CARN Study Guide Questions and Correct
Answers
What are s/s of opioid intoxication (10)? Ans: Low HR, Low BP,
Low temp, Constricted pupils (Miosis), Analgesia, Decreased GI
motility (Constipation), Itching, Sedation, Fatigue, Euphoria
How long after last opioid use can withdrawal symptoms present?
Long acting vs Short acting Ans: Long acting: 24+ hours
Short acting: 8-12 hours
What 2 criteria must a pt meet before buprenorphine initiation can
occur? Ans: Moderate withdrawal: 13-24
Must abstain from opioid use for >8-24hr
What are s/s of stimulant withdrawal (13)? Ans: Acute: Fatigue,
Depression, Hallucinations, Suicidal ideation, Irritability
Subacute: Exhaustion, Mood swings, Irritability, Brain fogginess,
Disturbed sleep
Protracted: Anhedonia, Sexual dysfunction, Decreased libido
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How is stimulant use disorder treated? Ans: PRIMARY
INTERVENTION: Safety!!! Depression assessment
First line Tx is behavioral therapy (CBT, Contingency management)
Other intereventions: Hydration, Nutrition, Symptom managemnet
- Anxiety/Agitation: Clonidine, Tizanidine
-Depression/Anxiety: SSRIs
Sleep: Melatonin, Antihistamines, Trazadone
What complications can arise from Club drug (Ex. MDMA,
Rohypnol, GHB, Ketamine) use? Ans: Rapid hyperthermia can
cause kidney/liver/cardiovascular failure
What are s/s of MDMA (Ecstasy) intoxication (7)? Ans: Increased
energy, Euphoria, Emotional warmth, Time/Distance distortions,
Peripheral distortions, Tactile disturbances, Hyperthermia
At what point during alcohol withdrawal can alcohol hallucinosis
occur? Ans: Occurs in the first 1-2 days of alcohol withdrawal
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At what point during alcohol withdrawal are seizures common?
Ans: Within the first 72hrs of decreased alcohol intake/cessation
- If a second seizure occurs, it is often within the first 6 hours
after the first
At what point during alcohol withdrawal would Delerium Tremens
(DT) present itself? Ans: DT can occur up to 3-4 days after alcohol
cessation
- Characterized by disorientation and autonomic dysfunction
- Risk Factors: Old age, Comorbid medical/surgical illness, Liver
dysfunction, Severe withdrawal s/s at initial assessment, History
of alcohol withdrawal seizures
What is treatment for benzodiazepine withdrawal? Ans:
Supportive care & benzo taper
- If the Benzo was prescribed, taper slowly!
If the Benzo was not prescribed, inpatient monitoring and Tx is
necessary to prevent seizures
At what point after discontinuing a Benzo abruptly, can
withdrawal begin? Long acting vs Short acting Ans: Long Acting:
20-80 hours
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