Alcohol And Drug-Related Disorders

Front 1

third leading cause of death in U.S.

Back 1

alcoholism

Front 2

who are likely drinkers?

Back 2

young, well educated, prosperous, urban

boys 4x girls (alcoholic) girls worsen quicker

Front 3

differentiate type I
and
type II alcoholics

Back 3

type I: adult onset, guilt, worry, little or no family history, men=women , good out come (75%) of pop.

type II: early onset, impulsive, distractable, male, family history,poor outcome (25%)

Front 4

what is CAGE?

Back 4

Cut down on drinking
Annoyed by criticism of drinking
Guilty about drinking
Eye-opener in the morning

Front 5

strong indication of alcoholism is ?(mg/dL)

Back 5

150 mg/dL

Front 6

rough correlation of blood alcohol levels and symptoms

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0-100 sedate tranquil
100-150 incoordinated, irritable
150-250 slurred speech, ataxia
>250 passing-out, unconsciosness
>350 coma, possible death

Front 7

common laboratory and clinical findings implying alcoholism

Back 7

fractured rib (30%)
elevated mean corpuscle volume
abnormal liver enzymes
increased GGT**
transaminase elevation

Front 8

most common age range of diagnosis of alcoholism?

common co-morbid condition?

Back 8

16-30

psychiatric problem

Front 9

% motor vehicle acidents involving alcohol?

continued alcoholism shortens lifespan by?

Back 9

50%

15 years

Front 10

why is alcohol tolerance so important?

Back 10

dianosis of alcoholism
increases likelihood of cirrhosis
increased tolerance= increased likelihood of dev. alcoholism

Front 11

red palms a sign of ?

what is Dupuytren's contracture?

Back 11

liver dysfunction

thickening and shortening of tissue beneath the skin of the palm

Front 12

best specificity and sensitivity of alcohol abuser test?

alcoholics show tolerance for?

Back 12

carbohydrate deficient transferrin (CDT)

other abuse substances, sedatives, marijuana etc...

Front 13

correllation of alcohol and suicide

Back 13

alcoholic 15x more likely to commit suicide

25%-50% of suicides have alcohol abuse or dependence present

Front 14

mild to moderate withdrawal symptoms seen in % of alcoholics

severe withdrawal?

Back 14

95%

5%

Front 15

onset of uncomplicated ETOH withdrawal?
peak?
lasts how long?

Back 15

6-8 hr onset
24-48 hr peak
lasts 5-7 days

Front 16

symptoms of uncomplicated ETOH withdrawal?

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anxiety, tremor, nausea, increased heart rate and blood pressure

Front 17

alcohol seizures type?
onset?
peak?
percent of patients?
usually who?

Back 17

grand mal
7-38 hrs
24-48 hrs
5%-15%
long-term alcoholics

Front 18

alcoholic hallucinosis type?
onset?
lasts?
percent of patients?

Back 18

vivid and unpleasant auditory hall.(maybe visual or tactile)
48 hrs after cessation
lasts 1 week
3%-10% w/severe alcohol withdrawal

Front 19

alcohol wthdrawal delerium (delerium tremens) is characterized by?

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agitation, tremors, autonomic instability, fevers, auditory and visual hallucinations, dissorientation

Front 20

percent of alcoholics with delerium tremens?
onset?
peak?
duration?

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5%
2-3 day onset
4-5 day peak
lasts 3 days
can be fatal

Front 21

possible mortality rate of delerium tremens if untreated?

may require which additional cares?

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20%

restraints, seclusion

Front 22

etiology of Wernicke-Karsakoff syndrome?

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alcoholics have thiamine (B1) deficiency due to poor nutrition.
causes brain damage w/ possible short-term memory loss or even death

Front 23

symptoms of Wernicke's encephalopathy?

80%-90% develop?

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opthalmoplegia, nystagmus, diploplia, ataxia, memory impairment, apathy

Karsakoff's psychosis

Front 24

symptoms of Karsakoff's psychosis?

if you suspect give them what?

if yo give them glucose what happens?

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loss of short-term memory
reduced initiative
confabulation

thiamine injection, then glucose

glucose alone can induce W-K syndrome

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risk of becoming alcoholic if parents are?
morelikely male or female

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4x regardless of who raises them


male

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molecular testing of ? for alcoholism may signify genetic predisposition

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ADH2-2

Front 27

higher rates of alcoholism among?

depression occurs in?

drug dependence/ anti soc. dis.?

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1st degree relatives

women

men

Front 28

what increases alcohol cravings?

Back 28

mu-opiate receptor increases in ventral striatum

Front 29

Tx for ETOH withdrawal?

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Benzos (diazepam) 20 mg/hr x3
12-steps
address psychiatric prob.

Front 30

three benzos adequately metabolized in liver disease, elderly?

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LOT
Lorazepam
Oxazepam
temazepam

Front 31

only benzo with predictable absorption IM?

Back 31

lorazepam

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alcoholic adjunct therapies

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disulfiram (hangover inducing)

craving: naltrexone (blocks opiod rec.) acamprosate(GABA), topiramate

Front 33

injectable for of naltrexone?
how long does it last?

Back 33

vivitrol

1 month