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43 Cards in this Set

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Substance Abuse
self-administration of a drug in a manner that DOES NOT CONFORM to the NORMS w/in one's given culture or society. (many are not legal drugs or medications). AFFECT THE BRAIN, CNS
Designer Drugs
Synthetic drugs - created in illegal laboratories for the express purpose of profiting from illicit drug trafficking. (as opposed to natural substance such as opium, marijuana, cocaine, etc)
Addiction
p118 an overwhelming compulsion that drives someone to repetitive drug-taking behavior, despite serious health and social consequences
Attempts to predict a person's addictive tendency using psychological profiles or genetic markers have largely been . . . .
Unsuccessful
Substance abuse depends on variables that can be placed into 3 categories
1. Agent or drug factors - cost, availability, speed of onset/termination 2. User factors - genetic factors (innate tolerance, prior experience 3. environmental factors - social/community norms, role models, educational opportunities
Narcotic analgesics
may be used legally for pain relier or sedative for sleep disorder.
Prescription drugs ___ cause addiction when used according to accepted medical protocols. The risk for addiction is primarily a fx of the __and ____of therapy
RARELY, dose, length
Substance Dependence
When a person has an overwhelming desire to take a drug and cannot stop
Physical Dependence
p119 refers to an altered physical condition caused by the adaptation of the NS to repeated substance use. Uncomfortable symptoms, known as WITHDRAWAL result when agent is discontinued. More common ___: alcohol, sedatives, some stimulants, and nicotine
Psychological Dependence
p119 No obvious signs of physical discomfort after agent is discontinued. User,DOES have an overwhelming desire to continue use.Craving! Responsible for relapse during sub. abuse therapy. __ usually requires HIGH doses for a prolonged time. Marijuana,and anti-anxiety drugs. Crack - ONE TIME USE may create ___
Withdrawal Syndrome
After physical dependence and sub. is discontinued. strong for ALCOHOL and SEDATIVES.
Prescription Drugs may be used to reduce the severity of w/drawal symptoms for wh. substances?
Alcohol - short-acting benzodiazepine, Opiod - methadone, Nicotine - nicotine patches or chewing gum (no drug intervention for w/drawal for CNS stimulants, hallucinogens, marijuana, or inhalants
Tolerance
p120 biological condition that occurs when the body adapts to a substance after repeated administration. Over time, higher doses of the agent are required to produce the same initial effect.__ should be thought of as a NATURAL CONSEQUENCE of continued drug use and not be considered evidence of addiction or substance abuse.
Cross-Tolerance
p120 Once tolerance develops to a substance, it often extends to closely related drugs.
CNS Depressants
Cause clients to feel sedated or relaxed. Barbiturates, nonbarbiturat sedative-hypnotics, benzodiazepines, alcohol and opiods.
Sedatives
Tranquilizers - sleep disorders and certain forms of epilepsy. 2 classes - barbiturates and nonbarbiturate sedative-hypnotics. Phys and Psych dep. and tolerance develops if taken for extended period of time at high doses. (abusers alternate btwn amphetamines (awake) and barbiturates (relax)) Medical use of these have declined.
Overdose of Sedatives
Extremely dangerous! User may stop breathing or lapse into a coma, death. W/drawal symptoms similar to alcohol
(drug names end in "al")
Benzodiazepines
One of the most widely prescribed classes of drugs (have replaced barbiturates for certain disorders).
primary indication: anxiety, prevent seizures, and muscle relaxants ("am" ie diazepam). Abuse is not common, abusers appear carefree, sleepy. Death to overdose is rare. W/drawal less severe than barb.or alcohol
Opioids
Narcotic analgesics. Prescribed for severe pain, persistent cough, and diarrhea. from unripe seeds of poppy plant, opium, morphine and codeine, synthetic drugs - meperidine (Demerol), oxycodone (OxyContin), methadone (Dolophine) and heroin
Opioids CONTD
rush of euphoria, slowed body activities, constricted pupils, an increase in pain threshhold, and respiratory depression. Addictions occur quickly, w/drawal intense symtoms -not life threatening. treated with METHADONE
Alcohol
ETHYL alcohol. Small doses on a daily basis reduce risk of stroke and heart attack. increased blood flow to certain areas of the skin - flushed face and smell on the breath. liver metabolizes one drink an hour. Overdose: sever hypotension, respiratory failure, coma and death.
Alcoholism causes . ..
cirrhosis -debilitating and often fatal failure of the liver to perform its vital fxs. abnormal blood clotting and nutritional deficiencies, sensitizes the client to the effects of all medications metabolized by the liver.
For Alcoholic client
Nurse should begin therapy with reduced medication doses until the adverse effects of the medication can be assessed. milk thistle!
Alcohol withdrawal
SEVERE and may be life threatening. Use of anticonvulsants. Behavioral counseling etc. Disulfiram -causes liver to NOT METABOLIZE alcohol, making person drinking sick! Acamprosate calcium -maintaining alcohol abstinence in clients with alcohol dependence.
Acamprosate calcium
May benefit client who are not candidates for naltrexone therapy. M of A -restoration of neuronal excitation - the alteration of gamma-aminobutyrate and glutmate activity in CNS. Contraindicated for severe renal impairment but may be used in clients at risk for hepatoxicity
Cannabinoids (hemp plant)
include marijuana, hashish, and hash oil (usually smoked). Pyschoactice property - delta-9-tetrahdyrocannabinol. Causes paranoia, euphoria, thirst, craving for food, chocolate and candy, bloodshot eyes (caused by dilation of BVs). THC accumulates in gonads.
Cannabinoids (contd)
last up to 24 hrs. introduces 4 times more tar into the lungs than tobacco smoke! increase risk of lung cancer, chronic use - lack of motivation in achieving or pursuing life goals. LITTLE physical dependence, tolerance, w/drawal symptoms.
Hallucinogens
Diverse class of chemicals - produces an altered, dream-like state of consciousness. Prototype of this class, pyschedelics- LSD (Schedule I). Unlike most drugs that have predictable symptoms, hallucinogens depend on mood and expectation of use.
Users of LSD or psilocybin
Experience laughter, visions, deep personal insight, hallucinations, smells, bright lights,
LSD
Oral administration - capsule, tablet, etc . drops of drug on paper. lasts 6-12hrs. Affects the CNS and ANS, increasing H.R., B.P, B.T, Dil Pupil. impaired memory, and inability to reason, flashbacks, little or no dependence
Other Hallucinogens
Mescaline, MDMA (ecstacy), DOM (rave scene), MDA (love drug), PCP (trancelike state), Ketamine (date rape) primary legal use is an anesthetic, produces unconsciousness and amnesia
Abused CNS Stimulants
Increases the activity of CNS. Some by prescription treat narcolepsy, obesity, ADHD. Abused - produce sense of exhilaration, improve mental and physical performance, reduce appetite, prolong wakefulness ("get high"). Amphetamines, cocaine, methylphenidate, and caffeine
CNS stimulants effects
similar to those of neurotransmitter norepinephrine - affects awareness, wakefulness by activating neurons in the reticular formation. increases H.R., B.P, B.T, Dil Pupil. Long term use - coming down w/ fits of rage, anxiety, restlessness, etc
Amphetamines and dextroamphetamines, methamphetamine (ice)
methylphenidate
Amp - made illegally, Dex - legal use for short-term weight loss, to treat narcolepsy. Meth - Schedule II drug. Methylphenidate (Ritalin)- used for ADHD, calms children who are inattentive or hyperactive, stimulates alertness centers of the brain (Schedule II). Same effects as cocaine and amphetamines
Ritalin mixed with cocaine
p125 speedball, tablets are crushed and used intranasally or dissolved in liquid and injected IV.
Cocaine
p125 Natural substance, leaves of coca plant - Andes Mtns. Eaten/chewed by locals - no ill effects. Schedule II. Similar effects to amphetamines but more rapid and intense. 2ND MOST COMMONLY abused drug. Small doses: intense euphoria, decrease in hunger, analgesia, illusions of physical strength, increased sensory perception. Larger doses: also cause rapid heartbeat, sweating, elation of the pupils and elevated B.T
Cocaine after effects
p125 irritability, insomnia, depression, extreme distrust, insects crawling under the skin, runny nose (chronic users), crusty redness around nostrils, Overdose: dysrhythmias, convulsions, stroke, death. W/drawal syndrome for amph. and cocaine is much less intense than that fr. alcohol or barbiturate abuse.
Caffeine
p125 Natural substance - often included in OTC pain relievers to increase effectiveness of pain medications. Mental alertness, restlessness, nervousness, irritability, insomnia, bronchodilation, increased BP, increased stomach acid, ghanges in glucose levels. repeated use - physical dependence and tolerance. W/drawal symptoms
Nicotine
p125 Is unique among abused substances in that it is legal, strongly addiction, and highly carcinogenic. 2nd hand smoke affects others. Nicotine -primary addictive substance in cigarette. lasts 30 min -several hours.
Nicotine cont'd
stimulates CNS directly, causing increased alertness and ability to focus, feelings of relaxation, and light-headedness. accelerated HR, increased BP - caused by activation of nicotinic receptors located throughout ANS. Serious for users taking oral contraceptives!! Fatal heart attacks.
Nicotine affects Endocrine and psychological and physical depedence
increasing basal metabolic rate, weight loss, reduces appetite. CHRONIC use: bronchitis, emphysema, lung cancer. Quickly dependence. Discontinued use: agitation, weight gain, anxiety, headache, extreme craving for drug. Only 25% of clients who attempt to stop smoking remain tobacco-free a year later.
Nurses Role
Medical history must include questions about substance abuse. IV users - HIV, hepatitis, TB etc . .
p120 STUDY THIS PAGE!
w/drawal symptoms and characteristic for selected drugs