Study guide Mental health 2
Alcohol
Death 400-700 mg/dl
300= ER
Within 4 to 12 hours of cessation or reduction of heavy, prolonged drinking
Hand, tongue, eyelid tremor
N,V
Malaise, weakness
Tachycardia
Sweating
Increased BP
Peripheral neuropathy-common in alcoholics because of vit B deficiency
Alcoholic Myopathy – acute/ chronic condition; in acute, also called acute alcoholic necrotizing
myopathy OR alcoholic thabdomyolysis – the person has sudden onset of MUSCLE pain,
swelling, weakness along with myoglobinuria – red tinge in urine; Creatine kinase may be
elevated – have ALCOHOL USE AND MALNOURISHMENT to produce this syndrome – Lab values
elevations of the creatinine phosphokinase (CPK), lactate dehydrogenase (LDH) and asparate
aminotransferase (AST); chronic symptoms cause wasting and weakness in skeletal muscles
Wernickes encephalopathy – most serious form of thiamine, deficiency in alcoholics –
symptoms include paralysis of ocular muscles, diplopia, ataxia, somnolence, stupor – If
thiamine replacement therapy if not undertaken, death will occur
Korsakoffs psychosis is idenfied by a syndrome of confusion, lack of memory, confabulation in
alcoholics; frequently encountered in people recovering from wernickes; in the US the 2
disorders are usually called Wernicke Korsakoff syndrome – tx is parenteral or oral thiamine
replacement
Cardiomypathy – accumulation of lipids in the myocardial cells – enlargement and weakened
heart – CHF or arrhythmias occurs – LABS show elevation in CPK, ASK, alanine aminotransferase
(ALT) and LDH –treatment is permanent abstinence – tx for CHF – oxygen, diuretic
Esophagitis – inflammation and pain in esophagus – irritation from frequent vomiting
associated with alcohol use
Gastritis-inflammation of stomach lining
Pancreatitis- acute or chronic- chronic leads to steatorrheas, malnutrition, weight loss, DM
Alcoholic Hepatitis- inflammation of liver. nausea and vomiting, loss of appetite, fatigue,
increased WBC, fever, jaundice; ascites and weight loss with severe cases. Severe- hepatic
encephalopathy
Cirrhosis-chronic injury to the liver; widespread destruction of liver cells which is replaced by
fibrous (scar tissue). Can have portal hypertension, esophageal varices, Hepatic encephalopathy
(impaired mental functioning, apathy, euphoria or depression, sleep disturbances increasing
confusion. Treatment includes no alcohol; reduce protein and reduction of intestinal ammonia
using neomycin or lactulose.)
Leukopenia-white blood cells are impaired in chronic alcoholics. Puts them at risk for
contracting infectious diseases and complicated recovery.
, Thrombocytopenia-platelet production and survival are impaired as a result of toxic effect of
alcohol. This places the alcohol at risk for hemorrhage. Quitting drinking quickly reverses this
deficiency.
Sexual dysfunction-change menstrual cycles and decrease fertility; for men, altered hormone
levels result in a diminished libido, decreased sexual performance, and impaired fertility –
gynecomastia may develop secondary to testicular atrophy.
1st 72 hours-Benzos or alcohol= high alert upon admission
Benzos
alprazolam – short acting benzo (withdrawal 12-24 hours)
Diazepam- long acting benzo (withdrawal 2-7 days)
Lorazepam – intermediate acting benzo
Intoxication: impaired judgment; slurred speech, impaired memory and attention,
unstead gait,sexual/aggressive behavior, nystagmus
Withdrawal: autonomic hyperactivity (sweat, SOB, dry mouth, dizzy, tachycardia),
insomnia, N and V, hallucinations, psychomotor agitation, anxiety, SEIZURES
Stimulants
Intoxication: euphoria, hypervigilance, anxiety, tension, anger, mem loss, psychosis, pupil
dilation, tachy/bradycardia, N,V, Wt loss, resp depression
Withdrawal: Within few hours to few days after prolonged use, Fatigue, cramps, depression,
HA, nightmares
Dysphoria – increased risk for suicide
Peak withdrawal within 2 to 4 days of abstinence
Caffeine – HA, fatigue, drowsy, difficulty concentrating
Nicotine – dysphoria, insomnia, irritable, anger, anxiety, difficulty concentrating, restless,
increased appetite
Opioids
INTOXICATION: initial euphoria followed by apathy or sadness, psychomotor agitation
or slowing; impaired judgment, drowsy, slurred speech, PUPIL constriction (if OD and
have brain anoxia will be dilated), respiratory depression, coma, death
Withdrawal opioids: dysphoria, sweating, yawning, fever, insomnia, piloerection (goose
bumps), muscle pain/aches, NV diarrhea, lacrimation, rhinorrhea, dilated pupils
OD tx-Naloxone
HERBS
Green tea -This herb is used to combat fatigue, prevent arteriosclerosis and certain
cancers, lower cholesterol, reduce tooth decay, and aid in weight loss.
Alcohol
Death 400-700 mg/dl
300= ER
Within 4 to 12 hours of cessation or reduction of heavy, prolonged drinking
Hand, tongue, eyelid tremor
N,V
Malaise, weakness
Tachycardia
Sweating
Increased BP
Peripheral neuropathy-common in alcoholics because of vit B deficiency
Alcoholic Myopathy – acute/ chronic condition; in acute, also called acute alcoholic necrotizing
myopathy OR alcoholic thabdomyolysis – the person has sudden onset of MUSCLE pain,
swelling, weakness along with myoglobinuria – red tinge in urine; Creatine kinase may be
elevated – have ALCOHOL USE AND MALNOURISHMENT to produce this syndrome – Lab values
elevations of the creatinine phosphokinase (CPK), lactate dehydrogenase (LDH) and asparate
aminotransferase (AST); chronic symptoms cause wasting and weakness in skeletal muscles
Wernickes encephalopathy – most serious form of thiamine, deficiency in alcoholics –
symptoms include paralysis of ocular muscles, diplopia, ataxia, somnolence, stupor – If
thiamine replacement therapy if not undertaken, death will occur
Korsakoffs psychosis is idenfied by a syndrome of confusion, lack of memory, confabulation in
alcoholics; frequently encountered in people recovering from wernickes; in the US the 2
disorders are usually called Wernicke Korsakoff syndrome – tx is parenteral or oral thiamine
replacement
Cardiomypathy – accumulation of lipids in the myocardial cells – enlargement and weakened
heart – CHF or arrhythmias occurs – LABS show elevation in CPK, ASK, alanine aminotransferase
(ALT) and LDH –treatment is permanent abstinence – tx for CHF – oxygen, diuretic
Esophagitis – inflammation and pain in esophagus – irritation from frequent vomiting
associated with alcohol use
Gastritis-inflammation of stomach lining
Pancreatitis- acute or chronic- chronic leads to steatorrheas, malnutrition, weight loss, DM
Alcoholic Hepatitis- inflammation of liver. nausea and vomiting, loss of appetite, fatigue,
increased WBC, fever, jaundice; ascites and weight loss with severe cases. Severe- hepatic
encephalopathy
Cirrhosis-chronic injury to the liver; widespread destruction of liver cells which is replaced by
fibrous (scar tissue). Can have portal hypertension, esophageal varices, Hepatic encephalopathy
(impaired mental functioning, apathy, euphoria or depression, sleep disturbances increasing
confusion. Treatment includes no alcohol; reduce protein and reduction of intestinal ammonia
using neomycin or lactulose.)
Leukopenia-white blood cells are impaired in chronic alcoholics. Puts them at risk for
contracting infectious diseases and complicated recovery.
, Thrombocytopenia-platelet production and survival are impaired as a result of toxic effect of
alcohol. This places the alcohol at risk for hemorrhage. Quitting drinking quickly reverses this
deficiency.
Sexual dysfunction-change menstrual cycles and decrease fertility; for men, altered hormone
levels result in a diminished libido, decreased sexual performance, and impaired fertility –
gynecomastia may develop secondary to testicular atrophy.
1st 72 hours-Benzos or alcohol= high alert upon admission
Benzos
alprazolam – short acting benzo (withdrawal 12-24 hours)
Diazepam- long acting benzo (withdrawal 2-7 days)
Lorazepam – intermediate acting benzo
Intoxication: impaired judgment; slurred speech, impaired memory and attention,
unstead gait,sexual/aggressive behavior, nystagmus
Withdrawal: autonomic hyperactivity (sweat, SOB, dry mouth, dizzy, tachycardia),
insomnia, N and V, hallucinations, psychomotor agitation, anxiety, SEIZURES
Stimulants
Intoxication: euphoria, hypervigilance, anxiety, tension, anger, mem loss, psychosis, pupil
dilation, tachy/bradycardia, N,V, Wt loss, resp depression
Withdrawal: Within few hours to few days after prolonged use, Fatigue, cramps, depression,
HA, nightmares
Dysphoria – increased risk for suicide
Peak withdrawal within 2 to 4 days of abstinence
Caffeine – HA, fatigue, drowsy, difficulty concentrating
Nicotine – dysphoria, insomnia, irritable, anger, anxiety, difficulty concentrating, restless,
increased appetite
Opioids
INTOXICATION: initial euphoria followed by apathy or sadness, psychomotor agitation
or slowing; impaired judgment, drowsy, slurred speech, PUPIL constriction (if OD and
have brain anoxia will be dilated), respiratory depression, coma, death
Withdrawal opioids: dysphoria, sweating, yawning, fever, insomnia, piloerection (goose
bumps), muscle pain/aches, NV diarrhea, lacrimation, rhinorrhea, dilated pupils
OD tx-Naloxone
HERBS
Green tea -This herb is used to combat fatigue, prevent arteriosclerosis and certain
cancers, lower cholesterol, reduce tooth decay, and aid in weight loss.
