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39 Cards in this Set
- Front
- Back
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4 "C's" of addiction |
Compulsive disorder Cravings Chronic relapsing brain tumor Cognitive impairment |
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Theories of addiction |
Biological Genetic Psychological Behaivioral Sociocultural |
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Biological theory |
specific effects on selected neurotransmitters pleasure center of brain |
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Genetic theory |
40-50% of vulnerability (more likely if have parents w/addiction) |
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Psychological theory |
self medication, low self-esteem, lack of impulse control, defense against anxious impulses tend to use more than 1 substance |
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Tolerance vs. Withdrawl |
Tolerance- body adapts, increasing amt needed to produce effect
Withdrawal- after long period of use, stoping results in physical & psychological s&sx |
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what is the psychiatric comorbidity w/addiction |
50% w/serious mental illness also have substance abuse problem |
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2 important ?'s w/assessment on substance abuse |
1- in the last yr have to ever drank or used drugs more than you meant to
2- have you felt you wanted or needed to cut down on your drinking/drug use in the last year |
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details of usage w/assessement (4 things) |
route quantity *time of last use usual pattern of use |
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alcohol withdrawal s&sx timing |
early signs w/in few hours of decreasing intake
signs peak in 24-48 hrs |
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alcohol withdrawal s&sx |
hyper-alertness jerky movement irritability easily startled "shaking inside" |
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alcohol withdrawal tx |
reduce pt anxiety orient to time and place clarify illusions to reduce client tremor |
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alcohol withdrawal delirium, what is it |
medical emergency, can result in death (CIWA- point scale)
tachy, diaphoretic, ^BP, hallucinations, agitation, paranoid illusions, fever, grand mal seizure |
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alcohol withdrawal delirium, timing |
peaks at 2-3 days after cessation, lasts 2-3 days |
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Med tx for alcoholism |
trexan, revia (naltrexone)
campral (acamprosate)
antabuse (disulfiram) |
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Trexan, Revia (naltrexone) |
blocks opiate receptors interferes w/mechanism of reinforcement reduces or eliminates the "high" and drug craving |
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Campral (acamprosate) |
helps pt abstain from alcohol reduces unpleasant effects of abstinence (axiety) reduces craving
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Antabuse (disulfiram) |
works on classical condition principle
alcohol-disulfiram rxn causes unpleasant S.E. |
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other alcoholism tx |
inpatient, outpatient health education |
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CNS stimulants |
cocaine, crack, amphetamines |
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common signs of stimulant abuse |
pupil dilation dryness of nasal cavity excessive motor activity |
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s&sx of withdrawal from stimulants- cocaine & crack |
depression, paranoia, lethargy, anxiety, insomnia, nausea, vomiting, sweating, chills |
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tx for withdrawal |
antidepressants (desipramine) dopamine agonist- bromocriptine |
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s&sx of hallucinogen use |
pupil dilation tachy tremors diaphoretic grandiosity |
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toxicity of hallucinogen |
psychosis brain damage death |
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OD s&sx of inhalants |
fatal cardiac rhythm interferes w/O2 to vital organs |
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"rave drugs" MDMA, MDE, MDA S.E. |
euphoria, ^energy, self confidence, closeness to others
adverse- hyperthermia, dehydration, kidney failure, heart failure |
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tx for "rave drugs" |
no antidote
treat symptoms |
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tx for date rape drugs (rohypnol, GHB) |
flumazenil- reduces sedative effect |
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opiates |
morphine, heroin, codeine, fentanyl, methadone |
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withdrawal effects from opiates |
stomach cramps, n/v, muscle aches, chills, fever, diaphoretic, yawning
toxicity- resp depression, cardiac arrest |
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tx for OD of opiates |
Narcan- reverses CNS depression |
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tx for opioid addictions |
methadone LAAM Naltrexone (trexan, revia) Naloxone (Narcan) clonidine (catapres) |
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methadone |
synthetic opioid blocks craving only med approved to treat pregnant opioid addict |
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LAAM |
methadone alternative |
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Naltrxone (trexan, Revia) & Narcan |
antagonist that blocks euphoric effects |
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Clonidine (catapres) |
non-opioid suppressor of opioid withdrawal symptoms effective somatic tx when combined w/naltrexone |
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responsibility of co-worker of impaired nurse |
clear documentation report facts nurse manager takes action |
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# nurses w/chemical dependence |
10-20% |
