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Ch 17

What is polysubstance abuse? Abuse of more than one substance.
What is intoxication? is use of a substance that results in maladaptive behavior.
What is withdrawl syndrome? Refers to the negative psychologic and physical reactions that occur when use of a substance ceases or dramitcally decreases.
What is detoxification? The process of safely withdrawing from a substance.
What is substance abuse? Is defined as using a drug in a way that is inconsistent with medical or social norms and despite negative consequences.
What is substance dependence? Unsuccessful attempts to stop the substance.
What is black out? Is an episode during which the person continues awareness of his or her behavior at the time or any later memory of the behavior.
What is Tolerance? Person needs more alcohol to produce same effect.
What is tolerance breaks? Occurs when very small amounts of alcohol intoxicate the person.
Later course of alcoholism Is when the person's functioning definitely is affected,often characterized by periods of abstinence or temporarily controlled drinking.
When does abstinence occur? When some legal, social, or interpersonal crisis, and the person may set up rules about drinking only at certain times or drinking only beer.
What is alcohol? A CNS depressant that is absorbed rapidly into the bloodstream.
What are the initial effects of Alcohol? Relaxation and loss of inhibitions.
Symptoms of intoxication Slurred speech, unsteady gait, lack of coordination, and impaired attention, concentration, memory, and judgement.
How long after cessation or marked reduction of alcohol intake to withdrawls occur? 4 to 12 hours.
Symptoms of withdrawal of alcohol? coarse hand tremors, sweating, elevated pulse and blood pressure, insomnia, anxiety, or N/V.
Severe symptoms or untreated withdrawal from alcohol include? hallucinations, seizures, or delirium.
When does alcohol withdrawal usually peak and when is it over? On the second day; 5 days
What medications are used for safe withdrawal of alcohol? Benzodiazepines
What are the physiologic effects of long term alcohol use? cardiac myopathy, wernicke's encephalopathy, korsakoff's psychosis, pancreatitis, esophagitis, hepatitis, cirrhosis, leukopenia, thrombocytopenia, ascites
Withdrawal symptoms of sedatives, hypnotics, and anxiolytics are? Autonomic hyperactivity; increased bp, pulse, respirations, and temp
How is detoxification managed in sedatives, hypnotics, and anxiolytics? by tapering the amount of drug the client recieves over a period of days or weeks.
What is tapering? administering or decreasing doses of a medication, is essential with barbituates to prevent coma and death that occur with the drug being stopped abruptly.
What are stimulants? drugs that stimulate or excite the CNS.
physiologic effects of stimulants are? tachycardia, elevated bp, dilated pupils, perspiration or chills, nausea, chest pain, confusion, and cardiac dysrhythmias.
Withdrawal from stimulants include: occurs within a few hours to days. Is not life threatening. Marked dysphoria is the primary symptom and is accompanied by fatigue, vivid and unpleasant dreams, insomnia, increased appetite, and phychomotor retardation.
How is stimulant withdrawal treated? not pharmacologically
What are opioids? popular drugs of abuse because they desensitize the user to both physiologic and psychologic pain and induce a sense of euphoria and well-being.
Symptoms of withdrawal from opioids? Anxiety, restlessness, aching back and legs, and cravings for more.
what are hallucinogens? Substances that distort the users perception of reality and produce symptoms similar to psychosis.
Symptoms of hallucinogen intoxication? maladaptive behavioral or psychologic changes: anxiety, depression, paranoid ideation, ideas of reference, fear of losing ones mind, and potentially dangerous behavior such as jumping out a window in belief one can fly.
Physiologic symptoms of hallucinogens include: Sweating,tachy, palpitations, blurred vision, tremors, and lack of coordination.
what are inhalants? Diverse group of drugs that include anesthetics, nitrates, and organic solvents that are inhaled for their effects.
Most common types of inhalants? aliphatic and aromatic hydrocarbons found in gasoline, glue, paint thinner, and spray paint.
Inhalant intoxication involves what effects? dizziness, nystagmus, lack of coordination, slurred speech, unsteady gait, tremor, weak muscles, and blurred vision.
Death may occur with inhalants due to what? bronchospasms, cardiac arrest, suffocation, or aspiration of the compound.
People who abuse inhalants may suffer from what? dementia, psychosis, anxiety, or mood disorders.
What are the two main purposes for pharmacologic treatment in substance abuse? *to permit safe withdrawal from alcohol, sedative-hypnotics, and benzo's *to prevent relapse.
For clients whose primary substance is alcohol what is used to prevent or to treat Wernicke-Korsakoff syndrome? vitamin B1 (thiamine)
What is alcohol withdrawal usually managed with and what is it used for? Benzodiazepines; to suppress the symptoms of abstinence
What is Antabuse used for? helps deter clients from drinking.
What products should a client avoid when taking atabuse? products that contain alcohol...Cough syrup, lotions, mouthwash, perfume, aftershave, vinegar, and vanilla and other extracts.
What anti-hypertensive is used to treat clients with opiate dependence? clonidine(catapres)-alpha 2 adrenergic...it is used to suppress effects of withdrawal or abstinence
What is dual diagnosis? A client with both substance abuse and other psychiatric illness is said to have____.
What major defense mechanism is used in substance abuse? denial
What is the initial priority in alcohol abuse? detoxification