Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
158 Cards in this Set
- Front
- Back
|
Continued use of drug despite related problems
|
substance abuse
|
|
|
A severe condition usually considered a disease. There may be physical problems with serious disruptions in the person's work, family, and social life.
|
Substance dependence
|
|
|
the psychosocial behaviors related to substance dependence.
|
addiction
|
|
|
Co-existence of substance abuse and one or more psychiatric disorder
|
dual diagnosis
|
|
|
biological need that develops when the body becomes adapted to having the drug in the system
|
withdrawal symptoms
|
|
|
with continued use, more of the substance is needed to produce the same effect
|
tolerance
|
|
|
The most common period for the first experience with drugs
|
adolescence
|
|
|
If regular use of alcohol and drugs is used before this age, the individual is more likely to have abuse and dependence problems as an adult
|
17
|
|
|
These groups have the highest excessive alcohol use
|
American Indians and Alaska Natives
|
|
|
A 3-item screening tool used to identify individuals who are hazardous drinkers or have active alcohol use disorders
|
AUDIT-C
|
|
|
the quickest drug abuse screening tool
|
B-DAST
|
|
|
public health approach to delivering early intervention to anyone who uses alcohol or drugs in unhealthy ways
|
SBIRT
|
|
|
The goal of SBIRT
|
Improve early identification of people who are overusing, abusing, or dependent on alcohol or other substances
|
|
|
The simplest biological measure to obtain a BAC
|
breathalyzer
|
|
|
blood alcohol is measured by a
|
breath device, urinalysis, or blood test
|
|
|
High tolerance is usually a sign of
|
physical dependence
|
|
|
Euphoria, labile mood, cognitive disturbances: decreased concentration, impaired judgment, loss of sexual inhibitions
|
0.05-0.14
|
|
|
Slurred speech, staggering gait, diplopia, drowsiness, labile mood with outburts
|
0.15-0.19
|
|
|
Stupor, aggressive behavior, incoherent speech, labored breathing, vomiting
|
0.2-0.29
|
|
|
Coma
|
0.3-0.39
|
|
|
Severe respiratory depression, death
|
0.4-0.5
|
|
|
Types of CNS depressants
|
Alcohol, barbiturates, benzos
|
|
|
More than 7 drinks per week or more than 3 per occasion for women; more than 14 drinks per week or more than 4 per occasion for men
|
risky or hazardous drinking
|
|
|
A person is experiencing physical, social, or psychological harm from alcohol use but does not meet the criteria for dependence
|
harmful drinking
|
|
|
When the person continues to drink to avoid withdrawal symptoms
|
physical and psychological dependence
|
|
|
tolerance develops to this class of drug rapidly
|
barbiturates
|
|
|
The preferred treatment for anxiety and related disorders
|
benzo
|
|
|
Amphetamine and cocaine
|
stimulants
|
|
|
act by releasing norepinephrine and dopamine from neuronal storage vesicles into the synapse
|
amphetamines
|
|
|
Changes the brain's chemistry, destroying the wiring in the brain's pleasure centers.
Damages the dopamine receptors and neurons decreasing the ability to experience pleasure without using the drug |
Methamphetamine (meth)
|
|
|
Can lead to hyperactive, obsessive, and violent behavior
|
methamphetamine
|
|
|
Causes blood vessels to constrict, it cuts off the steady flow of blood to all parts of the body, causing tissues damage and inhibits the body's ability to repair itself.
|
Meth
|
|
|
Acne develops, sores takes longer to heal, and the skin loses its luster and elasticity; poor dental
|
meth
|
|
|
Destruction caused by meth can be repaired with ____ of sobriety
|
more than 1 year
|
|
|
The cognitive effects that remain with meth use
|
severe impairment in memory, judgment, and motor coordination - symptoms similar with a pt with PD
|
|
|
Legal use of amphetamines
|
Narcolepsy, ADHD in children and adults, short-term weight reduction
|
|
|
the form of cocaine that is smoked is produced by a process
|
freebasing
|
|
|
The euphoria caused by cocaine starts with a ____ rush and followed by a _______ of less intense euphoria
|
10 to 20-second rush; 15 to 20 minute less intense euphoria
|
|
|
A person high on cocaine feels
|
euphoric, energetic, self-confident, and sociable
|
|
|
blocks the reuptake of norepi and dopamine, the receptors are continually activated causing euphoria
|
cocaine
|
|
|
presynaptic supplies of dopamine and norepi are depleted with cocaine cause a
|
crash as the drug wears off
|
|
|
Addiction to barbituates
|
downers
|
|
|
Addiction to stimulants
|
uppers
|
|
|
Opiates include
|
opium, heroin, meperidine, morphine, codeine, and methadone
|
|
|
Patients taking a maintenance dose of ______ may work and live normally, although they are still addicted to narcotics.
|
methadone
|
|
|
one characteristic of narcotic addiction is the development of
|
tolerance
|
|
|
the most important psychological response to opiate use is
|
euphoria
|
|
|
other psychological effects of narcotics include
|
apathy, detachment from reality, and impaired judgment
|
|
|
apathy, detachment from reality, and impaired judgment are also termed ___ when combined with drowsiness
|
nodding out
|
|
|
an OD of narcotics can rapidly lead to
|
coma, respiratory depression, and death
|
|
|
natural substances that act like morphine in the brain are known as
|
endorphins and enkephalins
|
|
|
endorphins and enkephalins bond with opiate receptors in
|
the brain and the pituitary gland
|
|
|
when large amounts of artificial opiates are taken over a long period, the brain responds by cutting off production of endorphins in an attempt to restore homeostasis. As the artificial opiates leave the system, there are no natural opiates to take their place.
|
theory of drug cravings
|
|
|
Causes sedation, an altered state of awareness, accompanied by a feeling of relaxation and mild euphoria
|
marijuana
|
|
|
prolonged use of marijuana may lead to
|
apathy, lack of energy, loss of desire to work or be productive, diminished concentration, poor personal hygiene, and preoccupation
|
|
|
apathy, lack of energy, loss of desire to work or be productive, diminished concentration, poor personal hygiene, and preoccupation is known as
|
amotivational syndrome
|
|
|
May precipitate psychosis when used by people with schizophrenia whose symptoms are otherwise controlled with antipsychotic drugs
|
marijuana
|
|
|
Marijuana's withdrawal pattern
|
one has not been documented
|
|
|
How many states have enacted laws legalizing medical marijuana?
|
16 plus D.C.
|
|
|
Drugs that create experiences very similar to those typical of a psychotic state
|
hallucinogens
|
|
|
Hallucinogens produce
|
perceptual distortions
|
|
|
LSD, peyote, mescaline, and psilocybin are commonly used
|
hallucinogens
|
|
|
Colorless and tasteless, often added to a drink or food, such as a sugar cube, and can be given to a person without the person knowing
|
LSD
|
|
|
Colors are described as more brilliant and sounds, smells, and tastes are heightened
|
LSD
|
|
|
Crossover of sensory experiences during which music may be seen or colors may be heard, with space and time distorted.
|
synesthesia
|
|
|
______ do not appear to cause physical dependence, but tolerance develops if they are used regularly; but causes impaired judgment and vulnerable people may experience "bad trips"
|
hallucinogens
|
|
|
Psychotic episodes in which the person may experience being paranoid, grandiose, or somatic delusions, usually accompanied by vivid hallucinations
|
bad trips
|
|
|
Taken to induce euphoria, a sense of intimacy with others, and diminished anxiety; one of the most widely used recreational drug in the world.
|
ecstasy
|
|
|
Ecstasy users usually report feeling the effects within ____, peaking at _____, and a plateau that lasts about ____
|
30 to 60 minutes
1 to 1.5 hours 2 to 3 hours |
|
|
At low doses, the user experiences euphoria, floating feeling, along with heightened emotionality and incoordination
|
PCP
|
|
|
PCP use may precipitate an intensely ______ characterized by extreme agitation.
|
psychotic experience
|
|
|
Because PCP is an _____, people feel
|
anesthetic; little to no pain
|
|
|
Butane gas (lighter fluid), gas, air fresheners, rubber cement, correction fluid, and nitrous oxide
|
inhalants
|
|
|
Used to obtain a euphoric effect because of the quality of high, the rapid onset of effect, and the low cost, and ease of availability.
|
inhalants
|
|
|
A runny nose, a pimple or sores around the mouth, symptoms of a cold
|
inhalants
|
|
|
Both a stimulant and depressant
|
nicotine
|
|
|
lung irritant
|
nicotine
|
|
|
readily absorbed into the bloodstream and has an almost immediate effect on the reward systems in the brain
|
nicotine
|
|
|
mimics acetylcholine; stimulates the release of dopamine and prolongs the action of dopamine by decreasing the metabolizing enzyme monoamine oxidase and increases the expression of nitric oxide, which inhibits dopamine reuptake
|
nicotine
|
|
|
Smoking is associated with
|
increased morbidity and mortality
|
|
|
An active ingredient in coffee, tea, chocolate, and many carbonated beverages
|
caffeine
|
|
|
major effects of caffeine use
|
increased alertness and increased BP
|
|
|
overuse of caffeine may cause
|
jitteriness
|
|
|
headache, irritability, sleepiness, fatigue, problems in attention and concentration, and decreased vigor
|
caffeine withdrawal
|
|
|
Rohypnol, GHB, and ketamine
|
date rape drugs
|
|
|
date rape drugs are so dangerous because
|
they can be slipped into a drink without being detected because they have no color, smell, or tastes.
|
|
|
Potential effects of date rape drugs
|
weakness, confusion, oss of consciousness, coma, and death.
|
|
|
people who had problems living in a committed relationship with a person with an addiction
|
codependency
|
|
|
With codependency, the person with the addiction is addicted to the drug, while the codependent person is
|
addicted to the person with the addiction
|
|
|
a support group for friends and family of people with alcoholism, created specifically to help family members cope with their own problems that stem from living with a person with alcohol
|
Al-Anon
|
|
|
Anyone who had had anything to do with a dysfunctional person while growing up or as an adult
|
codependency
|
|
|
Co-occurrence of psychiatric and substance use disorders
|
dual diagnosis
|
|
|
even small amounts of ____ may precipitate psychotic episode in a patient with schizophrenia
|
cocaine
|
|
|
the tendency of a substance abuse to run in families
|
biological factor
|
|
|
___ people are predisposition experience a physiological response to alcohol
|
Asian
|
|
|
Asian people experience this when drinking alcohol
|
flushing, tachycardia, and an intense feeling of discomfort
|
|
|
Clinicians have observed a link between substance abuse and several psychological traits, such as
|
depression, anxiety, antisocial personality, and dependent personality
|
|
|
Northern europeans have a higher rate of
|
alcoholism
|
|
|
highest/lowest rate of religions with alcoholism
|
roman catholics; Jewish
|
|
|
___ of symptoms depends on the half-life of the particular drug
|
time course
|
|
|
____ of symptoms depends on the drug dose and length of use
|
severity
|
|
|
higher-than-therapeutic doses for moth than 1 month can produce
|
physical dependence
|
|
|
an intensified return of the symptoms for which the drug was prescribed in the first place
|
symptom rebound
|
|
|
the _____ system is a pathway in the brain that originates from dopamine-producing cells in the brainstem and targets higher regions of the brain
|
mesolimbic dopamine
|
|
|
the expected outcome for patients in withdrawal from drugs or alcohol
|
the patient will overcome withdrawal safely and with minimal discomfort
|
|
|
expected outcome for patients dependent on drugs or alcohol
|
the patient will abstain from all mood-altering chemicals
|
|
|
____ is an essential aspect of care for drug-dependent patients
|
development of a support system
|
|
|
a pattern of behavioral, physiologic, and cognitive symptoms that develop due to substance use or abuse; usually indicated by tolerance to the effects of the substance and withdrawal symptoms that develop when use of the substance is terminated
|
substance dependence
|
|
|
The excessive use of a substance, especially alcohol or a drug. A pattern of harmful use of any substance for mood-altering purposes
|
substance abuse
|
|
|
Treatment of choice for nicotine
|
nicotine replacement therapy
|
|
|
treatment of choice for alcohol
|
naltrexone
|
|
|
Naltrexone with alcohol
|
reduces alcohol reward and results in decreased alcohol craving and reduced drinking
|
|
|
Treatment of choice for heroin
|
Methadone
|
|
|
The process of helping a person with an addiction safely through withdrawal is
|
detoxification
|
|
|
Fluids, eating, acetaminophen, kaopectate, small amount of milk, seizure precautions, a cool washcloth to the forehead, position changes
|
how the patient should be treated symptomatically
|
|
|
difficulty walking
|
ataxia
|
|
|
involuntary rhythmic eye movements
|
nystagmus
|
|
|
the drug of choice in treating alcohol withdrawal, prevent seizures, and have a better margin of safety
|
benzos
|
|
|
LSD patients experiencing a "bad trip" often respond to
|
reassurance and may be talked down.
|
|
|
Patients coming down from a LSD "bad trip" should
|
be oriented frequently, discouraged from closing their eyes.
|
|
|
People with a PCP-induced psychosis do not respond well to
|
attempts at interactions
|
|
|
PCP and meth users are more likely to
|
become violent and strike out in response to their misperceptions and panic
|
|
|
PCP feels little to no ___ and have ____
|
pain; enormous strength
|
|
|
Acutely agitated PCP and LSD users require
|
a safe environment that has minimal stimulation
|
|
|
The time when a pt is at highest risk for relapse
|
the first months after cessation
|
|
|
an opiate antagonist effective in helping the alcoholic pt maintain abstinence, as it diminishes the craving during the early stages of abstinence and works best when accompanied by psychosocial interventions
|
naltrexone
|
|
|
a long-acting injection of naltrexone
|
vivitrol
|
|
|
interrupts the metabolism of alcohol, causing a buildup of a toxic substance in the body if the person uses alcohol in any form
|
disulfiram
|
|
|
disulfiram's physiological response may include:
|
a severe headache
N&V flushing hypotension tachycardia dyspnea diaphoresis chest pain palpitations dizziness confusion |
|
|
When a pt is taking disulfiram, they need
|
a written list of alcohol containing products, so they are able to avoid them.
|
|
|
Cough medicines, rubbing compounds, vinegar, aftershave lotions, and some mouthwashes
|
interact negatively with disulfiram
|
|
|
How long after d/c disulfiram can a person drink without the side effects?
|
14 days
|
|
|
An opioid antagonist that is structurally similar to naltrexone but with a number of advances for the treatment of alcohol dependence
|
nalmefene
|
|
|
No dose-dependent association with toxic effects to the liver, greater oral bioavailability, longer duration of antagonist action, and more complete binding with opioid receptor subtypes that are thought to reinforce drinking
|
nalmefene
|
|
|
demonstrated an increase in abstinence of alcohol drinking through decreased craving of alcohol
|
acamprostate
|
|
|
shows to positively affect length of total abstinence, time to relapse, total number of nondrinking days, and retention in treatment with minimal SEs (diarrhea, headache)
|
acamprostate
|
|
|
a selective SSRI that augments central serotonergic function approved for the treatment of depression
|
Celexa
|
|
|
Shown to reduce alcohol consumption and craving in patients with early-onset alcohol dependence
|
zofran
|
|
|
Problem with methadone treatment?
|
Class II drug, special treatments, patients have to go daily to receive medication
|
|
|
A partial agonist at opioid nerve receptors. Mimics the effects of opioids in some situations but blocks or reverses those effects in other situations by displacing opioids when they are present in excessive amounts
|
buprenorphine
|
|
|
consumption of alcohol and drugs during pregnancy can result in
|
miscarriage, low birth weight, premature labor, placental aburption, fetal death, and even maternal death.
|
|
|
Pregnant women addicted to heroin, ______ is safer for teh fetus than acute opiate detox
|
methadone maintenance
|
|
|
include goal setting, self-monitoring, functional analysis of drinking antecedents, and learning alternative coping skills
|
self-control strategies
|
|
|
focuses on learning skills for forming and maintaining interpersonal relationships, assertiveness, and drink refusal
|
social skills training
|
|
|
involves creating a written agreement with the patient that specifies targeted patient behavior and consequences
|
behavioral contracting
|
|
|
involves patients receiving incentives or rewards for adaptive behavior or meeting specific behavioral goals
|
contingency management
|
|
|
return of symptoms
|
relapse
|
|
|
relapse is dealt with as an
|
error from which to learn -- a temporary setback on the road to recovery
|
|
|
People, places, and things that have been associated with previous drug use
|
external triggers
|
|
|
situations that include all people, places, and things with a previous drug use is classified as
|
high-risk situations
|
|
|
thoughts and feelings contributing to past drug use, such as loneliness, boredom, or anger
|
internal triggers
|
|
|
family members that may cover up by making excuses to employees and other family members for the person's erratic behavior, but also ones that may tend to blame themselves for the behavior
|
enabling
|
|
|
addiction is a
|
family problem
|
|
|
goal for groups like Alcoholics Anonymous
|
total abstinence
|
|
|
goal of engagement
|
development of working relationship between pt and nurse
|
|
|
goal of persuasion
|
pt acceptance of having a substance abuse problem and the need for active change strategies
|
|
|
goal of active treatment
|
abstinence from substance use and compliance with medication
|
|
|
goal of relapse prevention
|
absence or minimization of return to substance abuse
|
