Intro Bipolar disorders
is characterized by mood swings from profound depression to extreme euphoria (mania) with intervening periods of normalcy
Bipolar Disorder
Two forms of dependence related to substance addiction
Physical Dependence: Need for increasing amounts to produce the desired effects.
Psychological Dependence: Overwhelming desire to repeat the use of a particular drug to produce please or avoid discomfort.
Medication classes abused in relation to sedative/hypnotic use disorder
PG. 292
Barbiturates, Non barbiturate hypnotics, Anti-anxiety Agents, Club drugs
Club Drugs include GHB, Rohypnol®, ketamine, MDMA (Ecstasy), Methamphetamine, and LSD (Acid).
Matching:
A) Symptoms occur within 6 to 8 hours, peak within 1 to 3 days, and gradually subside in 5 to 10 days.
B) Symptoms begin quickly, peak in 8 to 12 hours, and subside in 4 to 5 days
C) Symptoms occur within 1 to 3 days, peak between days 4 and 6, and subside in 14 to 21 days
_ From short-acting drugs (e.g., heroin)
_ From long-acting drugs (e.g., methadone)
_ From ultra-short-acting (meperidine)
Name the five treatment modalities for Bipolar Disorder.
Individual Psychotherapy
Group Therapy
Family Therapy
Cognitive Therapy
Psychopharmacology
3 Part question
1) What is the average age at onset of Bipolar Disorder?
2) Is bipolar disorder more common in single or married persons
3) True or False- Bipolar Disorder occurs more often in higher socioeconomic classes
1) Early 20's
2) Single
3) True
Name 4 classes of Psychoactive Substances
Classes of Psychoactive Substances:
Alcohol, Caffeine, Cannabis, Hallucinogens, Inhalants, Opioids, Sedatives/hypnotics, Stimulants, Tobacco
Medication classes abused in relation to stimulant related disorder
pg.295
Amphetamines, synthetic stimulants, non-amphetamine stimulants, cocaine, caffeine, nicotine
Name 4 Physiological symptoms for Hallucinogen Use Disorder
Nausea/vomiting
Chills
Pupil dilation
Increased blood pressure, pulse
Loss of appetite
Insomnia
Elevated blood sugar
What psychopharmacology medications and classes are used to treat mania?
Lithium Carbonate, Verapamil
Anticonvulsants, Antipsychotics,
Client is experiencing, or has experienced, a full syndrome of manic or mixed symptoms.
Client may also have experienced episodes of depression.
Bipolar 1 Disorder
What are the 4 phases of the Alcohol Use Disorder?
(The Patterns of use)
Phase I. - Pre-alcoholic phase: Characterized by use of alcohol to relieve everyday stress and tensions of life
Phase II. - Early alcoholic phase: Begins with blackouts—brief periods of amnesia that occur during or immediately following a period of drinking; alcohol is now required by the person.
Phase III. The crucial phase: Person has lost control; physiological dependence is clearly evident.
Phase IV. The chronic phase: Characterized by emotional and physical disintegration. The person is usually intoxicated more often than sober.
1) ____ and ___ intoxication produce euphoria, impaired judgement, confusion, and changes in vital signs (even in coma or death, depending on amount consumed.
2) ____ intoxication usually occurs following consumption in excess of 250mg. Restlessness and insomnia are the most common symptoms
1) Amphetamine and Cocaine
2) Caffeine
Name 4 Psychological symptoms for Hallucinogen Use Disorder
Heightened response to color,
sounds
Distorted vision
Sense of slowed time
Magnified feelings
Paranoia, panic
Euphoria, peace
Depersonalization
Derealization
Increased Libido
What drug class is used for the prevention and treatment of manic episodes associated with Bipolar Disorder?
Mood Stabilizing Agents
Examples: lithium carbonate, clonazepam, carbamazepine, valproic acid, lamotrigine, topiramate, oxcarbazepine, verapamil, antipsychotics
2 part question:
Characterized by bouts of major depression with episodic occurrence of hypomania. Has never met criteria for full manic episode.
A disturbance of mood (depression or mania) that is considered to be the result of the physiological effects of a substance (ingestion of or withdrawal from a drug of abuse or a medication or other treatment).
1) Bipolar 2 disorder
2) Substance-induced bipolar disorder
1) Alcohol Intoxication: Occurs at blood alcohol levels between ___ and ___ mg/dL
2) Death has been reported at levels ranging from ___ and ___ mg/dL
3) Alcohol Withdrawal: Occurs within __ and __ hours of cessation of or reduction in heavy and prolonged alcohol use.
1) 100 and 200 mg/dL
2) 400 and 700 mg/dL
3) 4 and 12 hours
1) _____ and _____ withdrawal may result in dysphoria, fatigue, sleep disturbances, and increased appetite.
2) Withdrawal from _____ may include headache, fatigue, drowsiness, irritability, muscle pain and stiffness, and nausea and vomiting.
3) Withdrawal from ______ may include dysphoria, anxiety, difficulty concentrating, irritability, restlessness, and increased appetite
1) Amphetamine and Cocaine
2) Caffeine
3) Nicotine
Which disorder does this describe?
Symptoms include impaired motor coordination, euphoria, anxiety, sensation of slowed time, and impaired judgment
Physical symptoms include conjunctival injection, increased appetite, dry mouth, and tachycardia.
Impairment of motor skills lasts for 8 to 12 hours
Intoxication
Cannabis Use Disorder
What is the questionnaire used as an assessment tool for nurses with a client who has a possible drinking problem?
Cage Questionnaire
Have you ever felt you should Cut down on your drinking?
Have people Annoyed you by criticizing your drinking?
Have you ever felt bad or Guilty about your drinking?
Have you ever had a drink first thing in the morning to steady your nerves (Eye-opener)
2 Part Question:
1) Chronic mood disturbance. At least 2-year duration. Numerous episodes of hypomania and depressed mood of insufficient severity to meet the criteria for either Bipolar 1 or 2 disorder.
2) Characterized by an abnormally and persisted elevated, expansive, or irritable mood and excessive activity or energy that is judged to be the result or direct physiological effects of another medical condition.
1) Cyclothymic disorder
2) Bipolar disorder associated with another medical condition
Name 5 characteristics of Fetal Alcohol Syndrome.
Abnormal facial features, Small head size
Shorter-than-average height, Low body weight
Poor coordination, Hyperactive behavior
Difficulty paying attention, Poor memory
Difficulty in school, Learning difficulties
Speech and language delays, Intellectual disability
Poor reasoning skills, Sleep and sucking problems as a baby
Vision or hearing problems, Problems with the heart, kidneys, or bones
Name 5 substances used in relation to inhalant use disorder
pg. 298
Aliphatic and aromatic hydrocarbons found in substances such as fuels, solvents, adhesives, aerosol propellants, and paint thinners.
Specific examples include: gasoline, garnish remover, lighter fluid, airplane glue, rubber cement, cleaning fluid, spray paint, shoe conditioner, typewriter correction fluid.
2 Part Question:
1) Name the 4 medication classes used in treatment of stimulant withdrawal or intoxication?
2) Name the 2 medication classes used in treatment of hallucinogens and Cannabinols withdrawal or intoxication?
1) Minor Tranquilizers, Major Tranquilizers, Anticonvulsants, Antidepressants
2) Benzodiazepines, Antipsychotics
2 Part Question:
1) Name 3 medications used in the treatment of Opioid withdrawal or intoxication?
2) Name the 1 medication and 1 drug class used as a depressant for substance intoxication or withdrawal
1) Narcotic analgesics: Narcan, Naltrexone, Nalmefene
Methadone, Buprenorphine, Clonidine
2) Phenobarbital (Luminal), Long Acting Benzodiazepines.