-
What is the definition of addiction?
- loss of control
- use despite negative consequences
- relapse tendancies
-
WHat does physically dependent mean?
- brain is altered
- physical w/d sx when decrease or stop use
-
What are withdrawal sx?
Physical sx that occur when substance is decreased or stopped
-
What is tolerance?
Increased need to use more drug to gain desired effect.
-
What is a Type I drinker?
- Social drinker that develops an alcohol abuse problem
- Positive family hx (mom/dad)
- Less neurotransmitters available
- Feels normal when drinks
- -neurotransmitter dump
- -if doesn't drink, feel anxious, depressed
- 50% of population Type I drinkers-prone to relapse
-
What is a Type II Genetic alcoholic?
- Adolescent onset
- Begins drinking a lot and continues drinking a lot
- male line-father to son
- first drink age 11-13
- less than 2 years from 1st drink to disease
- before drink, less neurotransmitters available
- 1st drink skyrockets neurotransmitters
- Enjoy drinking from 1st drink
- Often don't look drunk
- Can have co-morbid ADHD, depression, anti-social personalities
- Around 75% of prison population
- Angry when 1st come into tx
- Increased medical illness and will die prematurely
- Will never be able to drink in a controlled way.
-
What happens when someone spends 1 year in recovery?
3 years of development: emotional, social, intellectual
-
How is alcohol metabolized?
- 25 mg/L metabolized every hour=1.5 oz liquor, 12 oz beer, 4 oz wine
- Person with BAC .10 w/o S/S intoxication has developed tolerance
-
When is there medical detoxification?
BAL=350
-
How does antabuse/disulfiram work?
- Drinking + meds->rx that feels like a heart attack
- -flushing
- -chest pain
- -diaphoresis
-
How do revia and depade/naltrexone work?
blocks the pleasure from drinking alcohol and decreases cravings
-
How are vivitrol and naltrexone given?
ER injection 1x month
-
How does campral work?
helps those who recently quit remain abstinent.
-
What is the CAGE Assement?
- CUT DOWN
- ANNOYED WITH PEOPLE
- FEELS GUILTY
- EYE OPENER
-
What is criteria for alcohol intoxication?
- recent ingestion
- maladaptive behavior
- behavior not due to medical condition
- At least one
- -slurred speech
- -uncoordination
- -unsteady gait
- -nystagmus
- -impaired attn or memory
- -stupor or coma
-
What are S/S of alcohol withdrawal?
- Two or more;
- N/V
- Anxiety
- hallucination
- agitation
- insomnia
- seizures
- autonomic activity: increase in HR, increase in BP, sweating
- hand tremors
-
What benzos can one use for safe ETOH withdrawal?
-
What do you need to assess during alcohol withdrawal?
- BP and HR (V/S)
- What were you using?
- How much were you using?
- For how long?
- When did you last use?
- Have you ever tried to quit? When?
- How did it go?
- Did you have any bad things happen?
- CBC, H&H, platelets, K+, Ca+, Mg+, GGT
|
|
