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Signs of alcoholism
- craving
- physical dependence
- loss of control
- tolerance
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metabloism of alcohol
- ingestion and absorption into stomach and small intestine and into blood stream
- liver metabolism
- diffusion
- blood alcohol concentration (BAC...legal limit in TX .08)
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explain the liver matabolism
- over 90% of the ingested alcohol is converted into acetaldehyde, then acetone, and then carbon dioxide and water.
- high acetalkehyde levels adn chronic alcohol consumption impair liver function and lead to liver damage.
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within how many min after ingestion can alcohol be detected in the blood?
5
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alcohol level can be determined by testing a person's
- blood,
- urine,
- saliva,
- water vapor in breath
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Health hazards of alcohol
- liver disease (#1)
- immunity and infeciton
- digestive system
- nutritional deficiencies
- cardiovascular diseases
- neoplasms
- nervous system(wernicke-korsakoff's syndrome and korsakoff's psychosis)
- reproductive system
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ALD
Alcohol liver disease
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symptoms of mental confusion, ocular and gait disturbances
wernicke's encephalopathy
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persistent learning and memory problems characaterized by forgetfulness; easy frustration and lack of muscle coordination; and retrograde and anterograde amnesia
korsakoff's psychosis
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characteristic pattern of abnormal growth and developement resulting from maternal consumption of alcohol during pregnancy
Fetal Alcohol syndrome (FAS)
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What can cause FAS
- Alcohol
- drugs
- smoking
- poor nutrition
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physical characteristics of FAS
- Small head circumference
- small midface
- midface flasttened, depressed;
- underdeveloped maxilla
- ears abnormally positioned
- small eye opening
- skin folds at corner of the eye
- low nasal bridge
- short nose
- indistinct philtrum
- thin upper lip
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mental characteristics of FAS
- CNS involvement
- reductionin size of corpus callosum, cerebellum or basal ganglia
- may have seizures
- cognitive or developmental deficits (verbal or visual spatial learning)
- executive functioning (abstract thinkin,planning, organizing)
- mortor funcitoning (poor coordination, abnormal gait)
- ADHD
- social skills, behavior dysfunction
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predisposing factors of alcohol withdrawal syndrome
- malnutrition
- fatigue
- depression
- physical illnesses
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features of alcohol withdrawal syndrome
- tremor of hands, tongue adn eyelids
- nervousness and irritation; anxiety
- malaise, weakness, and headache
- dry mouth
- autonomic hyperactivity; sweating, rapid pulse rate, adn elevated bp
- transient visual, tactile adn auditory halluscinations
- insomnia
- crand mal seizures
- nausea or vomiting
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DTs
- Delirium Tremens or alcohol withdrawal delirium
- may occur within 1 week of cessation of heavy alcohol
- marked autonomic hyperactivity: rapid heartbeat adn sweating
- vivid hallucinations (visual,auditory, tactile)
- delusions and agitated behavior; tremor
- confusion and disorientation
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when do alcohol hallucinations occur
- within 48 hrs after abruptly stopping or reducing heavy alcohol intake of long-standing dependancy
- may last weeks or months
- schizophrenic symptoms
- delirium not present
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disulfiram
antabuse...alcohol sensitizing agent
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naltrexone
ReVia...anticraving agent
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most common drugs of abuse
- cannabinoids (MJ)
- depressants(valium, sleeping pills, downers, rophies, ludes)
- dissociative anesthetics (angel dust, special k)
- Hallucinogens (LSD, PCP, ecstasy)
- opioids and morphine derviatives (heroin, codeine, morphine, opium)
- stimulants (cocain, meth, amphetamines)
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What do steroids affect?
liver
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medical consequences of drug abuse
- Cardiovasular
- neurological
- gastrointestinal
- kidney damage
- live damage
- musculoskeletal
- respiratory
- prenatal
- infections
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Treatment mediations for drug users
- Methadon
- Levo-alph-acetyl-methadol (LAAM)
- Naltrexone
- phenobarbital or diazepam
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supresses withdrawl symptomes and drug craving associated with narcotic addcition
Methadone and LAAM
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Competes with opioids at teh opioid receptor sites therefore blocking the effects of heroine. Does not eliminate drug craving so is not the preferred treatment
naltrexone
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longer-acting sedatives used to treat sedative withdrawal symptoms
phenobarbital or diazepam
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4 questions that may provide a positive diagnosis
have you ever felt you ought to Cut down on your drinking or drug use
Have peopel Annoyed you by criticizing your drinking or drug use
Have you ever felt bad or Guilty about your drinking or drug use
have you ever had a drink or used drugs firs thing the morning (Eye-opener) to steady your nevers or get rid of a hangover
CAGE
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Extraoral exam: alcohol signs
- breath and body odor of alcohol/tobacco
- tremor of hands, tongue, eyelids
- skin: redness, spider petechiae on nose
- Face color: light yellowish brown
- eyes: red baggy/puffy facial features
- evidences of trauma (from falling)
- lips: angular chelitis due to poor nurtiion
- parotid gland: swelling
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extraoral signs of drug abuse
- Personal: long sleeves, small blood stains on clothes, dramatic weight loss, lack of interest in personal hygiene
- Eyes: sunglasses, pupils constricted/dialated, bloodshot
- arms, needle marks
- behaviorl: change in habits
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