Addiction Flashcards

1
Q

What is defined as hazardous drinking

A

Drinking above the level of 2-3 units/day for women and 3-4 units/day for men

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2
Q

What is defined as harmful drinking

A

Defined as a pattern of alcohol consumption causing health problems related to alcohol

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3
Q

What is defined as alcohol dependence

A

Behavioural syndrome of impaired control over alcohol use, with drinking becoming problematic and harmful

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4
Q

How to diagnose alcohol dependence

A

3 critieria met during 12 month period:
Tolerance.
Withdrawal symptoms/Alcohol withdrawl syndrome.
Use in larger amounts for longer periods than intended.
Time is spent obtaining alcohol or recovering from effects.
Social, occupational and recreational pursuits are given up/reduced.
Use is continued despite knowledge of alcohol related harm.

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5
Q

What screening tool can be used for alcohol use disorders

A

AUDIT

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6
Q

What happens in dependent drinkers

A

Lasting central nervous system changes take place which put people at long term risk of relapse

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7
Q

What laboratory investigations are useful in alcohol dependents

A

Gamma-glutamyl transferase which is a good biological marker of alcohol misuse.

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8
Q

Features of alcohol withdrawal

A

Sympathetic nervous system overactivity
Perceptual disturbances
Cognitive changes
Insomnia, GI distrubances and sometimes seizures

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9
Q

Symptoms of sympathetic nervous system overactivity

A

Raised pulse, raised blood pressure, sweating, tremor, raised temperature

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10
Q

Symptoms of perceptual disturbances

A

Visual, tactile or more rare auditory. Can be vivid dreams or hallucinations or llusions. Formication - sensation of feeling things crawling on the skin

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11
Q

Symptoms of cognitive changes

A

Anxiety, paranoia, delirium

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12
Q

What vitamin is lacking in alcohol dependents

A

Thiamine

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13
Q

What is the primary target for opioids

A

Mu opioid receptors and then dopamine

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14
Q

What are the other actions of opioids

A

Kappa and delta opioid receptors

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15
Q

What is the primary targey for cocaine

A

DAT and dopamine

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16
Q

What is the primary target for nicotine

A

Nicotinic ACh receptor and dopamine

17
Q

What is the primary target for ethanol

A

GABA/glutamate, increasing GABA and decreasing glutamate

18
Q

What is the primary target for benzodiazepines

A

GABA receptor, increasing GABA and dopamine

19
Q

What is the primary target for cannabis

A

CB1 receptors with an effect on dopamine

20
Q

Primary target for ecstasy

A

5-HT transporter which increases 5-HT and some DA

21
Q

Primary target for ketamine/PCP

A

NMDA which decreased glutamate

22
Q

Primary target for LSD

A

5-HT2 receptors which increased 5-HT

23
Q

Full agonist of opiates in clinical pharmacotherapy

A

Methadone

24
Q

Full agonist of cocaine in clinical pharmacotherapy

A

Buproprion

25
Q

Full agonist of nictotine in clinical pharmacotherapy

A

Nictotine - patches, gum, ect

26
Q

Full agonist of ethanol in clinical pharmacotherapy

A

Benzodiazepines, Baclofen

27
Q

Full agonist of ecstasy in clinical pharmacotherapy

A

SSRIs

28
Q

Antagonists of opiates in clinical pharmacotherapy

A

Naltrexone, buprenorphine

29
Q

Antagonist of nicotine in clinical pharmacotherapy

A

Mecamylamine

30
Q

Antagonist of ethanol in clinical pharmacotherapy

A

Naltrexone, nalmefene, flumazenil

31
Q

Antagonist of ecstasy in clinical pharmacotherapy

A

SSRI

32
Q

Antagonist of LSD in clinical pharmacotherapy

A

5-HT2

33
Q

Top of heirachy for aims in treatment for drug addiction

A

Total abstinence

34
Q

sseond in heirachy for aims in treatment of drug addiction

A

Reduce prescribed medication - methadone reduction

35
Q

Third in hierachy for aims in treatment of drug addiction

A

Stop illicit drug use - by prescribing substitute medication

36
Q

Bottom of hierachy of aims in treatment of drug addiction

A

Harm minimisation - vaccination for Hep B, needle exchange

37
Q

Opioid withdrawal symptoms

A

Dilated pupils, tachycardia, increased BP, sweating, piloerection, sneezing, yawning, rhinorrhoea, psychomotor agitation