final exam review mental health: substance abuse disorder

blood alcohol level for intoxication

100-200 mg/dL

legal limit for alcohol intoxication

0.08g/dl

pupils when intoxicated by alcohol

dilated

caffeine intoxication symptoms

restlessness, nervousness, excitement, insomnia, flushed face, diuresis, gi upset, muscle twitching, rambling thoughts and speech, tachycardia, agitation

amphetamines intoxication

agitation, agression, impaired judgement, hr racing, dilated pupils, sweating

key signs of amphetamine intoxication

compulsive behaviors, skin picking and sores

types of amphetamines

adderall, meth, meth, speed

what does cocaine cause

severe vasoconstriction

bath salt intoxication

agitation, paranoia, hallucinations, chest pain, increased pulse, high bp

taking off their clothes, superhuman strength, extremely aggressive and violent

bath salt behaviors

how do you feel on hallucinogens

out of body

hallucinogens cause...

intensified sensory experience

Phencyclidine Intoxication

very combative and aggressive, violent, belligerent, decreased pain response

what not to do with phencyclidine overdose

no lavage, no 4 point restraints, do not talk down

types of phencyclidines

antipsychotics (haldol), seizure meds (diazepam or benzo)

DXM intoxication

impaired judgement, loss of coordination, dizziness, nausea, hot flashes, hallucinations, seizures, brain damage, death

where is dxm found

cold and cough medicines

inhalants intoxication

dizziness, nystagmus, incoordination, slurred speech, unsteady gait, lethargy, depressed reflexes, psychomotor retardation, tremor, muscle weakness, blurred vision

dxm commonly used in...

adolescents

does tolerance rapidly develop with inhalants

yes

opioid intoxication

decreased response to pain, respiratory depression, nausea, constriction of pupils, drowsiness, slowed peristalsis and constipation, impaired judgement

substance withdrawal for alcohol

4-12 hours after last drink

major complication of alcohol withdrawal

hand tremors

severe complication of alcohol withdrawal

visual and tactile hallucinations

delirium tremens

a disorder involving sudden and severe mental changes or seizures caused by abruptly stopping the use of alcohol

prevent delirium tremens

oral benzodiazepines every two hours after withdrawal, antipsychotics/anticonvulsants, tapering dose

cannabis type of dependence

psychological dependence not physilogical

types of stimulants

amphetamines, cocaine, nicotine, caffeine, club drugs, bath salts

withdrawal from stimulants

- dysphoria, fatigue, sleep disturbance, increased appetite, psychomotor retardation, depression

cocaine blues

Users may find that it is difficult to experience pleasure

Is opioid withdrawal life threatening?

no

signs of opioid withdrawal

increased vitals, agitation, goosebumps, yawning, tearing, runny nose, twitching, abdominal cramps, diarrhea

withdrawal from heroin

6-12 hours after last use; peak 1-3 days; lasts 5-7 days

withdrawal from methadone

1-3 days after last dose; peak in 4-6 days; lasts 14-21 days

ego defense mechanisms

denial, rationalization, minimization

disease model

model that characterizes drug addiction as a disease

acronym for screening for alcohol

CAGE

CAGE stands for

cut down, annoyed, guilty, eye-opener

disulfiram (antabuse)

vomit when drinking, begin 24 hours after last drink, avoid all alcohol

Acamprosate calcium (Campral)

decrease alcohol cravings

naltrexone (vivtrol)

opioid antagonist: injectable form

naltrexone (ReVia)

opioid antagonist: reduce craving and relapse

pill for nicotine withdrawal

zyban

drugs for stimulant withdrawal

antipsychotics, anxiolytics for aggression, beta blocker

cocaine vaccine

produces anti-cocaine antibodies & prevents drug from crossing blood-brain barrier

inhalant drug therapy

antipsychotic (haldol)

medications used to manage opioid withdrawal and relapse

synthetic opiates, LAAM, buprenorphine (Buprenex), suboxone, naltrexone, narcan

synthetic opiates for withdrawal

methadone taper

Levo-alpha-acetylmethadol (LAAM)

take every other day, addictive, longer acting, must be prescribed and administered in clinics

buprenorphine (buprenex)

mild addiction, used to treat dependence, certification necessary

suboxone

combo of narcan and buprenex

naltrexone and nalmefene

blocks effects, no high

alcohol phases

•Phase I - Pre-alcoholic

•Phase II - Early Alcoholic

•Phase III - Crucial Phase

•Phase IV - Chronic Phase

wernicke's encephalopathy

caused by thiamine deficiency

symptoms of wernickes encephalopathy

paralysis of ocular muscles, diplopia, ataxia, stupor

how long does wernickes encephalopathy last

acute, reversible

Korsakoff's psychosis cause

casued by thiamine deficiency

is korsakoff's psychosis chronic

yes

korsakoff's psychosis

chronic memory disorder, alcohol-induced dementia

symptoms of korsakoff's psychosis

confusion, loss of recent memory, and confabulation

peripheral neuropathy

deficiency of vitamin B (especially thiamine), causes pain, burning, tingling, prickling in extremities

cardiac myopathy

signs of congestive failure, elevated cpk

myopathy

deficient of vitamin B causes sudden onset of muscle pain, swelling and weakness, reddish tinge in urine

esophageal varices

swollen, varicose veins at the lower end of the esophagus. cause portal hypertension.

lab value for hepatic encephalopathy

rising serum ammonia

Acamprosate calcium (Campral) moa

gaba receptor agonist and decrease glutamate

side effects of acamprosate calcium

diarrhea, dizzy, dry mouth, insomnia, sweating, anxiety, depression

dose of naltrexone (ReVia)

50 mgs a day, 24-hour duration

must be ....... to take naltrexone (reVia)

opioid free for 7-10 days

naltrexone (vivtrol) injectable form dose

380 mgs

watch for symptoms of ... with naltrexone (Vivtrol)

penumonia

amotivational syndrome

Loss of ambition and drive; a characteristic of long-term abusers of marijuana.

overdose of amphetamines

cardiac arrhythmias, HA, convulsions, htn, rapid hr, coma, possible death

molly

synthetic designer drug supposed to be pure MDMA which is not true

intoxication with club drugs

extreme empathy, reduced inhibitions, enhanced sense, rush, exhaustion, dehydration, arrhythmia

od with club drugs

high bp, faintness, panic attacks, loss of consciousness, seizures, and drastic rise of body temp, rhabdomyolosis

synthetic compounds- hallucinogens

lsd and pcp

natural occurring hallucinognes

peyote, mushrooms

withdrawal symptoms for hallucinogens

no symptoms

flashbacks with hallucinogens

experience trips even when you haven't tripped in months

DXM can cause

brain damage and death

warning signs for dxm use

child takes large amounts of cold meds, meds disappear from cabinet, find otc's in backpack or room, not doing well in school

od treatment for opioids

narcan and naltrexone

how often do you take LAAM

every other day

how soon do you feel the effects of rohypnol

effects in 10-20 mins

another name for rohypnol

roofies

how long do roofies last

8-12 hours

symptoms of steroid use

jaundice, fluid retention, high blood pressure, increase ldl, decrease in hdl, trembling

symptoms of steroid use for men

shrinking of testicles, reduced sperm counts, infertility, baldness, development of breasts, increased risk for prostate cancer, higher pitched voice

symptoms of steroid use for women

growth of facial hair, male-pattern baldness, change in menstrual cycle, enlargement of the clitoris, deepened voice

symptoms of steroid use for adolescents

growth halted

definition of pathologic gambling

persistent and recurring maladaptive gambling

gambling behaviors

preoccupied, restless, escape, recover losses, lying, illegal acts, loss of significant relationship

intermittent explosive disorder

losing control, serious injuries to self or others, destruction of property

what follows episodes of intermittent explosive disorder

remorse

meds for intermittent explosive disorder

lithium, anticonvulsants and tegretol; benzos, anxiety meds, sleep meds,, prozac

kleptomania

desire to steal

pyromania

a compulsion to set things on fire

treatment for pyromania

lacks motivation, may need incarceration