Exam 3 Chapter 14

Question 1

alcohol used to relieve everyday stress

Answer 1

phase 1: prealcoholic

Question 2

begins with blackouts; alcohol is now required by person

Answer 2

phase 2: early alcoholic

Question 3

person has lost control over alcohol use. physiological dependence is clearly evident

Answer 3

phase 3: Crucial

Question 4

person is intoxicated more than they are sober

Answer 4

phase 4: chronic

Question 5

peripheral nerve damage, pain, burning, tingling, prickly sensation of extremities
due to thiamine deficiency
-inadequate intake
-malabsorption

Answer 5

alcoholic peripheral neuropathy

Question 6

sudden oset of muscle pain, swelling, and weakness, reddish tinge to urine, rapid rise in muscle enzymes (LDH, CPK, AST)

Answer 6

acute alcoholic myopathy

Question 7

gradual muscle wasting and weakness of skeletal muscles

Answer 7

chronic alcoholic myopathy

Question 8

Most serious form of thiamine deficiency

characterized by paralysis of ocular muscles, diplopia, ataxia, somnolence, and stupor

Answer 8

Wernicke’s encephalopathy

Question 9

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

Answer 9

Korsakoff’s pyschosis

Question 10

effect of alcohol on heart is an accumulation of lipids in myocardial cells, resulting in enlargement and weakened condition

Answer 10

Alcoholic cardiomyopathy

Question 11

inflammation and pain in esophagus occurs bc of toxic effects on esophageal mucosa and also bc of frequent vomiting assoc with alcohol use

Answer 11

Esophagitis (esophageal varices)

Question 12

inflammation of stomach lining characterized by epigastric distress, n/v, distension

Answer 12

gastritis

Question 13

decreased exercise tolerance, tachycardia, dyspnea, edema, palpitations, nonproductive cough increased CPK, AST, ALT, LDH
Treatment is TOTAL ABSTINENCE from alcohol

Answer 13

alcoholic cardiomyopathy: looks like CHF or arrhythmia

Question 14

usually occurs 1-2 days after binge of excessive consumption, constant, severe epigastric pain, n/v and abdominal distension

Answer 14

pancreatitis

Question 15

leads to pancreatic insuffiency resulting in steatorrhea, malnutrition, wt loss, and DM

Answer 15

chronic pancreatitis

Question 16

enlarged, tender liver, n/v, lethargy, anorexia, high WBC, fever, jaundice, ascites and weight loss

Answer 16

alcoholic hepatitis

Question 17

widespread destruction of liver cells which are replaced by fibrous tissue; portal hypertension, ascites, esophageal varices, hepatic encephalopathy due to high ammonia levels

Answer 17

cirrhosis of liver

Question 18

impaired mental fxn, apathy, euphoria/depression, sleep disturbances, increased confusion, coma or death possible
Tx: abstinence from alcohol, no protein, neomycin or lactulose

Answer 18

hepatic encephalopathy

Question 19

Hematologic effects of alcohol

Answer 19

leukopenia and thrombocytopenia

Question 20

abnormal facial features, small head size, shorter than ave weight, diff paying attention, poor memory, diff in school, learning diffs, speech and lang delays, poor reasoning skills, intellectual disability, sleep and sucking probs as baby, vision or hearing probs, heart, kidneys, and bone probs

Answer 20

FAS

Question 21

BAC of 100-200mg/dL

Answer 21

intoxication occurs and withdrawal occurs within 4-12 hours of cessation or reduction of heavy use

Question 22

barbs, non-barbs, anti anxiety agents, club drugs

Answer 22

sedative-hypnotic

Question 23

primarily affect nervous tissue: depress activity of brain, nerves, muscles, and heart. reduce metabolism
mild sedation-death

Answer 23

sedative hypnotics: barbs, non barbs, antianxiety agents and club drugs

Question 24

decreased dreaming while on drug but rebound insomnia and excessive dreams during withdrawal

Answer 24

sedative hypnotics: barbs, non barbs, antianxiety agents and club drugs

Question 25

inhibits RAS for respiratory depression

Answer 25

sedative hypnotics: barbs, non barbs, antianxiety agents and club drugs

Question 26

amphetamines, synthetic stimulants, non-amphetamine stimulants, cocaine, caffeine, nicotine

Answer 26

stimulants

Question 27

high doses lead to hypotension (decreased CO, cerebral blood flow, and direct impairment of myocardial contractility)

Answer 27

sedative hypnotics: barbs, non barbs, antianxiety agents and club drugs

Question 28

high doses may suppress urine formation (decrease renal fxn)

Answer 28

sedative hypnotics: barbs, non barbs, antianxiety agents and club drugs

Question 29

stimulate liver enzyme production, produce jaundice, promote liver damage

Answer 29

sedative hypnotics: barbs, non barbs, antianxiety agents and club drugs

Question 30

high doses will decrease body temp

Answer 30

sedative hypnotics: barbs, non barbs, antianxiety agents and club drugs

Question 31

biphasic response (initial increase in libido, but then decreased ability to retain erection)

Answer 31

sedative hypnotics: barbs, non barbs, antianxiety agents and club drugs

Question 32

inappropriate sexual or aggressive behavior, mood liability, impaired judgement, or impaired social or occupational functioning

Answer 32

sedative hypnotics: barbs, non barbs, antianxiety agents and club drugs

Question 33

slurred speech, incoordination, unsteady gait, nystagmus, impairment of attention or memory, and stupor or coma

Answer 33

sedative hypnotics: barbs, non barbs, antianxiety agents and club drugs

Question 34

withdrawal symptoms: autonomic hyperactivity (sweating or pulse rate greater than 100), increased hand tremor, insomnia, n/v, hallucinations, illusions, psychomotor agitation, anxiety, and grand mal seizures

Answer 34

sedative hypnotics: barbs, non barbs, antianxiety agents and club drugs

Question 35

induce stimulation by augmentation of EPI, NE, or dopamine

Answer 35

psychomotor stimulants

Question 36

exert their action on the cellular level

Answer 36

: general cellular stimulants: caffeine and nicotine caffeine (cAMP) nicotine: ganglionic neurons

Question 37

most potent stimulant derived from nature

Answer 37

cocaine

Question 38

appetite suppressants

Answer 38

CNS stimulants

Question 39

tremor, restlessness, anorexia, insomnia, agitation, increased motor activity; increased alertness, decreased fatigue, elation and euphoria, subjective feelings of greater mental agility and muscular power

Answer 39

Stimulants (amphetamines, cocaine, caffeine, nicotine)

Question 40

increased BP, HR, cardiac arrhythmias, relax bronchial smooth muscle, increased myocardial o2 demand, vasoconstriction, MI, vfib, pulmonary hemorrhage (inhaled cocaine)

Answer 40

amphetamines, synthetic stimulants, non-amphetamine stimulants, cocaine, caffeine, nicotine

Question 41

result of chronic cocaine snorting

Answer 41

nasal rhinitis

Question 42

euphoria, affective blunting, changes in sociability, hypervigilance, interpersonal sensitivity, anxiety, tensio or anger, stereotyped behaviors or impaired judgement

Answer 42

amphetamines or cocaine intoxication

Question 43

caffeine intoxication level

Answer 43

+250mg

Question 44

crash: fatigue, depression, nightmares, HA, profuse sweating, muscle cramps, hunger

Answer 44

stimulant wd

Question 45

ataxia, peripheral and sensorimotor neuropathy, speech problems, and tremor

Answer 45

CNS effects of inhalants

Question 46

coughing and wheezing to dyspnea, emphysema, and pneumonia

Answer 46

respiratory effects of inhalants

Question 47

abdominal pain, nausea, vomiting, rash under nose or mouth, unusual breath odors, liver toxicity

Answer 47

GI inhalant effect

Question 48

acute and chronic renal failure and hepatorenal syndrome

Answer 48

renal system effects of inhalants

Question 49

symptoms similar to alcohol intoxication: dizziness, ataxia, euphoria, excitation, disinhibition, nystagmus, blurred vision, dbl vision, slurred speech, hypoactive reflexes, psychomotor retardation, lethargy, gen muscle weakness, stupor or coma

Answer 49

Inhalant intoxication

Question 50

exert both a sedative and analgesic effect; medical uses include relief of pain, diarrhea, and coughing.

Answer 50

opioids

Question 51

lethargy and indifference to the environment are common manifestations

Answer 51

opioid use

Question 52

oral, snorting smoking SC, IM or IV

Answer 52

modes of using opioids

Question 53

euphoria, mood changes, mental clouding, drowsiness, pain reduction, pupillary constriction, respiratory depression, suppression of cough in medulla

Answer 53

opioids on CNS

Question 54

increased stomach and intestinal tone and peristaltic activity of intestine is diminished leading to decreased mvmt of food through the GI tract (constipation or possibly fecal impaction)

Answer 54

opioids on GI tract

Question 55

at high doses, induce hypotension (histamine release)

Answer 55

opioids on heart

Question 56

initial euphoria, apathy, dysphoria, psychomotor agitation, impaired judgement, pupillary constriction, drowsiness, slurred speech, and impairment in attention or memory

Answer 56

opioid intoxication

Question 57

dysphoric mood, n/v, muscle aches, lacrimation or rhinorrhea, pupillary dilation, piloerection, sweating, diarrhea, yawning, fever, insomnia

Answer 57

opioid wd

Question 58

anxiety, depression, ideas of reference

Answer 58

hallucinogen intoxication

Question 59

Substance use assessment tools

Answer 59

MAST michigan alcohol screening test CAGE cut back, annoyed, guilty, eyeopener CIWA clinical institute withdrawal assessment of alcohol state

Question 60

codependent must begin to let go of the denial that probs exist. Abstinence from blanket denial may be a very emotional and painful period

Answer 60

stage 1 the survival stage of Tx for codependency

Question 61

reidentification (indiv glimpses true self through a break in denial system) accept the label of codependent and take responsibility for own dysfunctional behavior. its more painful not to enter reidentification.. accept limitations and are ready to face the issues of codependence

Answer 61

stage 2 the reidentification stage of tx for codependency

Question 62

relationships cannot be managed by force of will. each partner must be indep. and autonomous. goal is to detach from the struggles of life that exist bc of prideful and willful efforts to control those things that are beyond the indiv's power

Answer 62

stage 3 the core issues stage of tx for codependence

Question 63

stage of self-acceptance and willingness to change; relinquish power over others that was not theirs in the first place. reclaim personal power; integrity is achieved out of awareness, honesty, and being in tough with one's spiritual consciousness. Control is achieved through self discipline and self confidence

Answer 63

stage 4 reintegration phase of tx for codependence

Question 64

naltrexone, antabuse, Campral

Answer 64

meds to help abstain from alcohol

Question 65

gibe chlordiazepoxide (librium) and haldol

Answer 65

substitution for Stimulants

Question 66

phenobarbital (Luminal)-barbs | benzodiazepams-non barbs

Answer 66

substitution for depressants

Question 67

``` benzodiazepams clordiazepoxide (Librium) oxazepam lorazepam (ativan) diazepam (Valium) ```

Answer 67

substitution therapy for alcohol

Question 68

Narcan (naloxone) naltrexone (ReVia), and nalmefene (Revex), METHADONE + clonidine, buprenorphine (less powerful than methadone but fewer side effects)

Answer 68

substitution for opioids