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45 Cards in this Set
- Front
- Back
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What percentage of patients admitted to the hospital have alcohol problems?
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About 10-20% of patients admitted to the hospital have alcohol problems
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What is the rate of substance abuse and primary care?
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Are listed and prescription drug abuse varies from 5-10% and primary care
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Where considered safe drinking limits?
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Under 65 years old
5 drinks per day 14 drinks per week female or over 65 years old 4 drinks per day 7 drinks per week |
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Define
at risk of drinking |
At risk drinking =
safe limits of drinking are exceeded, but abuse or dependency criteria are not met |
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What percentage of college students report binge drinking?
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40% of college students report binge drinking in prior 2 weeks
One third of college students meet criteria for alcohol abuse |
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Percentage of pregnant/nonpregnant women engage in binge drinking
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2% of pregnant women engage in binge drinking
13% of nonpregnant women engage in binge drinking |
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First trimester drinking can produce:
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Drinking during first trimester can produce:
Low birth weight decreased birth length. Decrease head circumference. My are physical abnormalities. Alcohol related neural developmental disorders |
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Second and third trimester drinking can produce
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Developmental delay can be caused by drinking during second and third trimesters
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Where the medical complications of illicit drug use
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Drug use is associated with medical complications of pregnancy.
Placental abruption. Placental insufficiency. Chorioamnionitis. Spontaneous abortion. Postpartum hemorrhage. Preeclampsia |
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What percentage of life threatening injuries involve alcohol?
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70% of life threatening injuries involving alcohol
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What is a chemical treatment of acute alcoholism?
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Treatment of acute alcoholism
Thiamine 100 mg IM. To prevent Wernicke's encephalopathy. Long-acting benzodiazepines to prevent and treat alcohol withdrawal syndrome |
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When does withdrawal from short acting benzodiazepines begin?
How long will it last? |
Withdrawal from short acting benzodiazepines may occur within 24 hours and lasts for several days
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What percentage of elderly have alcohol when admitted to the hospital?
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6-11% of elderly have alcohol in them when admitted to the hospital
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How does alcohol rank as a psychiatric disorder among elderly?
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Alcohol is a third most common psychiatric disorder among elderly.
One third of older alcoholics are late onset alcoholics diagnosed after age 65 |
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Why is alcohol metabolized different an elderly?
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Elderly have altered pharmacokinetics because of:
More body fat Less water than younger people. Therefore higher alcohol concentrations with less alcohol ingestion |
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Conditions associated with alcoholism in the elderly
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Conditions associated with alcoholism in the elderly include:
Depression. Delirium. Chronic fatigue. Seizures. Repeated infections. Hypertension. Malnutrition. Peripheral neuropathy. Sexual dysfunction. Cardiomyopathy. |
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Limitations of hair analysis for drugs.
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Hair analysis is:
More useful for forensic than clinical work. Can be incorporated from external environment. His present and higher concentrations in pigmented hair at the nonpigmented hair. Cosmetic treatments and ultraviolet exposure decrease concentrations of drugs |
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What level of creatinine must be present and urine for a valid drug sample?
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A urine must contain at least 20 ng/mL to be considered valid
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Where the temperature limits for a valid urine for urinalysis
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Urine must be between 90°-100°F within 4 minutes of collection
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Define
dilute urine |
A dilute urine contains to-20 mg/dL of creatinine
And specific gravity between 1.0010-1.0200 |
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Define
Substitute urine |
Substituted Urine: Creatinine <2 mg/dL
And specific gravity not between 1.0010-1.0200 |
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What substances does DOT test for?
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DOT tests for 5 substances.
Amphetamines. Cannabinoids. Cocaine. Opiates. PCP. |
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What are the best test for chronic alcoholism?
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The best test for chronic alcoholism are:
GGT. AST. MCV |
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How much alcohol must one consume to elevate GGT?
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5 drinks a day for 2 weeks Will elevated GGT in most individuals
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How fast will GGT decline with abstinence?
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GGT will decline
50% in 2 weeks. To normal in 2 months |
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What are some non-alcohol related conditions that can increase the MCV?
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Nonalcohol conditions that can raise MCV are.
Chronic liver disease. Hypothyroidism. Folate deficiency. Megaloblastic disorder |
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What is NADH?
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NADH is produced during oxidation of alcohol and can be a marker for alcohol abuse
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What chemicals can falsely elevate NADH?
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NADH can be falsely elevated with consumption of.
I so propanol. Methanol. Ethylene glycol. Acetone and diabetic ketoacidosis or starvation acidosis |
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Was a ratio of blood alcohol to breath alcohol?
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Ratio concentration of alcohol in the breath to alcohol in the blood is approximately 2100:1
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How long after an alcoholic drink can of breath analysis be done?
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Should wait 15 minutes after last drink before measuring blood alcohol limit the alcohol in the mouth
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Describe instructions for breath alcohol analysis
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Weight 15 minutes after less drink.
Subject takes deep breath and measures taken in the last third of breath. Shallow breath usually underestimates blood level |
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Discuss urine tests for alcohol
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Urine testing for alcohol is qualitative, not quantitative.
Positive tests indicates alcohol within preceding 8 hours. Ethanol glucuronide (ETG) is metabolite of alcohol and urine. Highly sensitive, but mouthwashes etc. we'll give false values |
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List most common amphetamines
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Most common amphetamines are.
Amphetamine. Methamphetamine. MDMA. = Ecstasy MVA. MDEA = Eve |
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With to the following stamp for?
MDMA. MDA. MDEA |
MDMA = ecstasy = 3, 4 methylene dioxy methamphetamine.
MVA = 3, 4, methylene dioxy amphetamine. MDEA = Eve = 3, 4 methylene dioxy N. Ethyl amphetamine |
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Which isomer of amphetamines as stronger effects?
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D. isomer of amphetamines is more active and has more potential abuse
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What will Vicks nasal inhaler give a false positive test for?
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Vicks nasal inhaler will give a false positive test for methamphetamine. It is the L. isomer
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What are some sympathomimetic amines that cross react with the urine test for amphetamines?
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The following will cross-react immunoassay for amphetamines.
Phenylpropylanine Pseudoephedrine. L. methamphetamine (Vicks). Appetite suppressants containing ephedrine and phentermine. Selegiline benzphetamine parent |
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How long are amphetamines detectable in urine?
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Amphetamines are usually detectable for one-3 days and year
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What chemicals will reduce detection of amphetamines in urine?
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A high pH will reduce excretion therefore ingesting bicarbonate will reduce detection of amphetamines
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What does urine test for amphetamines and methamphetamine actually test for?
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The urine immunoassay for amphetamines actually test for amphetamine and methamphetamine.
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What are the 3 classes a barbiturates based on duration of action?
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The 3 classes of barbiturates based on duration of action are.
Thiopental = ultrashort acting. Pentobarbital, secobarbital, amobarbital = short acting = most commonly abused. Phenobarbital = long-acting, low abuse potential |
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How long or short acting barbiturates detectable and urine?
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Short acting barbiturates are usually detectable for one-4 days in urine. This includes butabarbital, pentobarbital, secobarbital
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What drugs metabolized to oxazepam ?
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The following drugs metabolized to oxazepan.
Clorazepate. Chlordiazepoxide. Diazepam. Temazepam |
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What benzodiazepines are likely to be missed in urine screen for benzodiazepines?
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Urine test for benzodiazepines target oxazepam.
Can miss clonazepam. Lorazepam. Triazolam |
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What common drugs can give false positive for benzodiazepines?
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Urine test for benzodiazepines can give false positives with the following.
Oxaprozin. Sertraline tolmetin |
