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PSYCH > TOPIC 11 - substance abuse and addictive disorders (pt 2) > Flashcards

TOPIC 11 - substance abuse and addictive disorders (pt 2) Flashcards

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1
Q

mandating for reporting substance abuse

A

reporting an impaired colleague is a peer responsibility
clean documentation is crucial and mandatory

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2
Q

who’s responsibility if intervention of substance abuse

A

nurse manager and administrators

If an impaired nurse remains in the practice situation and no action is taken by the nurse manager, the information must be taken to the next level in the chain of command

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3
Q

benefits of reporting an impaired colleague

A

improve safety of patients
protect healthcare professionals future ability to practice
improved physical health
improved or saved personal relationships
may save professional care

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4
Q

ten classes of psychoactive substances

A
  1. alcohol
  2. caffeine
  3. marijuana
  4. hallucinogens
  5. inhalants
  6. opioids
  7. sedatives
  8. hypnotics
  9. anxiolytics
  10. stimulants, tobacco, and other substances
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5
Q

marijuana

A

most commonly used illicit drug in the USA

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6
Q

nicotine addiction rates

A

addiction is high in all groups of people with substance dependence as well as those with psychiatric mental health issues

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7
Q

examples of CNS depressants

A

barbiturates
benzos
alcohol

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8
Q

intoxication symptoms of CNS depressants

A

Slurred speech
Incoordination
Unsteady gait
Drowsiness
Hypotension
Sexual or aggressive disinhibition
Impaired judgement
Impaired social or occupational function
Impaired attention or memory

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9
Q

CNS depressants overdose symptoms

A

Cardiovascular or respiratory depression, coma, shock, convulsions, death

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10
Q

CNS depressants overdose treatment

A

If awake, keep awake *
Induce vomiting
Administer activated charcoal (absorption of drug)
Check vitals every 15 minutes

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11
Q

CNS depressants coma interventions

A

Clear airway, insert endotracheal tube
Administer IV fluids
Gastric lavage with activated charcoal
Frequent vital sign checks continue after patient is stable (potential remains for shock and cardiac arrest)
Implement seizure precautions
Hemodialysis may be needed
Administer flumazenil (Romazicon) IV for benzodiazepine overdose

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12
Q

benzo antidote

A

flumazenil

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13
Q

examples of opiates

A

Morphine
Heroin
Codeine
Fentanyl
Methadone
Meperidine

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14
Q

opiate intoxication effects

A

Constricted pupils *
Decreased respiration
Decreased blood pressure
Slurred speech
Drowsiness
Psychomotor retardation
Initial: euphoria
Later: dysphoria
Impaired: concentration, judgment, memory

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15
Q

opiate withdrawl effects

A

Yawning
Insomnia
Irritability
Rhinorrhea
Panic
Diaphoresis
Cramps
Nausea and vomiting
Muscle aches
Chills and fever
Lacrimation
Diarrhea

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16
Q

pregnancy and heroin

A

do not abruptly stop use

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17
Q

opiates overdose effects triad symptoms

A

coma, pinpoint pupils, respiratory depression

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18
Q

other overdose effects of opiates

A

Cardiac arrest
Shock
Convulsions
Death

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19
Q

opiate overdose treatment

A

naloxone

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20
Q

important parts to naloxone

A

Quickly reverses CNS depression caused by opioid drugs
Short half-life
May need to repeat dose

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21
Q

examples of long term pharmacologic management of opioid use disorders

A

methadone, buprenorphin, maltrexone, clonidine

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22
Q

methadone

A

Opioid agonist that blocks the craving for opioids
Also used for detoxification
Most effective

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23
Q

which is the most effective long term management of opioid use disorder

A

methadone

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24
Q

buprenorphin

A

Opioid agonist-antagonist
Blocks the signs and symptoms of opioid withdrawal

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25
naltrexone
Opioid antagonist that blocks the euphoric effects of opioids.
26
what combination with clonidine is effective
with naltrexone
27
examples of CNS stimulants
Cocaine & crack Methamphetamine Caffeine Nicotine
28
intoxication effects of CNS stimulants
Dilation of the pupils* Dryness of the oronasal cavity Excessive motor activity Dilated pupils Tachycardia Increased blood pressure Nausea & vomiting Insomnia
29
withdrawl effects of CNS stimulants
Depression Paranoia Anxiety * Lethargy Insomnia Nausea Vomiting Sweating Chills Fatigue Agitation Apathy Disorientation Lethargy Craving Sleepiness
30
overdose effects of CNS stimulants
Respiratory distress Hyperpyrexia Convulsions Coma Stroke MI Death
31
psychological/perceptual effects of CNS stimulants
Assaultiveness Impaired judgement Euphoria
32
withdrawl treatment for CNS stimulants
desipramine (TCA) bromocriptine (Parlodel)
33
overdose treatment for CNS stimulants
antipsychotics ambient cooling (for hyperpyrexia) diazepam (for convulsions)
34
which overdose treatment is used for hyperpyrexia
ambient cooling
35
which overdose treatment is used for convulsions
diazepam
36
3 phases of cocaine and crack withdrawl
crash phase second phase third phase
37
what happens in the crash phase of cocaine and crack withdrawl
anxiety, depression, craving peaks, agitation. (4 days)
38
what happens in the second phase of cocaine and crack withdrawl
no motivation, anhedonia (10 weeks) Relapse is more likely
39
what happens in the third phase of cocaine and crack withdrawl
intermittent craving (undetermined length of time)
40
treatment for cocaine and crack withdrawl
Antidepressants such as desipramine (Norpramin) Dopamine agonist such as bromocriptine (Parlodel)
41
class of nicotine
can be a stimulant, depressant, or tranquilizer
42
importance of addiction and nicotine
highly toxic and addictive high dependence
43
withdrawl symptoms of nicotine
strong cravings irritability impatience increased appetite
44
drugs available to break nicotine addiction
bupropion (Zyban, same chemical structure as Wellbutrin) varenicline (Chantix) nicotine patches, gum, lozenges, nasal spray/inhalant
45
complications of smoking/chewing
Cancer: lung, mouth, throat, stomach, bladder -Cardiovascular disease
46
proposed benefits of e cigarettes
long term smokers may smoke less
47
risks with e cigarettes
does not prevent people from starting to use cigarettes increased death related to lung and brain injury
48
ingredients in e cigarettes
formaldehyde, risk for cancer nicotine : leads to cigarette use & addiction THC, use of some form of THC products prior to vaping
49
how much caffeine is needed for positive effects
250 MG OR LESS
50
how much caffeine is needed for fatality
5 grams = fatal
51
positive effects of caffeine
Increased alertness/decreased fatigue, lower risk of cardiovascular disease, lower risk of diabetes, increased metabolic rate
52
negative effects of caffeine
Increased BP, tachycardia, heartburn, irregular bowel movements, excess urination
53
active ingredient in marijuana
tetrahydrocannabinol (THC)
54
properties in marijuana
both depressant and hallucinogenic
55
desired effects of marijuana
euphoria, detachment, relaxation
56
long term effects of marijuana
lethargy, anhedonia, difficulty concentrating, loss of memory, amotivational syndrome
57
direct or indirect intentional inhalation of noxious substances results in
anoxia, seizures, irreversible brain damage, death
58
anoxia definition
The act of inhaling these noxious chemicals deprives the brain of oxygen
59
club drugs
MDMA MDA MDE Bath salts Flakka
60
what club drug can cause excited delirium
flakka
61
effects of simulated amphetamines (MDMA, MDA, MDE)
Cause serotonin surge (also norepinephrine) and other neurochemical effects Euphoria, heightened sociability, lowered inhibitions, increased self-confidence and energy After … deep depressive state is common, due to lack of serotonin after the surge Hyperthermia, hyponatremia, rhabdomyolysis, heart failure, kidney failure
62
bath salts effects
hallucinogenic-delusional properties, dissociation, extreme agitation, and feelings of superhuman strength and combativeness) and have the hyperaddictive qualities of cocaine and methamphetamines.
63
symptoms of excited delirium
violent behavior + hallucinations + body temp increases up to 106°F + muscle breakdown (rhabdomyolysis, which can lead to kidney failure) + extreme tachycardia (↑ risk of stroke or heart attack)
64
hallucinogens examples
Lysergic acid diethylamide (*LSD, ‘acid’) mescaline (peyote) psilocybin (‘magic mushroom’)
65
dissociative drugs
Phencyclidine piperidine (*PCP, angel dust, horse tranquilizer, peace pill) Ketamine (Special K) Salvia
66
what agonizes the kappa opioid receptors
salvia
67
LSD effects
Abusers also may have traumatic experiences and emotions that can last for many hours. Some short-term effects can include increased body temperature, heart rate, and blood pressure; sweating; loss of appetite; sleeplessness, dry mouth, and tremors
68
interventions for clients who took LSD
Low stimulus environment Minimal light and sounds 1-to-1 interaction reassures the client on LSD. Attempt to ‘talk the client down’ Speak slowly and clearly in low tones
69
medications for anxiety and tension related to LSD
diazepam or chloral hydrate
70
interventions for clients who took PCP
Give cranberry juice or ascorbic acid Minimal environmental stimulus DO NOT attempt to ‘talk client down’ Speak slowly and clearly in low tones Avoid touch if possible. If touching client is necessary, involve additional staff (client may have impulsive, bizarre, aggressive behaviors)
71
medications for PCP interventions
diazepam, haloperidol (never give a phenothiazine antipsychotic to a client on PCP)
72
conventional treatments for substance abuse treatment
Psychotherapy Group therapy Cognitive behavioral therapy (CBT) Motivational incentives Motivational interviewing 12 step programs
73
what role does the rescuer have within the chemically dependent family
Often steps in to save the addict, bails the addict out, makes excuses or fills in for the addict. Shielding the addict from consequences of substance abuse makes it easier for the addict to continue using.
74
what role does the hero have within the chemically dependent family
Tries to divert attention away from the problem by being too good to be true, secretly hoping that exemplary behavior will somehow make it easier for the addict to stop using. High achievers who do everything to assure that the addict has as little responsibility as possible, minimizing the possibilities for trouble to occur.
75
what role does the adjuster have within the chemically dependent family
Behaves apathetically to distance self from pain; passively withdraw from upsetting situations; hurting but attempts to avoid feeling the pain by refusing to confront the addiction or its consequences.
76
what role does the scapegoat have within the chemically dependent family
Draws attention away from the family's primary problem of dependency through delinquency or other misbehavior; reacts to feeling trapped by the situation at home by poor school performance, hostility and other behavior problems.
77
what role does the mascot have within the chemically dependent family
Also draws attention away from the family by trying to please, by acting in a humorous way; the clown.

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