3. Iszard- Agents associated with substance use disorder and Tx

Question 1

What is Schedule I drug?

Answer 1

No medical use; high addiction potential

Question 2

What is Schedule II drug?

Answer 2

Medical use; high addiction potential

Question 3

What is Schedule 3 drug?

Answer 3

Medical use; moderate abuse potential

Question 4

What is Schedule Iv drug?

Answer 4

Medical use; low abuse potential

Question 5

Flunitrazepam,
 heroin, 
LSD, 
mescaline,
 PCP,
 MDA, 
MDMA, 
STP

are what type of drugs?

Answer 5

Schedule I

Question 6

Amphetamines, 
cocaine,
 methylphenidate, 
short acting barbiturates, 
strong opioids

Are what type of drugs?

Answer 6

Schedule II

Question 7

Anabolic steroids, 
barbiturates, 
dronabinol,
 ketamine, 
moderate opioid agonists 

are what type of drugs?

Answer 7

Schedule III

Question 8

Benzodiazepines, chloral hydrate, mild stimulants (eg, phentermine, sibutramine), most hypnotics (eg, zaleplon, zolpidem), weak opioids

Answer 8

Schedule IV

Question 9

Agitation, hypertension, tachycardia, delusions, hallucinations, hyperthermia, seizures, death are overdose sx of what drugs?

Answer 9

1. Amphetamines,
2. methylphenidate
3. cocaine

Question 10

Slurred speech, drunken behavior, dilated pupils, weak and rapid pulse, clammy skin, shallow respiration, coma, death are overdose sx of what drugs?

Answer 10

1. Barbiturates
2. benzodiazepine
3. ethanol

Question 11

Constricted pupils, clammy skin, nausea, drowsiness, respiratory depression, coma, death are overdose sx of what drug?

Answer 11

1. Heroin

2. Other strong opioids

Question 12

Apathy, irritability, increased sleep time, disorientation, depression- CRASH are withdrawal sx of what drugs?

Answer 12

1. Amphetamines,
2. methylphenidate
3. cocaine

Question 13

Anxiety, insomnia, delirium, tremors, seizures, death are withdrawl sx of what drugs?

Answer 13

1. Barbiturates
2. benzodiazepine
3. ethanol

Question 14

Nausea, chills, cramps, lacrimation, rhinorrhea, yawning, hyperpnea, tremor are withdraw sx of what drugs?

Answer 14

1. Heroin

2. Other strong opioids

Question 15

PCP can have what long term effect?

Answer 15

PCP may lead to irreversible schizophrenia-like psychosis

Question 16

LSD can have what long term effect?

Answer 16

LSD can cause flashbacks of altered perception years after consumption

Question 17

What drug is used to:

1. Improve mental alertness
2. treat migraine headaches
3. treat headaches after epidural anesthesia

Answer 17

Caffeine

• also used by mouth for asthma, ADHD, and memory
• can be sued for weight loss and T2DM

Question 18

What is a standard drink?

Answer 18

0. 6 oz of pure alcohol
   - 􏰁12-ounces of beer (5% alcohol content). 􏰁
   - 8-ounces of malt liquor (7% alcohol content).

-􏰁5-ounces of wine (12% alcohol content).
􏰁
-1.5-ounces of 80-proof (40% alcohol content) distilled spirits or liquor

Question 19

What type of Kinetics is alcohol metabolism?

Answer 19

Zero-Order Kinetics
• Rate remains constant and is
independent of concentration or amount of chemical

• The biological system is the rate-limiting factor
• t1/2 increases with dose (not a true t1/2)

Question 20

What are key enzymes in alcohol metabolism?

Answer 20

1. Alcohol dehydrogenase (alcohol–> acetaldehyde)

2. Acetaldehyde dehydrogenase (acetaldehyde–> acetic acid)

Question 21

What is alcohol metabolism?

Answer 21

• ethanol undergoes extensive first-pass metabolism

- typical 70 kg adult can metabolize 7-10 g of alcohol per hour ~ 1 drink

Question 22

What withdrawl:
• Can be life threatening
• Major pharmacological objective is to prevent
seizures, delirium, and arrhythmias,
electrolyte rebalancing, thiamine therapy
• Benzodiazepines tx

Answer 22

Alcohol

Question 23

What drugs are used for acute alcohol withdrawal syndrome?

Answer 23

1. Thiamine (vitamine B1)
2. Oxazepam
3. Lorazepam (Ativan)
4. Diazepam (Valium)

I TOLD you not to drink!

Question 24

What drugs are used to prevent alcohol abuse?

Answer 24

1. Disulfiram (Antabuse)
2. Acamprosate
3. Naltrexone

DAN

Question 25

What drugs are used to treat acute methanol or ethylene glycol poisoning?

Answer 25

1. Ethanol

2. Fomepizole

Question 26

What drug used to treat alcohol and opiate dependence is a μ opioid receptor antagonist (long-acting) that:

• Reduces the craving for alcohol and the rate of relapse to either drinking or alcohol
dependence for the short term (12 weeks)

Answer 26

Naltrexone

• Individuals physically dependent on alcohol and opioids must be opioid-free before
initiating therapy because naltrexone precipitates an acute withdrawal syndrome

Question 27

What drug is a weak NMDA-receptor antagonist and GABAA receptor agonist (also affects serotonergic, noradrenergic, and dopaminergic systems)?

Answer 27

Acamprosate

• Reduces short-term and long-term relapse rates (more than 6 months)

Question 28

What drug irreversibly inhibits aldehyde dehydrogenase and causes extreme discomfort in patients who drink alcoholic beverages (flushing, throbbing headache, nausea, vomiting, sweating, hypotension, confusion due to the accumulation of aldehyde)?

Answer 28

Disulfiram

• Should not be administered with any medications that contain alcohol (cough syrups, cold preparations, mouthwashes)
• PATIENTS MUST BE HIGHLY MOTIVATED