Addictive Disorders

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substance dependence

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when drug use is not longer undercontrol and continues despite adverse effect

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substance abuse

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the purposeful use x at least 1 month of a drug that results in adverse effect to one's self or others

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tolerance

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reduced response to a drugs action it can b biologically inherited or developed gradually over time

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withdrawal

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a condition that occurs after a person who has used a substance reg. and heavily has recently decreased or stopped use, and now demonstrates a pattern of s/s that in general r the opposite of the acute effect of the drug

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craving

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psychological "hungry" feeling to engage in addictive behavior even if an individual was not originally planning to use....

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s/s alcohol poisoning

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mental confusion, stupor, coma
v
seizures
l breathing
hypothermia (lameness)

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alcohol poisoning -untreated

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choking v
↘ breathing
↘ heart
hypothermia
hypoglycemia
= death

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symptoms Alcohol Withdrawal (acute phase)

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n/v
diaphoresis
anxiety/agitation
tactile/auditory/ visual disturbance
↗pr_ bp
insomnia
seizures
Dt's hallucinations, extreme disoriented, restlessness, pupilary dilatation
↗ fever
↗ pr

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nurse interventions_ alcohol withdrawal

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initiate seizure precautions
monitor vs / shift
Orient pt frequently
set limits on manipulative behavior
encourage pt to return to his room....

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CAGE

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Cutting down alcohol
being Annoyed at what others say abt the drinking
Guilt abt ur drinking
open Eyes

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typical detox_ alcohol withdrawal

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lorazepam _ ativan
chlordiazepoxide_ Librium
diazepam_ Valium
oxazepam_ serax
chlordiazeproxide_klonopin

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alcohol withdrawal delirium TX

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benzo
airway protection
f and e maintenance
protect from injury
seizure precautions

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Wernicke encephalopathy

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thiamine_ bit B1 ↘
ataxia( loose of coordination)
confusion
Short memory impairment
coma....death

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Korsakoff's syndrome

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➡chronic memory disorder cause by severe thiamine ↘
↘speech
apathy
recovery not likely

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AA

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acceptance
surrender
processing grief
↗ power
+ power of the group

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post acute therapy_ Aversion Therapy

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disulfiram( Antabuse)
exposure to even am amt of alcohol results in excess acetadehyd...
tx alcohol dependence
goal_ ↘undesirable behavior_ classical conditioning
Do not drink alcohol = n/v

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disulfiram (Antabuse)

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prevent breakdown of alcohol
if alcohol= flushing, weakness, n/v
teach= products/food containing alcohol

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Naltexone (REVIA) harm reduction_recovering alcohol

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↘ urge to drink
↘ the high associated with drinking

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Acamprosate (CAMPRAL) harm reduction_rec. alcohol

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anti craving

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opiate therapeutic effective

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analgesia and sense of well being
morphine elixir_ hospice pts
fentanyl and benzo_ conscious sedation

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opiate s/e

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addiction
respiratory depression
PUPILLARY CONSTRICTION
n/v

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opiate withdrawal

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craving, anxiety, depression
chills/ hot flashes
diaphoresis
n/v/d
DILATED PUPILS
RESTLESS LEG SYNDROME

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opiate OD

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respiratory depression
bradycardia
unconsciousness
v
fatal
easily and quickly reverse narcan

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detox agents x opiates Methadone

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once/day

↓ withdraw in people addicted to heroin or other drugs without causing high

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psychostimulants

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induce temporary in either mental or physical functions or both

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psychostimulants: AMPHETAMINES

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include: methamphetomine(crystal meth)-dextromphetamine (dexedrine)

Therapeutic ef: tx x narcolepsy + ADHD

s/e: tachycardia, dry mouth, insomnia, anxiety

"Behavioral stimulants"

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psychostimulants: COCAINE

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Short acting, stimulates the "pleasure centers" of the brain.

NOT PHYSICALLY ADDICTIVE

crack: mixing powered cocaine + H2O + baking soda →cooking of the liquid

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psychostimulants: MARIJUANA

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NOT PHYSICALLY ADDICTIVE

tx wt ↓ r/t HIV/AIDS

n/v r/t chemo

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barbiturates

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anti-convulsant

sedative- hynotic

anti- anxiety

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barbiturates S/E

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respiratory depression→apnea + airway obstruction→coma→death

delirium-agitation-headache/n

act on the gaba neurotransmitters

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barbiturates USES

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induction of anesthesia

conscious sedation

medically induce coma

animal+ human euthanasia

TRUTH SERUM

death penalty

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benzodiazepines

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anti-convulsant/anxiety

sedative/hypnotic

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benzodiazepines WITHDRAWL

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= alcohol→ longer lasting

DT's →death

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benzodiazepines info

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pairly safe OD except when combined with other CNS depressants

ADDICTIVE- EXTENSIVE RECREATIONAL USE

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Definitions: SOPORIFIC

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sleep inducing drug

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definition: HYPNOTIC

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sleep inducing drug

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definition: SEDATIVE

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sedates or relaxes

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definition:NICOTINE

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mild stimulant

↓ alzheimer's

ADDICTIVE

5% people drink: alcoholic

80-90% smoke: addicted

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smoking censsation

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pick a quit day

ask doc: zyban, chantix, nicotine patches, gum, spray, lorenge

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phencyclidine PCP

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dissociative, anasthetic, hallucinogen stimulant

(angel dust, embalming fluid, toe tag, amp)

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PCP

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embalming fluid

↑ buzz→ health risks

RECREATIONAL DRUG

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substance disorder ASSESSMENT

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* when was ur 1st drink of alcohol?

*how much/often did u use at 1st?

when did alcohol consumption (cocaine etc)begin to cause problems?

*hv u experienced legal, financial...consequences?

*wht is the longest you've ever stayed sober

*wht caused relapse?

how long hv u been consuming the current amt of alcohol?