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Psychiatry > Addiction > Flashcards

Addiction Flashcards

1
Q

What are the criteria for substance abuse disorder?

A
  • mild: has 2-3 of the symptoms
  • moderate: 4-5 of the symptoms
  • severe: 6 or more

Symptoms

  • inability to cut down on the substance/ using too much
  • causing social impairment with work or school obligations/poor relationships with others because they want to spend time using
  • engaging in risk behaviors: putting others in danger to obtain the substance
  • physical changes: tolerance to the drug or withdrawal of the substance
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2
Q

What is the screening tool used for substance abuse disorder in adults?

A
  • CAGE
  • Have you felt the need to cut down/
  • have you felt annoyed about someone asking about you using the substance?
  • Have you ever felt guilty about using?
  • Do you ever need a fix of the substance in the morning to start your day?
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3
Q

Treatment for substance abuse disorder

A
  • psychotherapy and group therapy
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4
Q

What are the stages in identifying that a person has a problem with a substance?

A
  • pre-contemplative (denial)
  • contemplative (acknowledge problem)
  • preparation (getting ready to take 1st steps)
  • Action (actual behavior change)
  • Maintenance (sustain behavior w/o relapsing)
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5
Q

define addiction

A

Patient needs substance to feel normal. Baseline resets and then they need more of the substance to obtain the same high, but the baseline keeps getting reset.

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6
Q

____ tx for opioid intoxication

A

naloxone (0.4 to 0.8 mg) repeat dose every 2-3 minutes as needed

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7
Q

What is the most common abused substance?

A

-alcohol

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8
Q
  • Which substance is the patient intoxicated with
    • altered mental status
    • disinhibition
    • slurred speech
    • has trouble walking
A

alcohol

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9
Q

Chronic alcohol abuse can lead to ?

A
  • Wernicke’s encephalopathy, korsakoff’s encephalopathy, cirrhosis, GI bleeds, gastritis
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10
Q

Which amino acid can become depleted on chronic alcohol use?

A

thiamine

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11
Q

How much alcohol can the liver process per hour?

A

0.03 BAL/hour

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12
Q

What is the acute treatment for alcohol intoxication?

A

IV fluids and time

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13
Q

Chronic treatment for alcohol use?

A

AA (is better than disulfiram)

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14
Q

Which neurotransmitter does alcohol and benzodiazepines (BZD) stimulate?

A

GABA

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15
Q

Chronic alcohol use causes downregulation of GABA. If the patient stops alcohol after chronically using, what happens?

A

There is no inhibition of GABA. As a result, there will be an increased activity of the body, which can lead to seizures.

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16
Q

Which substance is the patient withdrawing from with the following symptoms: increased heart rate, hypertension, tremor, diaphoresis, agitation, confusion, and seizure

A

Alcohol or BZD–> same presentation

17
Q

Treatment for delirium tremens?

A

long acting BZD taper with rapid BZD

18
Q

Patient is intoxicated with which substance with the following symptoms: euphoria, decreased respiration rate, constricted pupils.

A
  • opioids
19
Q

Using heroin increases one’s risk for which infections?

A
  • hep B/C, HIV, and infective endocarditis
20
Q

Patient is experiencing pain, nausea, vomiting, diarrhea, with dilated pupils. Which substance are they withdrawing from?

A
  • opioids
21
Q

Treatment for opioid abuse

A
  • Narcotics anonymous

- methadone or suboxone

22
Q

What is the treatment for BZD intoxication?

A
  • flumazenil
23
Q

BZD overdose causes what in the elderly?

A
  • delirium
24
Q

Patient is agitated with dilated pupils, hypertension, and psychosis. What substance are they intoxicated with?

A
  • cocaine
25
Q

Using cocaine increases one’s risk for?

A
  • angina/hypertensive crisis
26
Q

Patient has constricted pupils, feels like bugs are crawling on them, and they are slow moving/depressed. What substance are they withdrawing from?

A
  • cocaine
27
Q

Patient has dilated pupils, psychosis, overheating with a fever and increased heart rate, and is constantly drinking water. What substance are they intoxicated with?

A
  • amphetamines
28
Q

Withdrawal of amphetamines looks like?

A
  • patient crashes–> depression
29
Q

Patient is super aggressive and is fighting everyone in the ER. On physical exam, there is vertical and horizontal nystagmus. Which substance are they intoxicated with?

A
  • PCP
30
Q

Treatment for PCP intoxication

A
  • Haldol acutely

- acidify urine to increase excretion of the substance

31
Q

Patient has paranoia, slow reflexes, conjunctivitis, and is very hungry. Which substance is the patient intoxicated with?

A
  • marijuana/THC
32
Q

A patient intoxicated with barbiturates will present how?

A
  • decreased safety margin, decreased respiratory rate, coma

Psychiatry (15 decks)

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