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2013-10-27 23:43:50

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  1. pschodynamic causal theory for etoh
    likely to become dependent feel phobic and feeling of inferioriy compared to social drinkers

    stereotypical char are result of and not cause of sub dependence
  2. biologic causal theory for etoh
    genetic predisposition; single most significant factor; persons vulnerability
  3. metabolism
    15 mL per Hr
  4. absorption
    20 mins of empty stom
  5. physiological effects of etoh
    • disinhibition
    • impaired judgement
    • fuzzy thinking
    • mental relaxation
    • depresses psychomotor act
    • anx and tension are relieved
    • becomes defensive
  6. detox etoh
    • med supervised bc of misery and risk of death
    • drugs that have a cross-dependence w etoh used to avoid sx of wd
  7. etoh detox meds used
    • benzodiazepines
    • Librium, ativan, valium
  8. benzos do
    minimize sx wd, prevent dts, decr seizures
  9. 3 S's
    • safety
    • sedation - benzos
    • supplementation - thiamine and folate
  10. DTs
    • delirium tremens
    • ultimate level of cns irratibility¬†
    • bd not only invents sensory input but also has extreme motor agitation
    • hallucinations become visible
    • tonic clonic seizure
  11. interactions
    etoh and others
    • cause profound cns depression
    • leads to death
  12. avoid etoh when taking
    barbs, antipsych, antidepress, benzos, and otehrs
  13. chloral hydrate and ativan
    intentional sedating unsuspecting person in bars
  14. chloral hydrate and etoh
    knockout drops
  15. etoh use by elderly
    group 1
    lifelong users
  16. lifelong users of etoh problems
    incr physical, cognitive, and emotional
  17. etoh use by elderly
    group 2
    late-onset users responding to stress
  18. FAS
    result of etoh inhibiting fetal development during 1st trimester; 3rd most common cause of mr
  19. characteristics of FAS
    • microcephaly
    • severe mr
  20. wernicke-korsakoff syndrome
    mental do characterized by amnesia, clouding consciousness, confabulation, mem loss, peripheral neuropathy
  21. wenicke-korsakoff caused by
    poor nutrition of alcoholic & neurotoxic nature

    decr amnt of thiamine, niacin, and folate
  22. librium
    • anx do and acute etoh wd
    • PO
    • anti tremor agent
    • parenteral used as anti panic
    • accumulation
  23. disulfiram antabase
    • stated w single dose of 250-500 mg/d
    • after 1-2 wks dose decr
    • maintenance dose of 12-250 mg/d
  24. disulfiram antabase
    taken w etoh may cause
    sweating, flushed face, tachy, hypotension, throbbing ha, n/v, palp, dyspnea, tremor, wkness, arryth, mi, cardiac failure, seiz, coma, death
  25. etoh cns effects
    • lg amnts: sleep, coma, deep anesth, death
    • others: slurred speech, short attention span, loud talk, mem deficit
  26. od
    • depresses cns and vital centers anesthesized
    • compromises breathing and hr -- coma/death
    • gi bld and hemorr, hypothermia
  27. wd
    rebound phenomenon
    sedation is predominant effect of etoh but as it wears off psychomotor act incr
  28. s/s wd
    • tremolousness
    • nervousness
    • anx
    • anor
    • nvd
    • insomnia
    • rapid pulse
    • incr bp
    • profuse perspiration
    • fever
    • unsteady gait
    • dif concentrating
    • exaggerated startle reflex
    • cravind aod
  29. dependence
    maladaptive pattern of sub use: tolerance, wd, need for more
  30. intoxication
    • dev of sub-spec synd dt recent ingestion
    • clinically significant malada behavior/psych changes
    • not dt gmc
  31. abuse
    • malad pattern of sub use leading to clinically signif impairment/distress
    • failure to fulfill roles
    • recurrent use in hazardous situations
    • leads to legal probs
    • never met criteria before
  32. wd dsm
    • dev of sub spec synd dt cessation
    • clinically sig distress/impairment
    • not dt gmc or other md
  33. tolerance
    need for more amnts of sub to achieve same effects
  34. dopamine works by
    • incr w etoh consumption
    • when dop falls they want more
  35. denial
    • most common
    • insists they can stop at any time
  36. codependence
    • all fam members effected and need tx
    • participate in behaviors that maintain addiction wo holding them accountable
  37. enabling
    • fam effected to extent where they rescue abuser¬†
    • lying
  38. s/s aod abuse
    • absenteeism esp after days off
    • freq accidents
    • drowsiness
    • slurred speech
    • inattention to appearance
    • incr isolation
    • freq secretive disappearances
    • tremors
    • flushed face
    • watery red eyes
    • spaced out
    • odor of etoh or mints
    • incr # phys complaints
    • disappearing prescriptions raiding med cab
  39. etoh toxic substance