SUDs quiz 2

recovery model

sees relapse as part of the process and an opportunity for progress

ADH and ALDH

enzymes that break down all into acetaldehyde → toxic byproduct that causes a hangover

liver

alcohol is metabolized in the ___ by enzymes

antabuse

behavioral deterrent of etoh

-makes you super sick after alc consumption

etoh effects

-CNS depressant

-euphoric effect caused by GABA

-resp depressant

-decreased balance, reflexes, judgement

-blackouts/amnesia

-alc hallucinosis, DTs, encephalopathy

alcoholic hallucinosis

hallucinating

-ego dystonic → terrifying

-support pt and be there for them

DTs

severe alc withdrawal

-acute delerium

-tremors, agitation, hallucinations

-diaphoresis, hyperthermia, tachycardia, HTN

-tx: benzos and supportive care

wernicke’s encephalopathy

sudden, severe brain disorder

-acute confusion, muscle loss, ataxia, visual vhanges

-thiamine deficiency → give vit B1/thiamine

-can be reversed

korsakoff’s syndrome

permanent change from chronic etoh use

-cannot create new memories

-preventable form of dementia

esophageal varices

esophageal veins distended dt increased pressure from defective blood flow thru cirrhotic liver

-portal HTN

-GI hemorrhage

alcoholic myopathy

degenerative changes of heart and skeletal muscles

-CPK elevations

-acute sxs: sudden onset of extreme muscle pain, edema and weakness in extremities, reddish tinged urine

-long termL cardiomegaly

acute alcoholic pancreatitis

constant, severe, left-sided epigastric pain

-N and V

-may become chronic

peripheral neuropathy

pain and numbness

-tingling, burning in extremities

benzodiazepines

mimic etoh and decrease excitatory response, anti convuslant, increase GABA

-CNS and respiration depression risks

-taper off

-ativan and clonidine

-front loading

naltrexone

decreases cravings

ativan and clonodine

popular benzos

opiate fx

pain suppression, pinpoint pupils, lowered HR, BP, resp rate, constipation, cough suppression, lax muscle tone, dry mouth

-withdrawal has opposite fx

opiate withdrawal

yawning, fever, muscle aches and pain, insomnia, dysphoric mood, N and V and D, rhinorrhea, pupillary dilation, diaphoresis

opioid detox

tylenol PRN for pain, OTC anti diarrheal, anti emetics for N and V (zofran), ativan PRN for anxiety, clonidine - antihypertensive and help w/ withdrawal sxs

-chronic methadone use, naltrexone to decrease cravings, naloxone for OD

-counseling and bx therapies

medication assisted tx for opioid

methadone

-buprenorphine + nalaxone: partial opioid receptor blocker, help control cravings, reduce withdrawal

stimulants

CNS activation, increased DA, increased NRG, decreased appetite/thirst, increased reflexes, HR, BP, breathing w/ cardiac risks

-hypersensitivity, dilated pupils

withdrawal of stimulants

depression, irritability, anergia, anhedonia, increased risk for depression, SI, or bx

cocaine/meth risks

cardiac artery restriction → heart arrhythmias

-MI

-increased cardiac demand, HR → acute chest pain and severe vasoconstriction

wellbutrine

antidepressant that can be used as meth and cocaine tx along with

-supportive care

-12 step

-sleep, dental, nutrition, infections

not

meds are __ required for stimulant withdrawal/detox