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76 Cards in this Set
- Front
- Back
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Inability to fulfill obligations at work, school and home is a sign of
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Substance Abuse
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Participation in physically hazardous situations while impaired (driving a car, operating machinery) is a sign of
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Substance Abuse
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Continued use despite recurrent social and interpersonal problems is a sign of
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Substance Abuse
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Recurrent legal or interpersonal problems is a sign of
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Substance Abuse
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Maladaptive pattern of substance use leading to clinically significant impairment or distress, manifested by ONE or more of the following signs within a 12 month period
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Substance Abuse
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Maladaptive pattern of substance use leading to clinically significant impairment or distress, manifested by THREE or more of the following within a 12 month period
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Substance Dependence
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Presence of tolerance to the drug is a sign of
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Substance Dependence
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Presence of withdrawal syndrome is a sign of
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Substance Dependence
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Substance is taken in larger amounts/for longer period than intended is a sign of
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Substance Dependence
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Unsuccessful or persistent desire to cut down or control use is a sign of
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Substance Dependence
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Increased time spent in getting, taking, and recovering from the substance; may withdraw from family and friends is a sign of
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Substance Dependence
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Reduction or absence of important social, occupational, or recreational activities is a sign of
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Substance Dependence
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Substance used despite knowledge of recurrent physical or psychological problems or that problems were caused or exacerbated by one substance is a sign of
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Substance Dependence
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Person’s physiological reaction to drug decreases with repeated administration of same dose
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Tolerance
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Psychological changes occur when blood and tissue concentrations of drug decrease after heavy prolonged use of substance
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Withdrawal
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Addiction is characterized by
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Loss of control of substance consumption;
Substance use despite associated problems; Tendency to relapse |
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Biological factor of addiction
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Specific effects on neurotransmitter systems
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Psychological factors of addiction
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Lack of tolerance for frustration and pain
Lack of success in life Lack of affectionate and meaningful relationships Low self-esteem, lack of self-regard Risk-taking propensity |
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Sociocultural factors of addiction
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Social and cultural norms
Socioeconomic stress |
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2 important assessment questions
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In the last year, have you ever drank or used drugs more than you meant to?
Have you felt you wanted or needed to cut down on your drinking or drug use in the last year? |
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When do signs of alcohol withdrawal appear?
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a few hours after cessation
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When do s/s of alcohol withdrawal peak?
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24-48 hours
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Naltrexone (ReVia)
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Reduces or eliminates alcohol craving
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Acamprosate (Campral)
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Helps client abstain from alcohol
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Topiramate (Topamax)
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Works to decrease alcohol cravings
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Disulfiram (Antabuse)
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Alcohol-disulfiram reaction causes unpleasant physical effects
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Examples of CNS stimulants
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Short acting: Cocaine, Crack
Long acting: Amphetamines, Dextroamphetamine, Methamphetamine, Ice (synthesized for street use) |
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Physical signs of intoxication r/t CNS stimulants
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Tachycardia, Dilated pupils, Elevated BP, N/V, Insomnia
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Psychological-perceptual signs of intoxication r/t CNS stimulants
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Assaultiveness, Grandiosity, Impaired judgement, impaired social/occupational functioning, euphoria, increased energy
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Effects of overdose with CNS stimulants
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Respiratory distress, ataxia, hyperpyrexia, convulsions, coma, stroke, MI, death
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Severe effects of CNS stimulants
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paranoia, delusions, psychosis, hallucinations (visual, auditory, tactile), severe anxiety, potential for violence
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Does paranoia and ideas of reference go away with cessation of CNS stimulants?
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No, may persist fo months afterward.
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Tx for overdose of CNS stimulants
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Antipsychotics, symptom management for hyperpyrexia (ambient cooling), convulsions (diazepam), resp. distress, Cardiovascular shock, acidification of urine (ammonium chloride for amphetamine)
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Effects of withdrawal of CNS stimulants
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Fatigue, depression, agitation, apathy, anxiety, sleepiness, disorientation, lethargy, craving
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Tx for withdrawal of CNS stimulants
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Antidepressants (desipramine), Dopamine agonist, bromocriptine
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Examples of CNS depressants
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Barbiturates, benzodiazepines, chloral hydrate, Glutethimide, meprobamate, ETOH
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Physical signs of intoxication of CNS depressants
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Slurred speech, incoordination, unsteady gait, drowsiness, decreased BP
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Psycological-perceptual signs of intoxication of CNS depressants
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Disinhibition of sexual or aggressive drives, impaired judgement, impaired social/occupational function, impaired attention/memory, irritability
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Effects of overdose of CNS depressants
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Cardiovascular/resp depression/arrest, coma, shock, convulsions, death
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Tx of overdose of CNS depressants if awake
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Keep awake, induce vomitting, activated charcoal, VS Q 15 min
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Tx of overdose of CNS depressants if in coma
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Airway, IV fluids, gastric lavage with charcoal, VS frequently, seizure precautions, dialysis, flumazenil (Romazicon) IV
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Effects of withdrawal of CNS depressants (prolonged heavy use)
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N/V, tachycardia, diaphoresis, anxiety, tremors, insomnia, grand mal seizures
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Effects of withdrawal of CNS depressants (after 5-15 years of heavy use)
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Delirium
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Possible tx for withdrawal of CNS depressants
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Carefully titrated detox with similar drug
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Abrupt withdrawal of CNS depressants can cause
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DEATH
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Examples of opiates
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opium, heroin, meperidine (demerol), morphine, codeine, methadone (Dolophine), hydromorphone (Dilaudid), Fentanyl (Sublimaze)
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Physical signs of intoxication of opiates
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Constricted pupils, decreased resp, drowsiness, decreased BP, slurred speech, psychomotor retardation
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Psychological-perceptual signs of intoxication with opiates
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Initial euphoria followed by dysphoria, impairment of attention, judgement, memory
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Effects of overdose of opiates
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possible dilation of pupils due to anoxia, resp. depression/arrest, coma, shock, convulsions, death
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Tx of overdose of opiates
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Narcan
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Effects of withdrawal of opiates
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yawning, insomnia, irritability, runny nose, panic, diaphoresis, cramps, n/v, bone pain, chills, fever, lacrimation, diarrhea
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Possible tx for withdrawal from opiates
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Methadone tapering, clonidine-naltrexone detox, buprenorphine substitution.
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What is an opiate?
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derivative/synthetic that affects the CNS and ANS. medically used as analgesic.
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what is a hallucinogen?
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produces abnormal mental phenomena in the cognitive and perceptual spheres (distortion in space/time, hallucinations, delusions, synesthesia
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Examples of hallucinogens
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LSD, Mescaline, Psilocybin, PCP
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Physical effects of intoxication with LSD, mescaline, Psilocybin
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Pupil dilation, tachycardia, diaphoresis, palpitations, tremors, incoordination, elevated temp, pulse, resp
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Physical effects of PCP
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vertical/horizontal nystagmus, increased BP, pulse, temp, ataxia, muscle rigidity, seizures, blank stare, jerking, repetitive movements, agitation, belligerence, impaired judgment
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Psychological-perceptual effects of intoxication with LSD, mescaline, psilocybin
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Fear of going crazy, paranoid ideas, marked anxiety, depression, synesthesia, depersonalization, hallucinations (sensorium is clear), grandiosity
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Effects of overdose with LSD, mescaline, psilocybin
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Psychosis, brain damage, death
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Severe effects of PCP use
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Hallucinations, bizarre behavior (barking like a dog), regressive, violent, very labile behavior
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Effects of overdose of PCP
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Psychosis, possible hypertensive crisis, CVA, resp arrest, hyperthermia, seizures
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Tx of overdose with LSD, mescaline, psilocybin
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room with low stimuli, "talk down", speak slowly/clearly in low voice, diazepam or chloral hydrate for extreme anxiety/tension
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Tx of overdose with PCP
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Acidify urine (cranberry/ascorbic acid); in acute stage, ammonium chloride; minimal stimuli; do not attempt to talk down, diazepam, haloperidol, medical intervention for: hyperthermia, high BP, resp. distress, HTN
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Methadone (Dolophine)
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Synthetic opiate blocks craving for and effects of heroin
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LAAM (l-α-acetylmethadol)
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An alternative to methadone
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Naltrexone (ReVia)
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Antagonist that blocks euphoric effects of opioids
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Clonidine (Catapres)
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Effective somatic treatment when combined with naltrexone
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Buprenorphine (Subutex)
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Blocks signs and symptoms of opioid withdrawal
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S/S of inhalant use
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euphoria, hallucinations, enhancement of sexual pleasure, giggling, laughter
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S/S of overdose with inhalants
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sudden death, numbness, weakness, loss of balance
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Tx of overdose of inhalants (organic solvents)
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no antidote
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Tx of overdose of inhalants (volatile nitrites)
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methylene blue and oxygen
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Tx of overdose of inhalants (anesthetics)
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neuropathy treated with B12
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Date rape drugs
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Flunitrazepam (Rohypnol or “roofies”)
Gamma hydroxybutyric acid (GHB) |
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Effects of date rape drugs
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Disinhibition
Relaxation of voluntary muscles Anterograde amnesia |
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Warning signs of impaired nurses
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Volunteers to work overtime, Leaves the unit often
Assigned patients complain of unrelieved pain, Inaccurate drug counts or increased “broken vials” |
