DOWNER

ALCOHOL ABUSE DEFINITIONS

Rapidly absorbed in bloodstream DETOXIFICATION – removing toxic substance
10mL alcohol in 1L blood = alcoholism WITHDRAWAL – surge of adrenaline once abrupt
LEVELS EFFECTS OVERDOSE stop using
0.1-0.2 Slow coordination Altered LOC INTOXICATION – physical/mental control decreases
Slurred speech INTOXICATION WITHDRAWAL
0.2-0.3 Tremors Breathing low + STIMULANTS
Irritability vomiting (Drugs)
Violence DEPRESSANTS
0.3 up Unconscious Coma (Alcohol,
Death Narcotics,
EFFECTS Opiates)
 Aggression  Impaired attention
 Blackouts  No concentration EFFECTS OS SUBSTANCE ABUSE
 Coordination problem  Impaired memory  NO friends
 Unsteady gait  Lack judgment  NO leisure activities
 Polyuria  NO spiritual values
  NO moral standards
WERNICKE – KORSAKOFF’s SYNDROME  abNOrmal physical functions
 Amnesia COMMON BEHAVIORS
 Increased family tension
 Clouding of consciousness Denial  Increased mental deterioration
 Confabulation Dependency  Sexual problems
 Peripheral neuropathy Demanding  Occupational problems
ALCOHOL WITHDRAWAL Destructive
SYND. Domineering
STAG EFFECTS
E TREATMENT OPIOIDS – desensitizes physiologic & psycho pain
1 6-8 hrs after intake Detoxification with medical Ex.
supervision OPIOID INTOXICATION
Anxiety and anorexia  Morphine
Insomnia and Pinpoint pupils
 Opium
DRUGS Apathy
tremors  Meperidine (Demerol)
Benzodiazepines (S/S) Respiratory depression
N/V and  Codeine
1.Lorazepam (Ativan) Lethargy & restless
hyperactivity  Hydrocodone Attention & memory
2.Diazepam (Valium)
HR and BP up  Methadone – detoxification impairment
Depression Uncoordinated
Alcohol antagonist DRUGS
2 8-12 hrs after intake movements
Disulfiram (Antabuse) Naloxone
Confusion Slurred speech
Give after atleast 12hrs Opioid antagonist
Gross tremors Immediately improves
Inhibits acetaldehyde into
Nervousness Respiration & consciousness S/S
a. dehydrogenase
Disorientation Craving
Severe adverse effects
Auditory and visual WITHDRAWAL Restlessmess &
 Arrhythmias
hal.  Drug intake ceases rhinorrhea
 MI  Markedly decreased
Illusions Anxiety w/ aching
 Cardiac failure  Precipitated by Naloxone backs and legs
Nightmares
 Seizures Nausea Vomiting
3 12-48 hrs after intake
 Coma Dysphoria & diarrhea
Severe hal.
 Death Sweating
Seizures GIVE
AVOID ANY ALCOHOL Fever
DILANTIN
ONCE TAKEN THIS MEDS Lacrimation
4 3-5 days after intake
Moderate effects
Confusion and
 Sweating, flushing, N/V
delirium
 HR up, BP down, RR up
Clouding of
 Throbbing headache
consciousn.
Disorientation  Tremors
Visual and tactile hal.  Weakness
Fever and BP up X PERFUMES, SHAVING WITHDRAWAL SYMPTOMS
Tremors and HR up CREAMS W/ ALCOHOL Occurs 6-8 hrs after intake
S/S
EMERGENCY  PR, RR, BP, Temp up  Nausea
FETAL ALCOHOL SYNDROME (FAS) – 1ST trimester  Hand Tremors  Insomnia
 Microcephaly  Anxiety  Psychomotor agitation
 Severe mental retardation
 Stillbirth DRUGS DRUGS
SEDATIVES, HYPNOTICS, ANXIOLYTICS – depressants
Lack of coordination Benzodiazepines – anxiolytics Barbituates & hypnotics
Slurred speech & stupor Unsteady gait Lethargic & confusion  Phenobarbital
Impaired communication Labile mood  Valium CAN BE LETHAL ONCE 2-10g
Coma Impaired attention  Xanax S/S Respi arrest, cardiac
RARELY FATAL ONCE P.O. failure, coma, death
TAPER TO DETOXIFY
 UPPER
STIMULANTS – Limited indications = high potential for abuse INHALANTS – causes PNS damage and liver disease
 Anesthetics
INHALANT ABUSE IN BRAIN
Amphetamines (Onamine) – to lose weight  Nitrates  Oxygen deprivation
Cocaine and ectasy – no use, immediate feeling of euphoria  Organic solvents
 Neurotoxicity
 Gasoline
INTOXICATION develops: PHYSIOLOGIC changes:  Seizures
 Glue
 Super active, talkative  HR BP up  Brain shrinkage
 Paint thinner
 Impaired judgment  Dilated pupils  Cognitive impairment
 Spray paint
 Weight loss  Diaphoresis and chills  Behavioral changes
 Unhappiness or anger  Nausea
 Anorexia  Chest pain and confusion TREATMENT
 Anxiety  Cardiac arrhythmias  Stop using inhalants
 Hallucinations & illusions  Seek medical attention
 euphoria  Provide supportive care
 Detoxification – addressing the effects to the body
Cocaine – “bugs” beneath skin / FORMICATION and foul smells  Rehabilitation
- Nasal septum perforation
COCAINE WITHDRAWAL
 Hours to days
 Depressive symptoms
o Marked dysphoria
o Agitation
o Nightmares
o Appetite increases
o Psychosis
o Suicidal ideations increases
Cannabis (Marijuana) – Delta-2 Tetrahydrocannabinol (THC)
- Found in flowering tops and stems of the plant
- Hashish – dried resinous exudates from female plants
THERAPEUTIC uses: INTOXICATION develops:
 Lowers IOP  Less than 1 min
 Relieves N/V associated  Peak levels: 20-30 mins
with chemotherapy  Lasts atleast 2-3 hours
(dronabinol, nabilone)  HR up, BP down
 Eye redness
TREATMENT  Psychotic symptoms
 Symptomatic and  Abnormal motor
overdose doesn’t occur coordination
 Withdrawal symptoms  Short-term memory loss
not present when  Inappropriate laughter
sudden cessation  Social withdrawal
 Increases appetite
 Disorientation
 Delirium
 Dysphoria

Hallucinogens / Psychedelics
NATURAL SYNTHETIC
Mescaline LSD – lysergic acid diethylamide

Psilocybin STP – dimethoxy-4

methylamphetamine
Cannabis PCP – Pencyclidine (most potent)

DMT – dimethyl tryptamine

DMA – methylene dioxyam
phetamine

INTOXICATION develops: TOXIC REACTIONS

 Behavioral and  Except PCP
psychological changes  Primarily psychological
 Hallucinations  Overdose doesn’t occur
 Anxiety
 Paranoid ideation TREATMENT
 Depression  Isolation
 Dangerous behaviors  Physical restraints LAST
 Ideas of reference RESORT
 ABUSE
S/S VIOLENT FAMILY CHARACTERISTIC PARTNER ABUSE CHILD ABUSE
 Upset  Social isolation Maltreatment of another in Maltreatment of child
 Agitation  Abuse of power and control an intimate relationship
 Withdrawn  Alcohol and drug abuse TYPES
 Aloof  Intergeneration transmission process TYPES o Physical
 Psychological abuse o Emotional
ABUSER CHARACTERISTIC  Emotional abuse – hard o Neglect
 Inadequacy  Low self-esteem to cope o Sexual
 Immature  Jealous and possessive  Physical abuse
 Poor problem solving  Act is rewarding o Choking CHARACTERISTICS OF PARENTS
o Fractures 1. Lack of parenting skills
o Homicide 2. Lack of understanding in
NURSING INTERVENTIONS children’s needs
 Sexual abuse
 Ensure the child’s safety and well-being. 3. Lack of money
o Pulling hair 4. Lack of education
 Thorough psychiatric evaluation.
o Biting nipples 5. With history of child abuse
 Establish trust to help child deal with trauma of abuse.
 Use play therapy to express his feelings.
WARNING SIGNS
 Refer to social works. Absence of trauma
Bruised genitalia
Unusual injuries
Switching child history
Evidence of old injuries
Delay in seeking treatment