ch 19 addictions
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abuse is ?
the habitual use of a substance that falls outside of medical necessity or social acceptance for single purpose of altering ones mood, emotion, or state of consciousness and resulting in adverse effects of the abuser o or others.
habitual psychological and physiological dependence on the substance or practice beyond one's voluntary control
what is the 3 C's of addiction?
- craving to compulsive use
- continued use despite the consequences
- loss of control
name four compulsive addictive behaviors?
gambling, shipping and spending, internet abuse, sexual addiction
what is the most common substance abused in US?
women who smoke and are pregnant have a chance for what?
babies with a low birth weight and an increased risk of developmental issues
the need for higher and higher doses to achieve the desired effect
occurs after long periods of continued use so that stopping use results in specific signs and symptoms.
given to people who have overdosed on an opiate
general assessment of a drug abuser:
- history of drug abuse
- medical history
- psychiatric history
- psychosocial (work, family, friends, ect)
benzodiazepine, glutethimide, and alcohol intoxicated effect and overdose
slurred speech, incoordination, unsteady gait, drowsiness decreased blood pressure, impaired judgment, impaired function, impaired attention, irritability. overdose- reparatory depression or arrest cardio depression or arrest, coma shock, convulsions death.
benzo, glutethimide, alcohol overdose treatments
if awake keep awake, induce vomiting, activated charcoal, vitals Q15, if unresponsive - ET tube, IV fluids, gastric lavage, check fro shock, seizure precautions, and give Romazicon (flumazenil)
withdrawal from benzo, glutethimide, alcohol
nausea, vomiting, tachycardia, diaphoresis, anxiety, irritability, tremors, marked insomnia, grand mal seizures and possible delirium with years ( 5 to 15) of use
possible withdrawal treatments from benzo and alcohol
abrupt withdrawal can lead to death, detox with similar drug
cocaine and crack come from where?
coca bush leaves
how soon is a high obtained when using crack or cocaine? injected , smoked, snorted
- snorted- 30 min
- injected 30 seconds
- smoked 4-6 seconds
how long is the average high with crack, cocaine?
- 15-30 min for cocaine
- 5-7 min for crack
in toxic effect from crack, cocaine:
tachycardia, dilated pupils , elevated BP, nausea, vomiting, insomnia, grandiosity, impaired judgment, euphoria
overdose crack, cocaine: and amphetamines
ataxia, hyperpyrexia, coma, convulsions, MI, respiratory distress death
overdose treatment of crack, cocaine: and amphetamines
antipsychotics, hyperpyrexia (ambient cooling), convulsions (diazepam), respiratory distress, cardiovascular shock, acidification of urine.
withdrawal from crack, cocaine:and amphetamines
fatigue, depression, agitation, apathy, anxiety, sleepiness, disorientation, lethargy, craving.
withdrawal treatments from crack, cocaine: and amphetamines
- antidepressant (desipramine)
- dopamine agonist (bromocriptine)
- increased energy and wakefulness, hyperthermia, euphoria
- severe effects-paranoid schizophrenia, delusions, psychosis, panic levels of anxiety, potential for violence.
opiates include what drugs?
opium, heroin, meperidine (Demerol), morphine, codeine, methadone, dilaudid, fentanyl,
opiate intoxication :
constricted pupils, decreased respirations and BP, slurred speech, psychomotor retardation, initial euphoria followed by dysphoria, impairment of attention, judgment, and memory.
overdose treatment of opiate overdose:
narcan-quickly reverses CNS depression
withdrawal effects with opiates:
yawning, insomnia, irritability, runny nose, panic, diaphoresis, cramps, nausea, vomiting, muscle and bone pain, chills, fever, diarrhea, lacrimation (secretion of tears)
treatments of withdrawal from opiates:
methadone tapering, clonidine-naltrexone, vivitrol, buprenorphine ( acts as a substitute)
Alcohol withdrawal delirium begins?
The state of delirium usually peaks 2 to 3 days (48 to 72 hours) after cessation or reduction of intake
Marijuana (Cannabis sativa) effects are:
- euphoria, detachment, and relaxation
- Overdose and withdrawal (other than craving) rarely occur.
LSD intoxication symptoms:
Pupil dilation, Tachycardia, Diaphoresis, Palpitations, Tremors, Elevated temperature, pulse, respiration, Synesthesia (e.g., colors are heard; sounds are seen), Grandiosity (e.g., thinking one can fly), Hallucinations, although sensorium is clear
LSD treatments :
- Keep patient in room with low stimuli—minimal light, sound, activity.
- Have one person stay with patient; reassure patient, “talk down” patient.
- Speak slowly and clearly in low voice
- Give diazepam or chloral hydrate for extreme anxiety or tension.
Hallucinogens:Lysergic acid diethylamide (LSD) and LSD-like drugs also known as?
mescaline (peyote), acid, and psilocybin (magic mushroom)
what drug is used for centuries in religious rites by Native Americans
peyote and magic mushroom
PCP is known as ?
angel dust, horse tranquilizer, and peace pill
signs and symptoms of PCP intoxication
acute anxiety to acute psychosis as well as aggression, violence, and loss of coordination, The drug produces a generalized anesthesia that lessens the sensations of touch and pain
Inhalant use, also referred to as “huffing” or “backing.”
teenagers (ages 13 through 17)
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