)
Maladaptive pattern of substance use characterized by repeated adverse consequences related to repeated use of the substance
Drug Abuse
5 C’s of Addiction
Chronic Control impairment Compulsive Continued use despite harm Craving
State of adaptation that is manifested by a drug class-specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist
Physical Dependence
State of adaptation in which exposure to a drug induces changes that can result in a diminution of one or more of the drugs effects over time
Tolerance
Usually predictable, given the pharmacology of the drug
Acute Problems
____ abuse of chemical substances can cause a wide array of physical, psychological and psychiatric morbidities. The substance-induced disorders discussed here mainly include _____ & _____.
Chronic
Intoxication & Withdrawal
Essential feature of substance dependence…
Continued use of a substance despite adverse substance-related problems
Severity of substance use disorder
0-1 symptoms = no dgx
2-3 = mild substance use disorder
4-5 = moderate
6+ = severe
Clinicians can also add “in early remission,” “in sustained remission,” “on maintenance therapy” and “in a controlled environment.”
Miosis indicates
Opioid
Nystagmus, miosis when severe
Sedative hypnotics or anxiolytics
Diaphoresis, flushed face and skin indicate
Sedative hypnotics or anxiolytics
Pt who is former alcoholic, should not take…
BZDs due to risk of relapse
Alprazolam physical dependence daily dose and time needed to produce dependence
8-16 mg x 42 days
Clorazepate physical dependence daily dose and time needed to produce dependence
45-180 mg x 42-120 days
Diazepam physical dependence daily dose and time needed to produce dependence
10-100 mg x 42-120 days
Alprazolam peak withdrawal symptoms appear in ____ days
2-3 days
Clorazepate peak withdrawal symptoms appear in ____ days
5-8 days
Diazepam peak withdrawal symptoms appear in ____ days
5-8 days
Main ADE we want to prevent when stopping BZDs
Seizures
How do you stop BZDs?
- Convert to long half life BZDs (chlordiazepoxide, diazepam)
- Taper by 20-25% per week over 2-3 months
- Pts who are unable to DC, extend period up to 6 months
1 mg alprazolam = _____ mg chlordiazepoxide = ____ mg diazepam
25 mg chlordiazepoxide
10 mg diazepam
Antiseizure adjuncts for BZD withdrawal
Carbamazepine
Valproic Acid
Anxiolytic adjuncts for BZD withdrawal
Hydroxyzine
Diphenhydramine
Drugs to help with insomnia during BZD withdrawal
Trazadone
Sedating antidepressant
Diphenhydramine
Hydroxyzine
