substance abuse pt 2 Flashcards
(15 cards)
what causes wernike korsakoff syndrome and whats this needed for
The cause of Wernicke-Korsakoff syndrome is a thiamine (vitamin B1) deficiency. Thiamine is needed for the brain to properly undertake cellular respiration to generate energy from nutrients.
first part of wernikes syndrome is Wernicke’s Encephalopathy whats its s/s
Confusion/delirium: can be quite extreme and even lead to aggression
Poor coordination: this can be noted by a person walking with a wide gait to maintain balance or starting to have tremors
Visual changes: double vision, nystagmus (eyes moving back and forth rapidly), ptosis (eyelids drooping)
In severe cases, temperature and blood pressure may start to drop.
second stage is korsakoff disease
when does it occur and s/s
occurs after the visual changes and poor coordination from Wernicke’s improves.
causes Confabulation is when a person doesn’t know the answer to something, so they just make up an answer. They are not lying; they do believe what they are saying at the time, regardless of it’s accuracy and then within minutes they may not remember what they said and say something entirely different about the same thing!
Other prominent symptoms of Korsakoff include:
Visual and auditory hallucinations
Lack of motivation
Disorganization: inability to complete basic tasks like ADLs
mild detox/withdrawal s/s (hangover)
Dehydration and electrolyte imbalances result in typical hangover presentations such as headache, nausea, muscle aches and polydipsia (increased thirst).
increased anxiety and cravings.
Increased sympathetic nervous system (SNS) activity can include hypertension, tachycardia, diaphoresis, tremor, pallor, and nystagmus (eyes moving back and forth)
what to assess with person in severe withdrawal: delirum tremens
CIWA scale: the blood pressure and heart rate. Then you will assess for the following:
Nausea and vomiting
Tremor
Auditory hallucinations
Sweating and diaphoresis
Visual hallucinations
Anxiety
Headache
Agitation
Change in orientation
Tactile hallucinations
nicotine affects on body
stimulation of the CNS (including increased release of dopamine and stimulation of nicotinic acetylcholine receptors)
inducing neurological oxidative stress and neuronal apoptosis
increasing BMR (associated with increased plasma levels of fatty acids, glucose and catecholamines)
narrowing of the coronary arteries
increasing blood flow to skeletal muscles/kā uaua
increasing respiratory rate & airway resistance
inducing hypercoagulability and increased blood viscosity
decreasing blood flow to skin
increasing heart rate, heart contractility and blood pressure
weed affects on body
and addiction affects
increased heart rate, dry mouth, bloodshot eyes, pupil dilation, and uaua/muscle relaxation with a slowed reaction time.
respiratory problems, irritability, anxiety & depression.
affects of cocaine and meth
increase in anxiety, paranoia, irritability, restlessness, etc. I
n addition, these stimulants can induce a variety of other physical effects, including tachycardia, vasoconstriction, increased blood pressure & decreased digestive activity
complications of long term meth and cocaine use
increase the risk of heart attack, hypertension, stroke, seizures, kidney disease, insomnia, anorexia and/or weight loss, stress, liver damage and immune system impairment.
heroin affects
relaxation, pleasure/euphoria, detachment or decreased awareness and a lessening of anxiety also occur with use
heroin health risks and other effects
respiratory depression, decreased blood pressure and heart rate and an overdose can cause stupor, coma or death due to respiratory failure. Other physiological effects include:
lethargy/drowsiness
constricted pupils
nausea & vomiting (though these typically fade with repeated use)
constipation
impotence in males and infertility and menstrual irregularity/amenorrhea in wāhine/females
increased risk of infections; particularly blood-borne infections with intravenous drug use & needle sharing
outline factors that cause substance abuse
Enhanced dopamine release and response via increased dopamine release, decreased dopamine removal from the synaptic cleft and/or enhanced dopamine-receptor binding
Faster substance absorption and higher substance load via snorting, puffing or injection allowing bypassing of first pass metabolism
Lipid-solubility of most addictive substances, allowing easier uptake by body cells, including brain cells
Substantial drop in dopamine levels below baseline after the ‘high’ (i.e. when the substance effects wear off), reducing pleasure/reward for other/’normal’ activities that excite this system and decreasing overall motivation
describe tolerance in relation to addiction
Tolerance occurs when dopamine receptors are downregulated (reduced in number). This results in the effects of a substance/drug not being as potent at the same dose, thus to achieve the same ‘high’, more substance/drug is required.
Tolerance also results in decreased pleasure/reward with other factors that normally stimulate this pathway. These factors contribute to addiction
effects of intoxication on nervous system
feelings of euphoria
decreased or delayed motor responses and coordination (e.g, slurred speech, unsteady gate, nystagmus)
decreased concentration decreased visual acuity decreased memory processing
decreased sensory perception, including pain
maladaptive behavioral or psychological changes (e.g. increased confidence, decreased inhibitions, inappropriate sexual or aggressive behavior, unstable mood, impaired judgment & decision making, and impaired social or occupational functioning)
stupor, unconsciousness, coma and death
affect of carbon monoxide on body
MO binds to the iron atom on hemoglobin, taking up oxygen (02) binding sites, therefore reducing the oxygen saturation of blood and reducing the amount of oxygen available to body tissues
