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30 Cards in this Set
- Front
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ethyl alcohol pharmacology
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rapidly and completely absorbed from GI tract. Oxidized in the liver to acetyladehyde then matabolized to CO2. Exreted from lungs and urine
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Intoxication
mild: moderate: severe: tx: |
impaired judgement, emotional lability.
dilated pupils, slurred speech, ataxia, staggering gait. coma, seizures, death ventilation, fluids, thiamine, glucose, sodium bicarbonate, magnesium |
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ethyl alcohol withdrawl
stage 1: stage 2: stage 3: |
6-8 hours after use, agitation, autonomic nervous system hyperactivity
hallucinations, paranoid behavior, and amnesia. 3-5 days after, disorientation, delusions, grand mal seizures |
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chronic effects of ethyl alcohol
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malnutrition-protein deficiency, also water-soluble vitamins and minerals
vascular changes-impotence, esophageal varices, arrhythmias and hypertension fetal alcohol syndrome in pregnant women Increased cancer risk-oral, larynx, esophagus, and liver hepatitis- liver cirrhosis, fatty liver |
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Red flags for alcoholism
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early drinking, blackout, missing work, personal problems-such as numerous wrinkles on a person's forehead to cause self confidence issues.
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self test for alcoholism
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CAGE
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Tx for alcoholism
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alcoholics anonymous, disulfiram, naltrexone
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disulfiram
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causes significant side effects if alcohol is ingested while on the drug.
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naltrexone
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oral opiod antagonist used to reduce alcohol cravings (suggesting maybe opioid receptors play a role in alcoholism)
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signs of advanced alcoholism
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edema, puffy face, parotid gland enlargement, advanced perio disease, sweet musty breath odor, ecchymoses, petechiae, telangectasias.
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dental management concerns for CNS depressants
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liver-impaired drug metabolism, bleeding abnormalities
oral- glossitis, angular heilitis, candida infection |
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nitrous oxide
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abuse-psychological but NOT physical, inhalation of 50% to 75% produces a "high" for 30 sec follow by sense of detachment for 2-3 min.. causes a tingling or warmth around the face, auditory illusions, slurred speech, and stumbling gait
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N2O intoxication
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dizziness, headache, tachycardia, syncope, and hypotension, impairs ability to drive or operate machinery.
Equilibrium, balance, and gait are affected with chronic use, mental dysfunction and infertility will result. Inhaling 100% Nitrous causes nausea, cyanosis, hypoxia that results in death |
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myeloneuropathy
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occurs with chronic abuse of nitrous
loss of finger dexterity, numbness of extremities, positional and vibratory neural sensations lost, cannot discern pain, light touch perception, temperature sensation |
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opioid analgesic pharmacology:CNS depressants
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heroin, methadone, morphine, hydromorphone, merperidine, oxycodone, and pentazocine* most commonly abused opioids.
elevate the user's mood, cause euphoria, relieve fear and apprehension, produces feeling of peace and tranquility |
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CNS depressant opioid analgesic abuse
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fixed, pinpoint pupils, resp. depression, hypotension and shock. slow or absent reflexes drowsiness or coma.
Tolerance develops to most effects except miosis and constipation |
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opioid withdrawal
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initial withdrawal yawning, tearing runny nose, sweating, restless sleep. anorexia, tremors, irritability, weakness, and excessive GI activity,
Increased heart rate, elevated BP chills/sweating, without tx symptoms disappear ater 8 days! |
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management acute overdose
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naloxone- if no response respiratory depression due to other causes
metadone- used to make pts comfortable during withdrawal, then eventually replaces drug |
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pain management of addicts
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NSAIDs- prescribed for pain or refer to MD for pain management
Be alert for drug seekers! Increased endocarditis risk- 30% chance of developing valve damage in IV drug users chronic pain-monitor suspicious refills through other healthcare providers |
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sedative hypnotic pharmacology
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barbituates, alcohol, meprobamate, chloral hydrate, benzodiazepines, and N2O. initial effects-slurred life.
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CNS stimulation is due to increased sensitivity as a result of what?
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blockage of inhibitory fibers leaving excitatory fibers unopposed
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date rape drug
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short acting benzodiazepines rophanyl "ruffies"
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first priority in managing and overdose???
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maintain life support!!!!!
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tx of acute overdose
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replace with a long acting benzodiazepine (valium or librium**) and gradually reduce it.
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cocaine
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stimulant action, free-base form (crack) is more pure and potent and addicting, the onset of euphoria is quicker
psychologic dependence becomes intense, but neither tolerance nor withdrawal has been shown. used primarily as a local anesthetic on mucous membranes of the nose to produce vasoconstriction and control hemorrhage |
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methamphetamines
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meth, dextroamphetamine, diethylopropion, methylphenidate, and phenmetrazine,
Theyre abused for their ability to produce a euphoric mood, increased energy and alertness, and a feeling of omnipotence and self-confidence pupil dilation, increase BP and RPM, anorexia and sweating. |
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methamphetamine overdose management
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phenothiazine-psychotic symptoms
amytriptyline for severe depression |
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Psychedelics (Hallucinogens) Phencyclidine
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angel dust "PCP" originally developed as a tranquilizer, inhibits re-uptake of dopamine, serotonin and nor-epinephrine
bizarre behavior aka Nicole |
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marijuana
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reddening of eyes, behavior changes, hand tremors. produce euphoria, and enhanced sensory perception followed by sedation
alters perceptual ability |
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adverse effect of marijuana
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apprehension, panic, losing one's mind.
physical dependence rare xerostomia is present and inflammation various keratotic lesions and leukoplakia chronic bronchitis and pre-cancerous changes THC reduces intraocular pressure and used in glaucoma tx. also used to tx nausea associated with chemo |