substance abuse

Question 1

What are the 3 C’s of an addiction

Answer 1

Craving
Consequences (use despite)
control (loss of control)

+ tolerance and withdrawal

Question 2

Cage screening tool

Answer 2

Cut down
annoyed
guilty
early morning

Question 3

alcohol use disorder can be diagnosed based on what criteria

Answer 3

loss of control
use with understanding of consequences
craving/compulsions

tolerance and withdrawal

Question 4

what does alcohol withdrawal look like

Answer 4

hand tremor, insomnia, hallucinations, anxiety, seizures

Question 5

alcohol intoxication/overdose symptoms

Answer 5

slurred speech, hand tremor with normal mental status

dilated pupil

(CNS depressant)

Question 6

is alcohol withdrawal life threatening?

Answer 6

yes, wernicke encephalopathy and delirium tremens

Question 7

what are the symptoms of delirium tremens

Answer 7

tremors, delusions, hallucinations, seizures

Question 8

how do we treat alcohol withdrawal

Answer 8

prevent with a detox order set
benzodiazapens on a schedule
fluids and vitamins (IV thiamine def)

Question 9

what screening do we use in alcohol withdrawal to determine benzodiazepine dose

Answer 9

CIWA-Ar

Question 10

Korsakoff is damage to?

Answer 10

maxillary bodies (permanent)

Question 11

what are some treatments/rehabilitation options for people with alcohol disorder

Answer 11

motivational interviewing, residential programs, AA, rehab programs

Question 12

what drug can we use to treat alcohol use disorder to maintain abstinence and inhibit GABA in the CNS

Answer 12

acamprosate

Question 13

what drug can we use in alcohol use disorder that improves abstinence and is an opioid antagonist

Answer 13

naltrexone

Question 14

what medication can we use in alcohol use disorder as a deterrent and cause flushing of the skin, accelerated HR, shortness of breath, headache, mental confusion and more

Answer 14

disulfiram

Question 15

in alcohol use disorders what are the labs

Answer 15

hyponatremia, microcytic anemia

elevated BP and HR

Question 16

medications for withdrawal aside from the thiamine/fluids

Answer 16

Benzodiazepam

diazepam**

Question 17

what Benzos should you use in alcohol withdraw if your patient has a known liver impairment

Answer 17

lorazepam

Question 18

intoxication symptoms with amphetamines and cocaine

Answer 18

increased energy/alertness

anxiety irritability

seizures

elevated BP and pulse

dilated pupils

loss of appetite

delusions *, euphoria with irritability

Question 19

how do you treat intoxication with stimulates

Answer 19

phentolamine for HTN and hyperthermia

haloperidol (for psychosis)

Question 20

withdrawal of stimulant symptoms

Answer 20

depression, increased sleep, increased appetite, cravings, irritability

Question 21

withdrawal treatment of amphetamines and cocaine (stimulants)

Answer 21

manage symptoms

Question 22

intoxication of sedatives ( benzodiazepines and barbiturates)

Answer 22

increased seizure threshold, sedation, coma, hypotension, hypothermia, hypoxemia, respiratory depression, depressed reflexes

(CNS depression)

Question 23

treatment of a benzodiazepine/barbituate overdose

Answer 23

flumazenil (opioid antagonist)

Question 24

treatment of sedative intoxication

Answer 24

ABC

airway
breathing
circulation

prevent heat loss
diuresis

Question 25

can withdrawal of sedatives be fatal?

Answer 25

yes anxiety, hyperreflexia, delirium, seizures, sweating, weakness, orthostatic hypotension

Question 26

sedative withdrawal treatment

Answer 26

phenobarbital

Question 27

LSD/PCP intoxication

Answer 27

dilated pupils, increased HR, paranoia, hallucinations muscular rigidity, violent behavior and nystagmus in PCP

Question 28

treatment of LSD/PCP in intoxication

Answer 28

diazepam/haloperidol if violent

Question 29

PCP/LSD withdrawal symptoms

Answer 29

flashbacks Benzos

Question 30

PCP psychiatric symptoms

Answer 30

agitation with blank stare stupor aggression bizarre behavior (picking up a car)

Question 31

LSD psychiatric symptom s

Answer 31

sensory distortion, hypersensitive of senses

Question 32

substance induced mental disorders

Answer 32

mental health disorder developed within 1 month of substance intoxication

Question 33

opioid related intoxication

Answer 33

pain relief with LOC leathrgy euphoria itching miosis (pinpoint pupils) consipation respiratory depression hypotension

Question 34

treatment of opioid intoxication

Answer 34

supportive care and NALOXONE (intranasally)

Question 35

is opioid withdrawal fatal symptoms

Answer 35

no, feels like it sweating, lacrimation, dilated pupils, violent yawning, restlessness

Question 36

opiote withdrawal scale

Answer 36

COWS

Question 37

withdrawal treatment for opioids

Answer 37

buprenorphine or methadone buprenorphine and naloxone

Question 38

what drug can you use in opioid withdraw if there is elevated blood pressure

Answer 38

clonidine

Question 39

what drug can you use in opioid withdrawal if there is itching and rhinorrhea

Answer 39

diphenhydramine

Question 40

what drug can you use in opioid withdrawal with diarrhea

Answer 40

Imodium

Question 41

Molly intoxication symptoms

Answer 41

hyperthermia, jaw clinching, nystagmus, tremors, psychogenic polydipsia, chills, nystagmus, dilated pupils, hyponatremia and cerebral edema, serotonin syndrome

Question 42

treatment of Molly intoxication

Answer 42

hypertonic saline solution hyperthermia ice bath

Question 43

what drug do you give for signs of serotonin syndrome

Answer 43

cyprohetadine