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Psych Midterm
Question | Answer |
---|---|
Addiction | can be either physical or psychological. a. A behavioral pattern of compulsive drug use. |
Physical | very dangerous to withdraw without chemical dependency. Needs close supervision. |
Psychological | not dangerous to stop with medical tx. |
Tolerance | physiologic result of repeated doses or ingestions where same dose/amount no longer gives the same effect. |
Habituation | to frequent or cause addiction. |
Theories of Dependency-Biologic | not clearly understood. There may be gene that alcoholics have that the rest of us don’t have. It may be why it seems hereditary. |
Theories of Dependency-Sociocultural | environment. Who your with and what you are doing. |
Theories of Dependency-Behavioral | learned to be a maladaptive way of doing/dealing with stress and anxiety |
Theories of Dependency-Interpersonal | correlation of infant-mother bonding. |
Drug dependency considered a physical illness: | 1. Incurability 2. Genetic predisposition to develop addiction under the right circumstances. 3. Cured by total abstinence |
Personality traits: | 1. Self-centered 2. Strong need to be in control of others 3. Seeking Attention 4. Great difficulty delaying gratification |
Consequence/Patterns | 1. Withdrawal 2. Symptoms 3. Alcohol 4. Significant work |
Defense Mechanisms Utilized-Denial | minimize/deny problem of alcoholism |
Defense Mechanisms Utilized-Rationalization | attempt to justify reason for abuse |
Defense Mechanisms Utilized-Intellectualization | person focuses only objective facts as a way of dealing with conflict of feelings and emotions. (Repress) avoiding dealing with unconscious conflicts or emotions |
Defense Mechanisms Utilized-Projection | shifting blame to someone or something else |
ALCOHOL | • Most commonly abused drug in US • Often progressive and fatal |
Alcoholism | primary chronic disease. Psychosocial/environmental factors that influence development. |
Alcoholism-Characterized: | 1. Continuous or periodic impaired control over drinking. 2. Preoccupation with alcohol. 3. Use of alcohol despite adverse reaction. 4. Distortions in thinking which equates to denial. |
Alcoholism-Simple Intoxication: | usually last about 12 hours followed by hangover beginning 4-6 hours after last drink. |
Alcoholism-Symptoms: | 1. Headache 2. Sweating 3. Vomiting 4. Thirst 5. Fatigue 6. Blurred vision 7. dizziness |
Alcoholism-Chronic use: | 1. Regular ingestion of large quantity of alcohol. 2. Regular/heavy drinking on weekends 3. Binges followed by long periods of abstinence. |
Alcoholism-Physical Addiction: | Cells does not function without alcohol. |
Alcoholism-Alcohol Withdrawal Syndrome: | physiologic/behavioral symptoms begin when blood alcohol drops. Seizures, agitation |
Alcoholism - Stages of Withdrawal-Early withdrawal: | 6-12 hours after last drink! |
Alcoholism - Stages of Withdrawal-Early withdrawal: a. Symptoms: | anxious, irritable, agitated, tremors, sweating, nausea, vomiting |
Alcoholism - Stages of Withdrawal-Major withdrawal: | onset of seizures, hallucinations, DT’s (delirium & tremors), 3 days without alcohol, NEEDS SUPERVISION!!!!!!!!!!! |
Alcoholism - Stages of Withdrawal-Major withdrawal: a. Symptoms | increased bp, increased temp (fry brain), increased pulse (cardiac arrest) |
Alcoholism - Stages of Withdrawal-Medical Complications | 1. Cirrhosis of the liver (no clotting, no bleeding) 2. Pancreatitis 3. GI Bleeding |
WERNICKE’S ENCEPHALOPATHY | Vitamin B1 deficiency. Standard ER protocol for alcoholics. B1 shot and MVI bag (banana bag) IV. It can progress to KORSAKOFF’S PSYCHOSIS |
WERNICKE’S ENCEPHALOPATHY-Symptoms: | memory loss, delirium, unsteady gait, altered LOC leading to coma. |
KORSAKOFF’S PSYCHOSIS | Niacin & vitamin B1 deficiency. Degeneration of cerebellum and peripheral nervous system. IT IS PERMANENT |
KORSAKOFF’S PSYCHOSIS-Symptoms: | dementia, amnesia, psychosis |
FETAL ALCOHOL SYNDROME | Drinks in excess during pregnancy |
FETAL ALCOHOL SYNDROME-Symptoms: | low birth weight, growth deficiency, learning disability, heart defect, facial malformation, hyperactive |
FETAL ALCOHOL SYNDROME-Treatment | 1. Active family involvement. 2. 12 step AA 3. No mouthwash or rubbing alcohol 4. Antabuse- daily – makes you get sick if you drink. 5. Interventions. |
FETAL ALCOHOL SYNDROME-Relapse Prevention | New friends. Relapse is high. Indentifying triggers. What people need to do to prevent. |
CHEMICAL DEPENDENCE-Stimulants | PSYCHE. amphetamines, crack, cocaine, nicotine, caffeine, ice |
CHEMICAL DEPENDENCE-OPIODS | PHYSICAL . heroin, morphine, Demerol, opium, methadone |
CHEMICAL DEPENDENCE-Depressants | PHYSICAL . sedatives, hypnotics, antolytics (antianxiety meds), sleep meds |
CHEMICAL DEPENDENCE-Hallucinogens | PHYSICAL (EXCEPT LSD) LSD, PCP, ecstasy, marijuana |
CHEMICAL DEPENDENCE-Narcotics | PSYCHE AND PHYSICAL |
CHEMICAL DEPENDENCE-Inhalants | PSYCHE. aerosol cans, gasoline, huffing |
STIMULANTS | 1. Used in daily basis or binges orally/IM 2. Psychologically addicting |
STIMULANTS-Symptoms: | 1. Hyperactivity 2. Irritability 3. Combativeness 4. Paranoia 5. Increased pulse/heart rate 6. Increased bp 7. Pupil dilation (amphetamines) 8. Reduction of appetite/fatigue 9. Increase in concentration (initially) |
STIMULANTS-Withdrawal | 1. No physical symptom 2. Depression/sense of crashing – antidepressant 3. Psychosis- usually for 1 yr after addiction. a. Cocaine remains in brain 10 days after use. |
STIMULANTS-Complications | 1. Cerebral hemorrhage (stroke) 2. MI 3. Seizures 4. Overdose of crack – resp failure |
STIMULANTS-Treatment | 1. Antidepressant 2. Neuroleptics (mood disorders) seizure drugs 3. Calcium channel blocker – craving |
OPIODS | Can be locked up in a room |
OPIODS-Physiological effects of opiods | 1. Respiratory depression 2. Drowsiness 3. Euphoria 4. Emotional lobility (up and down) 5. Lack of sexual drive 6. Apathy |
OPIODS-Pathophysiology | highly addictive, works on opiod receptors on CNS. Psychologically/physically addicting. |
OPIODS-Withdrawal | 1. Tearing of eyes 2. Runny nose 3. Sweating 4. Fever 5. Chills 6. Muscle/joint pain 7. Diarrhea 8. Restlessness 9. Irritability |
OPIODS - Treatment-Methadone | alleviates craving but does not produce high a. From heroin (antedote) b. Use for chronic pain |
OPIODS - Treatment-2. Clonidine/catapress | a. Also used for HTN and cravings |
OPIODS - Treatment-Narcan | antedote of opiod, standard drug for overdose a. Respiratory depression b. Heroin- can cause acute withdrawal c. May have to give again (rebound) |
DEPRESSANTS-Symptoms: | 1. Respiratory depression 2. Over sedation 3. Impaired coordination 4. Brain Damage |
DEPRESSANTS-Treatment | 1. Inhouse detox (med supervision) 2. Need to taper the drug |
HALLUCINOGENS | LSD is not physically addicting - it is used to enhance awareness. |
HALLUCINOGENS-ADVERSE | “Bad Trip”. Paranoid, depressed, frightening hallucinations LONG TERM EFFECT: can become psychotic, paranoid, flashbacks |
PCP | physically addictive 2. severe withdrawal symptoms 3. psychotic state similar to schizophrenics 4. unpredictable violence 5. enormous strength 6. no pain |
PCP-Complications | 1. vital signs: severely elevated temp, bp, hyperthermia, HTN, dangerous self and others |
PCP-Treatment | 1. decrease stimuli when restrained 2. halidol (sedate) Need to watch closely |
MARIJUANA | 1. psychologically addictive 2. useable for chemotherapy – glaucoma, vomiting, nausea |
MARIJUANA-Symptoms: | 1. distortion of time/space, heightened awareness, sedative effect. Chemo pts, AIDS |
INHALANTS-risk | progressive brain damage, kidney, liver, cardiac arrest. No physical withdrawal symptoms |