Ch 7 Pharm

what are three categories that the variables of addiction fall into?

*agent or drug of abuse *user factors *environment

What are other hallucinogenic drugs that are abused?

*mescaline (from peyote cactus) *MDMA (XTC) *DOM (Rave parties) *MDA ("love drug") *PCP ("Angel dust") *ketamine (date rape drug)

What is tolerance?

A biological condition that occurs when the body adapts to a substance after it is repeatedly administered. Over time, higher doses are needed to produce the same initial effect

what might you see you in a patient who is using sedatives and sedative hypnotics?

they may appear dull or apathetic, with slurred speech and lack of motor coordination. Effects may last an entire day. People addicted often alternate between amphetamines,which keep them awake for days, and barbiturates, which help them relax and fall asleep. These drugs are frequently combined with other drugs.

why are CNS stimulants taken as drugs of abuse?

to produce a sense of exhilaration,improve mental and physical performance, reduce appetite, prolong wakefulness, or simply get high.

What precautious measures are taken to prevent medications from being abused?

usually prescribed at lowest effective dose for the shortest amount of time necessary to treat the medical problems. Numerous laws have been passed as an attempt to limit drug abuse and addiction

what is substance dependence?

when a person has an overwhelming desire to take a drug and cannot stop it

what is tolerance?

when the patient requires a higher dose of the substance to produce the initial effect

What symptoms of withdrawal can be observed for the nicotine drug classification?

Increased appetite

what is cirrhosis?

a harmful and often fatal failure of the liver to perform its vital functions. Liver failure causes abnormalities in blood clotting and nutritional deficiencies and sensitizes the patient to the effects of all medications metabolized by the liver.

what are stimulants?

a varied family of drugs with the ability to increase the activity of the CNS.

what is addiction?

abuse of a substance; an overwhelming feeling that drives someone to use a drug repeatedly despite serious health and social consequences

explain the addiction and withdrawal of opioids.

addiction occurs rapidly and withdrawal can produce intense symptoms. withdrawal is unpleasant but not life-threatening. Heroin addicts may be switched to methadone to prevent unpleasant withdrawal symptoms. Withdrawal from methadone is more prolonged than from heroin or morphine, but the symptoms are less intense.

what are the two most commonly abused drugs?

alcohol and nicotine

what are two most commonly abused drugs?

alcohol and nicotine

what are popular benzodiazipines?

alprazolam (Xanax) diazepam (Valium) temazepam (Restoril) triazolam (Halcion) midazolam (Versed)

what do stimulants include?

amphetamines, cocaine, methylphenidate,and caffeine

what is physical dependence?

an altered physical condition caused by the nervous system adapting to repeated substance abuse

what are benzodiazipines?

another group of CNS depressants that have the potential for abuse. One of the most widely prescribed classes of drugs. replaced barbiturates for certain disorders.

what are two primary classes of sedatives?

barbiturates (treat sleep disorders and epilepsy) and non barbituate sedative-hypnotics

what drugs are included in the group of CNS depressants?

barbiturates, non barbiturate sedative hypnotics, benzodiazepines, alcohol and opioids (causes patients to feel sedated or relaxed)

why is caffeine considered a CNS stimulant?

because it produces increased mental alertness, restlessness, nervousness, irritability, and insomnia.

why is alcohol classified as a CNS depressant?

because it slows the actions of the region of the brain responsible for alertness and wakefulness.

why is nicotine placed into a class by itself rather than as a CNS stimulant?

because it's actions and long term consequences but nicotine stimulates the CNS directly, causing increased alertness and ability to focus, feelings of relaxation, and lightheadedness.

what happens with cocaine overdose and withdrawal syndrome?

can cause dysrhythmias, convulsions, stroke, or death due to respiratory arrest. Withdrawal syndrome for amphetamines and cocaine is much less intense than that from alcohol or barbiturates.

what symptoms do most CNS stimulants include?

cardiovascular and respiratory activity, raising blood pressure, and increasing respiration rate. other symptoms include dilated pupils, sweating, and tremors. Overdoses of some stimulants lead to seizures and cardiac arrest.

what drug is being abused if the nurse finds ncreased heart rate, dilated pupils, elevated body temperature, and sweating?

cocaine

describe alcohol metabolism.

detoxification of alcohol by the liver occurs at a slow, constant rate, which is not affected by the presence of food. The average rate is about 15 ml per hour. if consumed at a higher rate alcohol will accumulate in the blood and produce greater effects on the brain.

what is one of the most widely abused drugs?

ethyl alcohol

what symptoms are most associated with a narcotic analgesic overdose?

excessive sweating, agitation, goosebumps chills, increased heart rate

what mostly causes the risk for addiction of prescription drugs?

function of the dose and length of therapy. Prescription drugs rarely cause addiction when used as prescribed

what are the effects of alcohol?

relaxation, sedation, motor impairment, loss of motor coordination, reduced judgment, and decreased inhibition.

the nurse recognizes that methylphenidate (Ritalin) is classified as?

schedule 2 drug

what are opioids prescribed for?

severe pain, persistent cough, and diarrhea.

what are the effects of marijuana?

slows motor activity, decreases coordination, and causes disconnected thoughts, paranoia, and euphoria. It increases thirst and craving for food, particularly chocolate and other candies. One hallmark symptom of marijuana use is red or bloodshot eyes, caused by dilation of blood vessels. THC accumulates in the gonads.

what are cannabinoids?

substance is obtained from the hemp plant Cannabis sativa. include marijuana, hashish, and hash oil. 61 cannabinoid chemicals have been identified but ingredient responsible for most of the psychoactive properties is THC.

what are designer drugs?

synthetic drugs that are created in illegal laboratories solely for making money in illegal drug trafficking

what effects do high doses of amphetamines give the user?

the feeling of self confidence, euphoria, alertness, and empowerment. long term use often causes feelings of restlessness, anxiety, and fits of rage, especially when the user is coming down from a drug high

how does physical dependence differ from psychological dependence?

the patient exhibits signs of withdrawal after the drug is discontinued

What is one unusual adverse effect of LSD?

Flashbacks; user experiences effects again weeks, months or years later.

What is LSD made from?

Fungus that grows on rye and other grains

How would the nurse educate a patient on disulfiram (Antabuse)?

If alcohol is ingested, the patient may experience shortness of breath, nausea and vomiting, & headache.

All abused substances effect which body system?

Nervous

What is a drug that is often applied via transdermal patch to ease signs of drug discontinuation, including agitation, weight gain, anxiety, headache and extreme craving?

Nicotine

What is cross - tolerance?

Once tolerance develops to one substance, it often occurs with the use of closely related drugs

What are three substances that come from natural sources and are frequently abused?

Opium, marijuana, and cocaine

what organ is most affected by alcohol abuse?

The liver. Alcoholism is a common cause of cirrhosis.

What is withdrawal syndrome?

Unpleasant symptoms experienced when a physically dependent client discontinues the use of an abused drug

Repeated use of caffeine can create an increase in what?

Urination

What symptoms or effects can be predicted from hallucinogen abuse?

Variable symptoms; depend on mood & expectations of the user & surrounding environment; common occurrences are hallucinations & afterimages (image projected onto people as they move). Usually bright lights & vivid colors. Some users hear voices. Others report smells. Many experience profound sense of truth & deep directed thought. Unpleasant experiences: anxiety, panic attacks, confusion, severe depression, or paranoia.

describe overdose of alcohol.

produces vomiting, severe hypotension, respiratory failure, and coma. Death due to alcohol poisoning is common.

What drug was once used for bronchodilation but has been discontinued because of psychotic episodes in some patients?

Amphetamine

What do abused substances have in common?

An ability to affect the nervous system particularly the brain

What are hallucinogens (also called psychedelics)?

An assorted class of chemicals that in common the ability to produce an altered, dreamlike state of consciousness.

what are the effects of oral opioids?

FX begin within 30 minutes I'm a last over a day. Parenteral forms produce immediate effects, including brief, intense rush of euphoria sought by heroin addicts. Extreme pleasure to slowed body activities and extreme sedation. Signs include constricted pupils, an increase in the ability to withstand pain, and respiratory depression.

What is alcohol withdrawal commonly treated with?

A short acting benzodiazepine

what is narcolepsy?

A sleep disorder in which people fall asleep unexpectedly

What is the sleep disorder drug class for which patients often fake or change prescriptions?

Barbiturates

What is psychological dependence?

Causes no apparent signs of physical discomfort after the agent is stopped; person will have an intense craving & display an overwhelming desire to continue using the substance even if there are obvious negative economic, physical or social consequences.

A patient is admitted with liver failure. What nursing action is most appropriate prior to delivery of medications for this patient?

Check drug dosing because of issues related to metabolism

Which drug was once used as a local anesthetic?

Cocaine

what is the second most commonly abused illegal drug in the United States?

Cocaine

Several drugs once used for therapeutic purposes are now?

Considered illegal.

What drug may cause psychological dependence to develop after one dose?

Crack cocaine

What symptoms of withdrawal can be observed for the cocaine drug classification?

Depression

What other drugs are classified as CNS stimulants?

Dextroamphetamine (Dexedrine) methamphetamine (Desoxyn) methcathinone methylphenidate (Ritalin) cocaine caffeine

What symptoms of withdrawal can be observed for the opioid drug classification?

Dilated pupils, goose bumps, yawning

what drugs are given to patients for alcohol withdrawal?

Disulfiram (Antabuse): inhibits acetaldehyde dehydrogenase, the enzyme that metabolizes alcohol. if alcohol is consumed, the patient becomes violently ill with headache, shortness of breath, nausea and vomiting, and other symptoms. alcohol sensitivity can continue for up to 2 weeks after discontinuing. As a pregnancy category X drug, never taken during pregnancy. Acamprosate calcium (Campral, Forest): adverse reactions include diarrhea, flatulence, and nausea. Drug not recommended for patients who have impaired kidney functioning.

What is the risk of addiction to prescription drugs based on?

Dose and length of therapy

what is the prototype substance for the hallucinogen class?

LSD; all hallucinogens are scheduled 1 drugs and have no medical use.

What symptoms may be experienced by LSD users?

Laughter, visions, religious revelations, deep personal insights

What organ system is most likely to be malfunctioning in a patient diagnosed with alcoholism?

Liver

What can opioid withdrawal be treated with?

Methadone

what are four commonly abused barbituates?

Pentobarbital (Nembutal) Amobarbital (Amytal) Secobarbital (Seconal) A combination of secobarbital and amobarbital (Tuinal)

what are benzodiazipines used for?

Primary indication is anxiety (anxiolytic drugs). Also used for short term treatment of seizures and as muscle relaxants.

what synthetic drugs are in the opioid class?

Propoxyphene (Darvon) hydromorphone (Dilauded) oxycodone (OxyContin) fentanyl (Duragesic, Sublimaze) methadone (Dolophine) heroin

LSD is also known as?

Psilocybin

What schedule classification are all hallucinogenic drugs?

Schedule 1

what would the nurse find when assessing the patient for use of barbiturates?

Slurred speech, lack of muscle coordination, decreased respirations

What is the most common way nicotine enters the body?

Through inhalation of cigarette, pipe or cigar smoke

what substances produce little physical dependence or tolerance?

marijuana

what is the most commonly used illegal drug in the United States?

marijuana, a natural product obtained from cannabis sativa.

what are some frequently abused illegal substances?

marijuana, opioids, sedatives, and hallucinogens such as LSD or meth amphetamines

what can you expect to see in individuals who abuse benzodiazepines?

may appear carefree, detached, sleepy, or disoriented. death due to overdose is rare. Abusers may combine with alcohol, cocaine, or heroin. if combined with other agents death due to overdose is very likely.Withdrawal syndrome is less severe than barbiturate withdrawal or alcohol withdrawal.

what medications would be used for opiod withdrawal?

methadone

what does addiction depend on?

multiple, complex, and interacting variables

what disorders are treated by prescription stimulants?

narcolepsy, obesity, attention deficit disorder and ADHD

what are opioids?

natural or synthetic morphine like substance obtained from the unripe seeds of the poppy plant

what does alcohol intoxication?

occurs when muscle coordination is lost and mental function is affected

what three drugs does the opioid class include?

opium, morphine, and codeine, processed from natural substances found in the unripe seeds of the poppy plant

Explain what happens when overdose of barbiturates and non barbiturate sedative-hypnotics occurs.

overdose is extremely dangerous. These drugs suppress the respiratory centers in the brain, and the user may stop breathing or enter a coma. Death may result. Withdrawal symptoms from these drugs are similar to those of alcohol withdrawal and may be life threatening.

what two categories is substance dependence classified into?

physical dependence and psychological dependence