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28 Cards in this Set

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Is alcohol a depressant or a stimulant?
both
How is alcohol abuse diagnosed?
if there is clearly recurrent (but not continuous) impaired social & occupational function due to alcohol use over a 1 year period
When does a patient have alcohol dependence?
if the patient also has tolerance (increased amounts need to achieve effect), withdrawl, and/or compulsive and continuous use
What are the 2 groups of alcoholics?
• Type 1
• Type 2
Describe a Type 1 alcoholic
• adult onset
• steady, gradually escalating consumption
• guilty, worried, rigid, perfectionistic, dependend, introverted
• modest family history
• both males and females
• some recover completely
• 75% of alcoholics
Describe a Type 2 alcoholic
• alcohol-seeking from adolescence & early adulthood
• impulsive, distractible, risk-taking, antisocial characteristics w/ recklessness & aggression
• strong family history
• primarily males
• very treatment resistant
• 25% of alcoholics
What are signs and symptoms of alcoholism?
• anxiety
• blackouts
• depression
• frequent injuries/accidents
• headaches
• insomnia
• nausea/vomiting
• palpitations
• tachycardia
• vague GI problems
What is the CAGE acronym?
• C: Cut down (Have you ever felt you should cut down on your drinking?)

• A: Annoyed (Have people annoyed you by criticizing your drinking?)

• G: Guilty (Have you ever felt bad or guilty about your drinking?)

• E: Eye-opener (Have you ever had a drink first thing the morning to steady your nerves or get rid of a hangover?)

* two or more positive answers suggests alcoholism
What lab markers are elevated in chronic drinking?
• gamma-glutamyl transferase (GGT)
• RBC MCV
What are the characteristics of the different stages of alcohol intoxication and their corresponding blood alcohol level?
• euphoria, disinhibition, alcohol breath (up to 100 mg/ml)
• irritability, incoordination, mood swings (100-150 mg/ml)
• apathy, dysarthria, ataxia (150-250)
• Alcoholic coma (250-450)
What makes up a "bananna bag"?
• MVI
• folic acid
• thiamine
What are the different syndromes of alcohol withdrawl?
• alcohol withdrawl
• alcohol withdrawl delirium
• alcohol-induced psychotic disorder w/ hallucinations
What are characterisitics of alcohol withdrawl?
• tremulousness, N/V, anxiety, tinnitus, blurred vision
• usually begins during the 1st day of reduced drinking
• convulsions can occur on the 2nd day
What are characteristics of alcohol withdrawal delirium?
• agitation
• ataxia
• delusions
• disorientation
• fever
• hallucinations
• memory disturbances
• tremor
What are characteristics of alcohol-induced psychotic disorder?
• auditory hallucinations
• mixed withdrawal symptoms (mild tremor, anger, apprehension)
• patient has a clear sensorium and is oriented
• usually occurs in the first 3 days after cessation of drinking
What are medical complications of chronic alcoholism?
• anemia
• cirrhosis
• diarrhea
• gastritis
• gastric ulcer
• hypertension
• insomnia
• pancreatitis
• persistent impotence
• vitamin malabsorption
What are neurologic complications of chronic alcoholism?
• alcoholic cerebellar degerneration
• alcoholic myopathy & cardiomyopathy
• cerebral atrophy
• central pontine myelinolysis
• Marchiafava-Bignami disease
• peripheral neuropathy
• Wernicke
What are psychiatric complications of chronic alcoholism?
• Alcohol-induced persisting dementia
• drug abuse
• Korsakoff's syndrome
• suicide
What medication should be used in the treatment of alcohol withdrawl to sedate until calm?
• benzadiazepines
• carbamazepine or depakote (is next best alternative)
What medication can be used to treat tremulousness in alcohol withdrawl?
• Librium (Chlordiazepoxide)
• Lorazepam or Oxazepam (may be better in pts w/ liver disease or confusion
What medications can be used to treat delirium from alcohol withdrawl?
• Librium (Chlordiazepoxide)
• low-dose Haloperidol (if Benzodiazepines does not work alone)
• Cloninde (relieves sweating, tremor, tachycardia)
• atenolol (used with Benzo can shorten the course of delirium)
What drug can be used to decrease craving in treating alcoholics?
Naltrexone (ReVia)
What is the MOA of Disulfiram (Antabuse)?
• inhibits aldehyde dehydrogenase leading to toxic acetaldehyde build-up
• causes anxiety, apprehension, headache, hypotension, N/V, sweating, tachycardia
What is the difference between drug abuse and drug dependence?
• Abuse: marked social/occupation impairment and compulsive excessive drug use over a period of a year

• Dependence: presence of tolerance, withdrawal, and/or continuous compulsive use over a 1-year period
What are illnesses that IV drug abusers are in danger of getting?
• cellulitis
• hepatitis
• HIV/STDs
• pneumonia
• SBE
• TB
• tetanus
• thrombophlebitis
What are the psychological symptoms of opioid intoxication?
rush or dysphoria followed by drowsiness
What are the physical symptoms of opioid intoxication?
• bradycardia
• constipation
• hypotension
• hypothermia
• miosis
• N/V
• respiratory depression
• slurred speech
What are symptoms of opioid withdrawal?
• decreased appetite
• fever
• intense craving
• N/V
• pupil dilatation
• sweating
• yawning