7. Substance-related and addictive disorders Flashcards
MOA of alcohol
Activates GABA and inhibits glutamate…hence it is a CNS depressant
(GABA is inhibitory…glutamate is excitatory)
________________ (ethnic group) often have less of this enzyme ______________.
Asians
Aldehyde dehydrogenase
Drug of choice for alcohol withdrawl?
Chlordiazepoxide (Librium)
Most common type of hallucination in DTs?
Visual
Confabulations
Inventing stories of events that never occurred. Patient unaware that they are “making these up”
*Often associated with Korsakoff’s psychosis
“Banana bag” for treating nutritional deficiencies in alcoholic patients
Thiamine
Folic acid
Multivitamin
Drug that is used first-line for alcohol use disorder. Can be used in patients with liver disease
Acamprosate (Campral)
Topiramate (Topamax)
Anticonvulsant…potentiates GABA, inhibits glutamate receptors
Reduces cravings for alcohol and reduces alcohol use
Effect of alcohol on MCV
Increase
Thiamine before or after glucose for patient with altered mental status?
Thiamine BEFORE Glucose. Or you can precipitate Wernicke-Korsakoff syndrome
Thiamine is a coenzyme used in carbohydrate metabolism.
MOA of amphetamines
Block reuptake and facilitate release of DA and NE
Grinding teeth
Amphetamine abuse
PCP mechanism of action
Antagonizes NMDA glutamate receptors and activates dopaminergic neurons
Drug similar to PCP but less potent
Ketamine
PCP intoxication symptoms
“RED DANES”
Rage
Erythema of skin
Dilated pupils
Delusions Amnesia Nystagmus Excitation Skin dryness
Synesthesia…what is it?
What drug is it associated with?
One sensory stimulation evokes another, such as hearing a sound produces a color
PCP
Violence
PCP
Date-Rape drug
GHB…Gamma-hydroxybutyrate
*Dose-specific CNS depressant that produces confusion, dizziness, drowsiness, memory loss, respiratory distress, and coma
Opioid that causes pupil dilation
Meperidine
“Demerol dilates pupils”
Treatment for barbituate overdose
Sodium bicarbonate: to alkalinize the urine to promote renal excretion
Treatment for benzodiazepine overdose
Flumazenil
Withdrawl from what class of drugs has the highest mortality rate?
Barbituates
Gold standard for treatment of opioid addiction in pregnant women
Methadone
Classic triad of opioid overdose
“Rebels admire morphine”
Respiratory depression
Altered mental status
Miosis
Withdrawal symptoms of opiates?
Life threatening?
Anxiety Insomnia Anorexia Fever Rhinorrea Piloerection
NOT life threatening
Pill form of THC that is FDA approved for certain indications
Dronabinol
MOA of cannabinoid receptors in brain
Inhibit adenylate cyclase
Why is it important to identify the solvent that a patient has inhaled?
Some may require chelation
Ex. leaded gasoline
MOA of caffeine
Adenosine antagonist
Increases cAMP and stimulates release of excitatory neurotransmitters
Cigarette smoking during pregnancy is associated with?
Low birth weight
SIDS
postnatal morbidities
Drug that reduces rewarding aspects of nicotine and prevents withdrawl symptoms?
MOA?
Varenicline (Chantix)
Partial agonist at alpha4beta2 nicotinic cholinergic receptor
Antidepressant that inhibits dopaine and norepinephrine reuptake
Buproprion
