#5-Dobrisky-Substance Abuse
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| show | a characteristic that is present when withdrawal of the drug results in physiological disruptions
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| show | biological need that develops when body adapts to having the drug in the system; a substance specific syndrome
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| Tolerance | show 🗑
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| show | A maladaptive pattern of substance use leading to clinically significant impairment or distress
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| Substance dependence | show 🗑
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| Polysubstance abuse | show 🗑
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| Cross-tolerance | show 🗑
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| show | When a person has two identified primary psychiatric diagnosis—most commonly used when one dx is drug or alcohol related
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| Gateway drugs | show 🗑
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| show | age, ethnicity, genetic predisposition; co-morbidities; stress
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| show | peer influence; social norms; family influences; support system
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| show | access to and cost of substance; severity of punishment
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| show | rapid release of neurotransmitters, followed by a reduced-from-baseline level
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| dopamine levels change how when drugs are used? | show 🗑
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| glutamate is associated with | show 🗑
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| which cultures and ethnic groups is substance abuse more prevelant? | show 🗑
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| substance abuse is viewed differently depending on... | show 🗑
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| show | it rises
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| barbiturates, benzodiazepines and alchohol are all | show 🗑
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| show | cns depressants
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| show | cns depressants: hypnotics
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| show | barbiturates
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| barbiturates produce excessive drowsiness with an initial response of | show 🗑
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| show | rapidly
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| show | barbiturates
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| name six barbiturates | show 🗑
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| show | barbital
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| what was the preferred treatment for anxiety in the 1960's? | show 🗑
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| show | benzos
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| show | they can be
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| show | alcohol
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| show | seizures
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| show | benzos are longer acting and less intense
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| which is longer acting: benzos or barbiturates? | show 🗑
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| which is less harmful in case of overdose? benzos or barbiturates? | show 🗑
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| show | illegal CNS depressant
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| show | alcohol
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| GHB is considered to be a | show 🗑
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| show | intoxicating, sedating, euporic
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| show | growth hormone
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| GHB affects heart rate and respirations by | show 🗑
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| What drug is considered to be the forget-me pill? | show 🗑
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| this drug is a benzo, it's illegal in the US and is used as a date rape drug | show 🗑
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| the Rohypnol pill is accelerated by | show 🗑
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| show | without knowing
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| show | tasteless, odorless, dissolves quickly
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| which is the most widely used and most abused substance? | show 🗑
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| any amount of alcohol is considered to be harmful to | show 🗑
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| the ability to metabolize alcohol is predetermined by | show 🗑
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| show | ehtanol (ETOH)
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| show | altering effects
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| show | proof
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| in the US proof is how much the ethanol concentration? | show 🗑
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| show | ethanol intoxication
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| the concentration of alcohol depends on what? | show 🗑
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| alcohol is absorbed through | show 🗑
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| show | the rate of absorption
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| show | yes
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| show | liver
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| show | 90
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| does the excretion of alcohol vary or does it take place at a fixed rate? | show 🗑
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| the healthy liver can metabolize how much alcohol in an hour | show 🗑
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| show | circulates in the blood
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| what type of dependence is developed with alcohol use? | show 🗑
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| show | blood alcohol concentration
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| BAL stands for | show 🗑
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| a BAC of 20 is equivilant to a BAL of | show 🗑
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| effects of a BAL of 0.02 | show 🗑
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| show | relaxed
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| at what BAL is judgment mildly impaired and the ability to make rationale decisions is declined? | show 🗑
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| at what BAL is driving impaired, speech slurred, and ataxia and decreased sensory function evident? | show 🗑
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| show | reaction time
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| show | 0.10
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| at 0.15 the BAL there is increased impairment and the alcohol level is equivalent to | show 🗑
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| show | potential cardiovascular and respiratory collapse and loss of consiousness
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| at what BAL is cardiovascular and respiratory collapse a potential complication? | show 🗑
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| show | 0.30
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| neurological sydromes resulting from etoh abuse include | show 🗑
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| wernicke-korsakoff syndrome is inflammatory | show 🗑
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| show | inflammatory degeneration
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| show | memory loss and cognitive changes
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| wernicke-korsakoff syndrome is caused by a deficit of what? | show 🗑
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| show | brain atrophy with dysarthria and impaired consiousness
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| show | anterograde amnesia
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| show | alcohol, cigarretes and marijuana
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| what ethnicities experience more adverse effects from alcohol use? | show 🗑
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| show | never fully returns to pre-drug level
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| show | cns depressants
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| barbituates are the major cause of | show 🗑
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| what form of alcohol is actually considered to be good for you in moderate amounts? | show 🗑
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| show | increased HDL, decreased LDL, decreased diabetic complications and decreased blood sugar levels
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| show | one ounce
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| the standard drink size for wine is | show 🗑
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| the standard drink size for beer is | show 🗑
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| show | 0.45
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| show | 40
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| show | varies
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| show | 1 ounce per hour
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| show | fixed
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| show | liver
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| the kansas legal limit for alcohol is | show 🗑
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| show | inhibits absorption
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| show | wernicke-korsakoff
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| wernicke-korsakoff-->brain... | show 🗑
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| show | memory loss and cognitive changes
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| if a person that abuses alcohol is suffering from memory loss and cognitive changes, what syndrome may they have? | show 🗑
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| show | that's a long name to REMEMBER...memory loss...
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| show | marchiafava bignami
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| brain atrophy... | show 🗑
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| show | brain atrophy
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| what clinical manifestations may result from brain atrophy related to marchiafava bignami | show 🗑
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| a common clinical manifestation of "march-i-a-fava big-nami" is | show 🗑
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| show | all increased
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| the risk for what complications r/t bleeding increase with etoh abuse | show 🗑
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| show | decrease
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| the cardiovascular systemic effects of alcohol abuse are | show 🗑
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| show | decreased WBC production, increased size of RBC, impaired production of clotting factors and platelets
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| show | production is decreased
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| what happens to platelets when alcohol is abused | show 🗑
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| show | increase in size
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| show | MCV
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| show | fatty liver, cirrhosis, varices & ascites
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| accumulation of fats in liver cells leads to | show 🗑
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| chronic hepatic inflammations lead to | show 🗑
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| what develops as a result of impaired liver circulation | show 🗑
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| show | increased gastric secretions that promote bacterial growth
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| show | alcohol abuse
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| show | respond to insulin
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| the sleep cycle disturbance caused by etoh abuse is also referred to as | show 🗑
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| show | by reducing parathyroid hormone release
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| show | etoh consumption during pregnancy
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| show | ACTH
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| what elevated liver enzyme indicates alcohol has been consumed recently? | show 🗑
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| what is the normal range for GGT | show 🗑
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| GGT...gin gin tequila | show 🗑
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| is a ggt level accurate in the 15-30yo age range? | show 🗑
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| show | anemia
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| show | GGT, RBC size, MCV, uric acid, triglycerides, AST, Urea and carbohydrate deficient transferring
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| show | 12-24 hours from last drink
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| show | alcohol withdrawal syndrome
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| how common is AWS | show 🗑
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| early symptoms of AWS can start within | show 🗑
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| show | 24-48 hours
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| when will AWS symptoms decrease | show 🗑
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| what time frame is a seizure more likely to occur with AWS | show 🗑
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| what changes in the HR are seen in AWS? | show 🗑
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| seizures can occur within | show 🗑
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| show | 24-48hrs after last drink
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| show | 4-5days after last drink
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| show | no
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| show | n/v, anxiety, tremor
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| show | visual, auditory or tactile hallucinations
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| what is different about the hallucinations in AWS patients? | show 🗑
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| alcohol withdrawal delirium is also referred to as | show 🗑
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| show | DTs
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| show | occurs in less than 10% of those with AWS
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| show | disorientation
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| the DTs are often accompanied by | show 🗑
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| show | DTs
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| what assessment tools are used to determine if a patient may have an substance abuse problem? | show 🗑
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| CAGE stands for | show 🗑
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| what score on the CAGE questionnaire indicates potential etoh abuse? | show 🗑
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| show | alcohol
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| show | a brief drug abuse screening tool
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| what DAST score suggests a significant drug abuse problem? | show 🗑
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| show | alcohol use disorders identification test
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| show | drug and etoh
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| if screening tests shows that problems might exist what type of questions with the nurse follow up with? | show 🗑
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| when eliciting history of substance abuse how should questioning start? | show 🗑
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| show | readiness to change
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| key assessment items include | show 🗑
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| show | an opage grayish ring around the eyes
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| what causes arcus senilis? | show 🗑
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| how might the hands be affected by alcohol abuse? | show 🗑
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| in addition to red palms what else may be red? | show 🗑
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| facial redness is known as | show 🗑
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| an enlarged liver may cause what clinical manifestation? | show 🗑
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| show | guaiac
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| show | increased
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| show | cardiac arrhythmia
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| show | drug abuse
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| how are the eyes affected by drug abuse? | show 🗑
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| cardiac arrhythmias, needle tracks, cellulites, conjunctivitis, poor dentition, rapid weight loss and changes in pupil size are indicative of | show 🗑
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| show | alcohol abuse
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| show | benzos
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| show | tapered down
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| show | short-acting: Ativan
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| the pt with severe withdrawal will more than likely be taking which type of benzo? | show 🗑
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| show | short acting benzo
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| ativan is used when | show 🗑
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| librium is | show 🗑
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| show | when it is severe
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| show | symptoms-triggered dosing
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| show | may over medicate patient
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| show | CIWA scale
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| what is the antidote for benzos? | show 🗑
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| what is the antidote for opiates? | show 🗑
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| if symptoms of withdrawal do not progress in a predictable manner what tool is then used? | show 🗑
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| show | co-morbidities and psychiatric illnesses
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| show | every 1-2 hours
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| show | discontinue the CIWA
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| show | the absent or mild withdrawal
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| what dosing changes are made if there is a CIWA-R score of 9 or less? | show 🗑
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| a CIWA score of 10-19 indicates | show 🗑
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| a CIWA score of greater than 20 indicates | show 🗑
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| show | withdrawal with delirium
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| show | treated with anti-seizure medication
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| what Vitamins are often needed during withdrawal? | show 🗑
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| show | Thiamine, Folic Acid and Vitamin B12
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| besides thiamine, folic acid and vitamin b12 what is also needed | show 🗑
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| what treatment is used as an alcohol teterrent by interupting the metabolism of ETOH | show 🗑
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| show | aftershave lotion and mouthwashes
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| show | vanilla extract & vinegar
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| show | cough-medicines
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| what reaction will a patient have if they drink etoh while taking antabuse | show 🗑
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| campral is used to treat what in early sobriety | show 🗑
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| to prevent relapse for alcoholics that have a "slip" | show 🗑
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| high-dose withdrawal of cns depressants substitutes medication | show 🗑
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| low dose withdrawal depends on | show 🗑
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| insomnia, anxiety, elevated temp, pulse and respiratory rate, fine tremors, GI upset, muscle aches, diaphoresis and a labile BP indicate withdrawal from | show 🗑
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| what are the nursing priorities in acute situations of withdrawal? | show 🗑
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| show | observation, meds, emotional & nutritional
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| the drug abuser still needs pain relief, it is best to | show 🗑
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| in order to avoid relapse we should assist the patient to avoid | show 🗑
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| motivational interviewing focuses on listening rather than | show 🗑
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| show | changes is up to the patient
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| fatigue, workaholism, cover-ups, exaggerations, rationalizations, self-pity, victim role, frustration vs appropriate anger, impatience and negativism are all signs of | show 🗑
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| show | preventing abuse
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| secondary prevention is aimed at | show 🗑
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| show | decreasing complications of addiction
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| the most important sign of a healthy recovery is when the patient | show 🗑
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Created by:
Lori Dobrisky
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