Substance abuse E4

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  1. What are signs of long term physical issues with alcohol?
    • depletion in B vitamin
    • liver damage
    • neuro-cognitive disorders such as Wernicke-Korsakoff
    • Confabulation
  2. What is Korsakoff syndrome and what is it's cause?
    Korsakoff syndrome is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1). Korsakoff syndrome is most commonly caused by alcohol misuse, but certain other conditions also can cause the syndrome.
  3. What tests will show someone has WKS?
    Long term alcohol abuse is the common cause of wernicke-korsakoff sydrome.

    It is linked to Vitamin B-1 deficiency. Liver and thiamine levels will be checked also.
  4. What are symptoms of WKS?
    • amnesia for events that happen after the onset of the disorder
    • difficulty understanding the meaning of information
    • difficulty putting words into context
    • hallucinations

    exaggerated storytelling, or confabulation
  5. What is the Alcohol AUDIT assessment scores show?
    20+ is a high risk of alcohol abuse, while 0-7 is a low risk
  6. Which NT does alcohol enhance that increases cravings and tolerance?
    • GABA: gaba-alpha neuroreceptors have an inhibition effect.
    • Chronic alcohol use leads to compensatory decrease in response
    • This results in tolerance to effect of alcohol and desire to drink more for the same effect
  7. Which NT does alcohol effect that causes withdrawal?
    • Glutamate: this fits into the NMDA neuroreceptors
    • NMDA receptors have an excitatory effect, but alcohol puts the brain to sleep.
    • In chronic alcohol use, the NMDA receptors become very sensitive to small amounts of glutamate
    • If the alcohol use suddenly stops, the brain becomes hyperexcitable
  8. What symptoms will you see with someone going through alcohol withdrawal in the first 6-12 hours?
    • Tremor
    • Insomnia
    • Anxiety
  9. What symptoms will you see with alcohol withdrawal in the first 12-24 hours?
    • Diaphoresis
    • gI
    • Sensitivity
    • hallucinations

    • headache
    • anorexia
    • palpitations
  10. What symptoms will you see with alcohol withdrawals in 24-48 hours?
    tonic-clonic seizures
  11. What is the cause of Delirium Tremens and what symptoms will it show?
    After 48-72 hours of alcohol withdrawal: hallucinatioins (visual or auditory), disorientation, agitation

    HTN, low graade fever, diaphoresis
  12. What are the levels of care for each:
    1. Low levels of withdrawal
    2. Medium levels
    3. High levels
    • 1. Low: can be treated in an out-patient setting
    • 2. Medium: can be treated using medications (Valium) in a psych unit
    • 3. High: needs "medical detox" with IV Ativan in a hospital setting
  13. What is the mg/dL BAL value that is considered incompatible with life?
    • 400mg/dL = a BAL of 0.40%
    • **Legal limit = 0.08%**
  14. What are the stages of "Readiness for change" assessment? (6)
    • 1. Pre-contemplation
    • 2. Contemplation
    • 3. Preparation
    • 4. Action
    • 5. Maintenance (6 months)
    • 6. Relapse/recycling
  15. How long does it usually take to change a habit in the maintenance phase?
    6 months
  16. What drug is used to treat an Opioid overdose?
    Naloxone (Narcan)
  17. What drug is used to maintain opioid levels and helps with withdrawals?
    Suboxone
  18. What is Naloxone used for?
    Opioid overdose
  19. What is Buprenorphine used for?
    Opioid withdrawals and blocks other opioid euphoric effects
  20. What drug is used to replace Heroin and prevents withdrawals?
    Methadone
  21. What is Methadone used for?q
    • Used to replace Heroin by preventing withdrawals and decreasing cravings (has a less therapeutic effect)
    • Also effective in chronic pain
  22. What is the COWS scale used for?
    Opioid withdrawal
  23. What are the life threatening risk of stimulant intoxication?
    Death from cardiac issues
  24. What are the two drugs that are standard meds for alcohol withdrawal?
    Diazepam PO or Lorazepam IV
  25. What does HALT stand for?
    • Hungry
    • Angry
    • Lonely
    • Tired
    • for alcoholics

Card Set Information

Author:
edeleon
ID:
329428
Filename:
Substance abuse E4
Updated:
2017-03-12 05:08:20
Tags:
substance abuse nursing
Folders:
Psych exam 4
Description:
lecture notes
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