NCAC II, NCAC I Exam, NCAC I Pharmacology, NCAC Practice Test - Momentix Book, Alcoholics Anonymous (AA), 100% Coverage. Rated A Family Structure - ✔✔-Alcoholic

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NCAC II, NCAC I Exam, NCAC I Pharmacology, NCAC Practice Test - Momentix Book, Alcoholics Anonymous (AA), 100% Coverage. Rated A Family Structure - ✔✔-Alcoholic marries an enabler, the first... child is the Hero... they are usually perfect "see we are good" The second child is the scapegoat and can do no right. Then is the lost child. If they have another that child is the mascot. Lost Child - ✔✔-Most likely to commit suicide Epinephrine/NE - ✔✔-*Body's natural stimulant *responsible for anxiety and fear, anger, hostility & violence *Instinctual fight or flight *predominant neurotransmitter in brain *affected by cocaine and amphetamines Serotonin - ✔✔-*responsible for calmness and sleep, appetite, some memories *responsible for some types of depression *offsets the effects of E/NE *affected by cocaine and amphetimines GABA - ✔✔-*Natural anti-anxiety, anti-convulsant. *Helps cope with stressful situations *affected by etoh, benzo, barbs Endorphins - ✔✔-*body's natural pain killer *brain does not distinguish between physical, emotional & spiritual pain. In all instances endorphins are released *More pain receptor sites than pleasure receptor sites. * We remember painful events more vividly our our brains are designed to avoid these situations. *Increase in endorphins vis exercise, laughter, meditations, sleep, food, healthy relationships/sex & music *Affected by opiates, soma & etoh Dynorphin - ✔✔-Form of endorphin that is released at childbirth. 700x stronger than morphine. Helps offset fatigue, forget the intensity of the pain, bonds mother and child. Acetylcholine - ✔✔-*Memory, Movement, Motivation, New Learning (learning in general) *Depletion results in alzheimers symptoms *Affected by THC Anandamide - ✔✔-Similar to aceylcholine. *Memory, New Learning specific, calmness, controlling movement *Affected by THC Glutamate - ✔✔-*Memory *Duck tape of the brain... regenerates and mimics other neurotransmitters to fill the gaps for the ones that have been damaged *Anti Convulsant Dopamine - ✔✔-*Pleasure (located in the pleasure pathway) *every drug mimics or releases dopamine *cocaine and other stimulates actually block the re-uptake of dopamine so that it increases the dopamine response *etoh & opiates enhance dopamine release that would otherwise block/inhibit dopamine secreting neurons. *Schizophrenia is noted to be too much dopamine in the brain *too few dopamines mimic parkinsons *Affected by all drugs but mostly meth. Methamphetimine high - ✔✔-most resembles schizophrenia Meth withdrawal - ✔✔-mimics parkinsons Meth results in the release of so much dopamine - ✔✔-that it can take YEARS for the person to learn to feel pleasure again. PIP (phenylimide Indoleamine Pyrimidine) - ✔✔-*responsible for feeling of true care/love *affects various parts of the brain at one time *decreases after about 3 years bc the brain cannot sustain the same level of intensity. The passion sorta burns out. *PIP changes to endorphins after decades in a relationship Adverse Effects of substances are usually seen - ✔✔-in those with ADHD or Bipolar w Korsacoff Wenicke Syndrome - ✔✔-After prolonged alcohol abuse, the person is unable to walk steadily (like walking in sand), eyes twitch back and forth State Dependent Learning - ✔✔-Learn when high on THC, does not remember when sober, does remember when under the influence of THC later. Pharmacology - ✔✔-Branch of science that examines how psychoactive substances taken to alter bodily functions or enhance bodily functions interact with the brain and body Psychoactive Substance - ✔✔-any drug that affects the CNS and alters consciousness and or perceptions physiological effects - ✔✔-physical signs psychological effects - ✔✔-alterations in perception or judgment caused by substance. chemical interaction - ✔✔-physiological and psychological effects of 2 or more substances administered at the same time withdrawal - ✔✔-signs and symptoms that occur when an indiv that is physically dependent on a substance discontinues its use. treatment applications - ✔✔-method of detox, stabilization & maintenance tolerance - ✔✔-after repeated admin. a given dose of a substance produces a decreased effect or conversely with increased/larger doses must be administered to get the effect observed with the original dose dependence - ✔✔-known as addictions, a behavioral pattern of compulsive substance use characterized by consistent involvement with the use of a substance, securing of its supply and a high tendency to relapse after withdrawal. detoxification - ✔✔-eliminating the substance from your body *The first step in sobriety and treatment Levels of Psychoactive Substance Use - ✔✔-Recreational- Circumstantial-Intensified Use- cCompulsive Use cross tolerance - ✔✔-the ability of pharmacologically similar substances to substitute for one another in relation to tolerance and prevention of withdrawal (ie using hydrocodone when heroin isn't available) Schedule I - ✔✔-No medical Use, cannot be dispensed by a prescriber. Severe dependence, high potential for abuse Schedule II - ✔✔-Severe dependence, high potential for abuse. Some accepted medical use, but with severe restrictions Schedule III - ✔✔-Moderate or low physical dependence OR high psychological dependence. Moderate potential for abuse Has accepted medical uses and can be dispensed by authorized prescriber Schedule IV - ✔✔-Limited physical or psychological dependence. Low abuse potential. accepted medical use. Schedule V - ✔✔-limited dependence, very low potential for abuse, medcial use Methods of Administration - ✔✔-*orally (inhale or ingested) *nasally (longest acting) *IM *IV (most instense) *subcutaneously *topically *sublingually *rectally Blood Brain Barrier - ✔✔-series of cells that prevent certain chemicals from reaching the brain metabolites - ✔✔-by-product of the liver breaking substances down that can be eliminated metabolism - ✔✔-body getting rid of the substance. elimination CNS - ✔✔-brain and spinal cord PNS - ✔✔-all neurons outside the CNS CNS is made of - ✔✔-Reticular Activating System: Awake/Asleep Limbic System: feelings Basal Ganglia: fine motor skills Limbic System is made of - ✔✔-Cerebral Cortex: voluntary motor skills, sensory input Hypothalamus: Liaison between CNS & PNS PNS is - ✔✔-the Autonomic Nervous System (unconscious bodily functions) which is sympathetic nervous system *increases breathing, etc) and parasympathetic (decreases) Neurotransmitters are either - ✔✔-inhibitory or excitatory Agonist - ✔✔-psychoactive substance binds to neurons and elicits a reaction as if it were a neurotransmittor Antagonist - ✔✔-substance binds and prevents other neurotransmitters form binding to that neuron CNS depressants - ✔✔-Alcohol, barbituates, benzos Short term effects of depressants - ✔✔-impaired coordination, slurred speech, staggered gait, drowsiness, muscle relaxation, slowing of breath, slowing of HR, dizziness, sedation, loss of memory, euphoria, impaired judgement, decreased inhibition, decreased fear, confusion, irritability, paranoia, Pathological Intoxication - ✔✔-Unusual reaction to depressants. The person becomes agitated and belligerent after only small doses habituation - ✔✔-repetition of behaviors until hey are a habit. Legal limit of alcohol in 21+ in most states - ✔✔-.08 Toxic alcohol levels - ✔✔-.4 Cirrhosis - ✔✔-swollen, scarred or dead liver tissue Stages of alcohol dependence - ✔✔-Early: escaping from social situations, sneaking to drink, feelings of guilt, difficulty stopping & preoccupation Middle: Loss of control, impaired social relationships, changes in drinking patterns, temp sobriety, morning drinking, neglect of health needs. Late: drink in order to function, binges, withdrawal sx, blackouts, etc Alcohol must be detoxed - ✔✔-under medical supervision due to risk of seizures. Often given Librium. Alcohol Withdrawal - ✔✔-Stage 1: Tremors 24-36 hr after last drink, irritability, nausea, vomiting, slurred speech, jitters, tremors. 90% of alcohol dependent people experience Stage 2: Hallucinations distorted perceptions occur in 25% Stage 3: Wdrawal Seizures Grand Mal, 7-48hr after last drink, peak is 13-24 hr. 1/3 of clients experience Stage 4: DT Confusion, delusions, hallucinations, severe agitation, tachycardia, dilated pupil, fever, 3-5 days after drinking, 15% fatality rate. Lasts 72 hours or less in 80% Pharmacotherapy - ✔✔-Medications prescribed to treat SUD Anesthetic - ✔✔-sub used to induce a controlled state of unconsciousness Analgesic - ✔✔-sub used to relieve pain Barbituates paired with etoh - ✔✔-exacerbated effects due to potentiation Benzo - ✔✔-*tolerance develops QUICKLY, within 1-3 weeks, but does not develop to the anti-anxiety effects. Dependence is likely if used over 4 months, 80-85% who take over 2 years. *medical detox due to risk of seizures Stimulants include - ✔✔-amphetamines, cocaine, caffeine, nicotine Potency of stimulants - ✔✔-1. Cocaine 2 Meth 3 Dexedrine 4 amphetamine 5 ritalin 6 caffeine 7 nicotine Amphetamines use outside of adhd - ✔✔-often for weight loss Meth is - ✔✔-schedule II Reverse Tolerence - ✔✔-when a psychoactive substance produces an enhanced response to a smaller dose than the original. Seen in amphetamines You can withdraw from Amphetamines after the first use - ✔✔-even without dependence. Tx includes some antidepressants Cocaine Overdose - ✔✔-1) vomit, headache, cold sweats, muscle twitches 2) convulsions, rapid gasping breaths, decreased blood pressure 3) dilated pupils, paralyzed, unable to breath, cardiac arrest and death *no medicinal treatment to counter the overdose Cocaine Withdrawal phases - ✔✔-1. crash- depression, anxiety, exhaustion, cravings 2. hypersomnia, decreased att span, poor recall, increased appetite, muscle twitching 3. intense cravings marked by reduction to enjoy life and pleasure *meds that help; Provigil, symmetrel, parlodel, tofranil, norpramin Alcohol and cocaine are often combined - ✔✔-VERY dangerous. Produces cocaethylene Caffiene - ✔✔-Xanthines: naturally occurring stimulants. includes caffeine, theophylline (tea) and theobromine (chocolate) Caffienism - ✔✔-over 650mg of caffeine- 5 cups of coffee Tobacco withdrawl - ✔✔-coughing, lack of concentration, dizziness, fatigue, nervousness, stomach issues, throat problems, sleep disturbance, skin issues, mood alterations. Narcotics - ✔✔-Opioids and Opiates Opiates - ✔✔-opium, morphine, codeine Opioids - ✔✔-synthetic opiates- demeral, hydros, oxys, etc Heroin Long Term effects - ✔✔-increased risk of infection, pneumonia, irregular levels of sex hormones, asthma & bronchial infections, liver disease, collapsed veins, abnormal cortisol levels, chronic constipation, etc OVERDOSE ON HEROIN - ✔✔-is imminent- especially with the way it is being cut with fentanyl needle freaks - ✔✔-people psychologically dependent on heroin, not physiological Treatment for heroin - ✔✔-Ovedose: Narcan (naloxone) Antagonists: Naloxone, Naltrexone Use of vivitrol- which is naltrexone Therapeutic Communities (NA, etc) - ✔✔-are being used in the criminal justice field in the treatment of heroin addicts. Speed Balling - ✔✔-Combining Heroin with a stimulant like cocaine. Very dangerous. Causes heart to give out. LAAM - ✔✔-old school treatment of opiate addiction. Not used now due to the abuse ability. every 3 or so days. Methadone - ✔✔-detox is harder than that of the actual opiate. daily basis. Buprenorhine - ✔✔-suboxone, subutext, Fentanyl and Demerol - ✔✔-causing major public health concern Hallucinogens - ✔✔-LSD, MDMA, Shrooms, PCP, peyote, etc Bad Trip - ✔✔-Can include anxiety attacks, depressive episodes, and psychotic breaks that resemble schizophrenia. Can last for days especially with PCP PCP - ✔✔-can be physically dependent. All others are psychological only. Many claim this is the most dangerous drug ever to be abused. LSD - ✔✔-starts in gastrointestinal tract Lasts up to 12 hours can cause permanent damage to the brain flashbacks can be permanent detox - ✔✔-Quiet room with little to no stimulation MDMA - ✔✔-starts with a weird period that lasts about 30-60 min, then a rush period for 20-30 min and the high period that last several hours. Can be fatal due to dehydration, increased heart rate and decreased blood pressure paired with high body temps Cannabis - ✔✔-Marijuana (Schedule I) Hashish (Sched I) Marinol (Sched III) Effects last 8-12 hours Marijuana - ✔✔-potency ranges from .5 to 11%, street grade is about 3%. Hashish - ✔✔-30%THC or more. European/Middle Eastern cannabis Amotivation Syndrome - ✔✔-condition characterized by regular users of cannabis being lethargic, lacking drive, being apathetic, etc Inhalants - ✔✔-gases that are administered via breathing through mouth or nose within 10 seconds they relax the muscles around the heart and brain. Lipid soluble - can damage the brain quickly. Solvents, Nitrites and Anesthetics have similar effects. Can result in death due to respiratory asphyxia or heart arythmia Steroids - ✔✔-anabolic- memic natural steroids androgen- natural male hormones Adlerian Psychology - ✔✔-*Individual Psychology. Goal directed. *Everyone is striving to toward superiority and perfection. *Must learn how to handle inferiority. *Fictional Functioning imagined central goal that gives a client purpose or guides behavior *Lifestyle- clients chosen method on moving through life *phenomenolgy- viewing the world from the client's perspective *private logic- subjective reality as we view it *Social Interest- an awareness of being part of the human community and how one interacts with the social world *The goal is to further develop the client's social interest and help them connect with the social world in a more meaningful way. Behavioral Therapy - ✔✔-Pavlov- Classical Conditioning (UCS = UCR, CS=CR) Skinner- Operant Conditioning behavior is reinforced and learned by the consequences of the bx Bandura- Social Learning. Bx is learned by observing the consequences of other's behavior Human behavior is learned and can be unlearned Applications: Contingency Management: rewards are given for period of abstinence (chips) Community Reinforcement: social circle reinforces healthy behavior Assertion Training: Ct learns skill to resist negative influences and bx in life Cue Exposure training: constantly exposed to triggers and cues covert sensitization: client imagines himself using and immediately visualized worst possible outcome. aversion therapy: use is paired with unpleasant feeling such as electric shock or nausea Brief Therapy - ✔✔-Shorter time period and fewer sessions. Good for those without insurance, etc. Stages: Induction: ct makes decision to seek therapy and the clinician assesses the client's willingness to change. Therapy matches motivation level Alliance: Counselor forms an alliance with the ct. Clinician assesses impediments to change and motivation to change as well as setting goals and doing tx plan and contract Refocus/Change: working phase. every session is on task with homework, goal setting, applying lessons, etc. Termination/Homework: assist with relapse prevention. Set long term goals Continuation/Follow up: check in or f/u apt for as long s homework is planned. make sure that they are connected. CBT - ✔✔-*Counseling that focuses simultaneously learning new behaviors and restructuring automatic thoughts *Used for depression, anxiety SUD, pain d/o and other disorders *Ct can be assisted in recognizing and discarding selfdefeating behaviors, emotions, etc *"What keeps them doing _____" Client must have willingness to change for this method to work. there must be commitment. Gestalt - ✔✔-*Client gains awareness of their bx and learns how to accept personal responsibility for those bx *Based on existentialism- focus on present day and personal responsibility for ones own destiny *Contact is the procvess of interacting with nature & with other people without losing one's sense of individuality. * Uses empty chair method By acknowledging the under dog and top dog they can work through the problems Motivational Enhancement therapy (MET) - ✔✔-*method of counseling where the client's internal motivation is the driving force for changing problem bx *FRAMES (feedback, emphasis on personal responsibility, clear advice to change, a menu of alternative, therapist empathy, facilitation of client self efficacy) *Goes hand in hand with the stages of change Used in arenas where sessions are infrequent Stages of Change - ✔✔-Precontemplation, Contemplation, Preparation, Action, Maintenance, Relapse not considering treatment- casually considering treatment- makes decision to change- begins changecontinued commitment- return to problem behavior Person Centered Therapy - ✔✔-Carl Rogers Approach to counseling where the client directs the treatment process bc she is capable of invoking change within herself. Based on humanism- the movement that focuses on the innate nature of all humans to achieve our potential and find meaning in our lives 3 characteristics- congruence (match external bx with internal feelings / thoughts. Unconditional positive regard (counselor shows the client constant acceptance and caring) empathy (identify with & understand the subjective world of the client. Decreases defensiveness and encourage openness. Explore inner secrets and issues Psychoanalytical Therapy - ✔✔-FreudA deterministic method of counseling where the mental dysfunction results from internal conflict and memory. Human bx is largely influenced by internal drives. We all have an unconscious mind that functions outside of our awareness. It is brought to the conscious mind via the analysis of resistance. 3 components: Id (unconscious aggression and sex, the animal) Superego ( the conscience) and Ego ( mediates for the other 2) Defense Mechanisms stem from this theory. Good with those who chronically relapse or have deep seeded personality issues. Defense Mechanisms: - ✔✔-Denial- refusing to accept reality Displacement- transferring a feeling about an unpleasant situation onto another individual (grading wasn't' fair) Projection- attributing unacceptable thoughts or feelings to another ind or object (she only has friends bc of $) Rationalization- hiding the true reason behind a bx or feeling but doing so in a self serving way with incorrect explanations (I didn't run for president bc I didn't want to upset you win I won) Repression- blocking unpleasant experiences or thoughts from the conscious mind (I don't remember that night...) Sublimation- redirecting maladaptive bx into a socially accepted bx (I am sad so I will go to lunch w a friend) Rational Emotive Behavioral Therapy (REBT) - ✔✔-a method that focuses on changing the problematic beliefs of an individual as a result of the events of his life Events do not disturb people, their view of it does. ABC ModelActivating Event - negative event in ones life Belief- how a person thinks or feels about an activating event Consequences- how an ind behaved based on the beliefs concerning the activating event Counselor should dispute and correct illogical beliefs Targets thought distortions often associated with SUD Reality Therapy/Control Theory - ✔✔-*method that focuses on how the client perceives the external world & behaviors he exhibits fit those perceptions and needs *it isn't important how the world really exists, only the client's perception of how it exists. * basic principles- dev a therapeutic relationship, focus on current bx, ask client to eval that bx, develop a plan for change, get commitment from client, accept 0 excuses, no punishment, never give up on client. *there are 4 components that guide our functioning (doing, thinking, feeling and physiology) *Success Identity- the place in therapy where the client has self worth is able to love and be loved Self Help Meetings - ✔✔-12 step, celebrate recovery, rational recovery, etc Solution Based Therapy - ✔✔-primarily focuses on the problem, not the person., Utilization- where counselor uses previous successes to motivate change Positive and self affirming, gets good results Family Systems Counseling - ✔✔-SUD person has an enabler (provides responsibility), a hero (provides self worth), scapegoat (provides focus), lost child (provides relief) and a mascot (provides distraction) Group Counseling - ✔✔-counseling with group members who have similar situations and experiences. The effectiveness depends greatly on the effectiveness of the leader. Qualities of a good leadercourage, stamina, self-awareness, openness, sense of humor, belief in the process, caring/goodwill, abilty to be a role model, aware of cultural perspectives and bias, maintain power posture, willingness to seek new experience, commitment Have an informed consent. Stress confidentiality Screening v Assessments - ✔✔-Screening tools are brief and determine basic information, assessment goes further into the meat of things. Develop an individualized treatment plan - ✔✔-this is based on the assessment toole should have a problem statement, goal statement, measurable objectives, and include strategies Treatment Modalities - ✔✔-Indiv Counseling, Group Counseling Family or Systems Counseling, Detox Tx Inpatient- hospital style, 24 hr staff Residential- 24 staff, medical on call IOPOP- assessment/referral programs, education programs, Therapeutic community, transitional programs, Documentation - ✔✔-Make sure to complete progress notes on each visit. These should include the personal account of the visit, and where the person is on the clinical course and treatment plan goal Progress Notes: DAP- data assessment plan or SOAP- subjective, objective assessment plan Referral - ✔✔-the proves of seeking assistance for an issues that is beyond the scope of your practice. Can be for additional services or to replace you if there is a reason you are ineffective multidisciplinary team - ✔✔-a group of professionals that are all working on the client. example would be the probation officer, dcs, dhs, and mental health pr [Show More]

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