-
pschodynamic causal theory for etoh
likely to become dependent feel phobic and feeling of inferioriy compared to social drinkers
stereotypical char are result of and not cause of sub dependence
-
biologic causal theory for etoh
genetic predisposition; single most significant factor; persons vulnerability
-
-
absorption
20 mins of empty stom
-
physiological effects of etoh
- disinhibition
- impaired judgement
- fuzzy thinking
- mental relaxation
- depresses psychomotor act
- anx and tension are relieved
- becomes defensive
-
detox etoh
- med supervised bc of misery and risk of death
- drugs that have a cross-dependence w etoh used to avoid sx of wd
-
etoh detox meds used
- benzodiazepines
- Librium, ativan, valium
-
benzos do
minimize sx wd, prevent dts, decr seizures
-
3 S's
- safety
- sedation - benzos
- supplementation - thiamine and folate
-
DTs
- delirium tremens
- ultimate level of cns irratibility
- bd not only invents sensory input but also has extreme motor agitation
- hallucinations become visible
- tonic clonic seizure
-
interactions
etoh and others
- cause profound cns depression
- leads to death
-
avoid etoh when taking
barbs, antipsych, antidepress, benzos, and otehrs
-
chloral hydrate and ativan
intentional sedating unsuspecting person in bars
-
chloral hydrate and etoh
knockout drops
-
etoh use by elderly
group 1
lifelong users
-
lifelong users of etoh problems
incr physical, cognitive, and emotional
-
etoh use by elderly
group 2
late-onset users responding to stress
-
FAS
result of etoh inhibiting fetal development during 1st trimester; 3rd most common cause of mr
-
-
wernicke-korsakoff syndrome
mental do characterized by amnesia, clouding consciousness, confabulation, mem loss, peripheral neuropathy
-
wenicke-korsakoff caused by
poor nutrition of alcoholic & neurotoxic nature
decr amnt of thiamine, niacin, and folate
-
librium
- anx do and acute etoh wd
- PO
- anti tremor agent
- parenteral used as anti panic
- accumulation
-
disulfiram antabase
- stated w single dose of 250-500 mg/d
- after 1-2 wks dose decr
- maintenance dose of 12-250 mg/d
-
disulfiram antabase
taken w etoh may cause
sweating, flushed face, tachy, hypotension, throbbing ha, n/v, palp, dyspnea, tremor, wkness, arryth, mi, cardiac failure, seiz, coma, death
-
etoh cns effects
- lg amnts: sleep, coma, deep anesth, death
- others: slurred speech, short attention span, loud talk, mem deficit
-
od
- depresses cns and vital centers anesthesized
- compromises breathing and hr -- coma/death
- gi bld and hemorr, hypothermia
-
wd
rebound phenomenon
sedation is predominant effect of etoh but as it wears off psychomotor act incr
-
s/s wd
- tremolousness
- nervousness
- anx
- anor
- nvd
- insomnia
- rapid pulse
- incr bp
- profuse perspiration
- fever
- unsteady gait
- dif concentrating
- exaggerated startle reflex
- cravind aod
-
dependence
maladaptive pattern of sub use: tolerance, wd, need for more
-
intoxication
- dev of sub-spec synd dt recent ingestion
- clinically significant malada behavior/psych changes
- not dt gmc
-
abuse
- malad pattern of sub use leading to clinically signif impairment/distress
- failure to fulfill roles
- recurrent use in hazardous situations
- leads to legal probs
- never met criteria before
-
wd dsm
- dev of sub spec synd dt cessation
- clinically sig distress/impairment
- not dt gmc or other md
-
tolerance
need for more amnts of sub to achieve same effects
-
dopamine works by
- incr w etoh consumption
- when dop falls they want more
-
denial
- most common
- insists they can stop at any time
-
codependence
- all fam members effected and need tx
- participate in behaviors that maintain addiction wo holding them accountable
-
enabling
- fam effected to extent where they rescue abuser
- lying
-
s/s aod abuse
- absenteeism esp after days off
- freq accidents
- drowsiness
- slurred speech
- inattention to appearance
- incr isolation
- freq secretive disappearances
- tremors
- flushed face
- watery red eyes
- spaced out
- odor of etoh or mints
- incr # phys complaints
- disappearing prescriptions raiding med cab
-
etoh toxic substance
acetaldehyde
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