Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Health 32 > Addiction > Flashcards

Addiction Flashcards

1
Q

proper use of alcohol i.e. recommended = how many units?

A

14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

hazardous use (of alcohol) meaning?

A

use of a drug other than directed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what type of alcohol use would be associated with problems at work or home, legal problems, drink driving and continued use despite adverse consequences?

A

harmful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what type of alcohol use would compulsion, tolernace, withdrawal and silence of behaviour be associated with?

A

dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

why/ how is alcohol tolerance brought on?

A

liver breaks down quicker as accustomed to it = have to dirnk more to get same effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what does SBIRT refer to in regards to the screening that any HCP can initially undertake?

A

screening, brief intervention and referral to treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

interventions to alcohol aimed at individuals can help make people aware of the potential risks they are taking at an early stage, patients are most likely to change their behaviour if it is tackled early, true or false?

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

3 stages to dealing with alcohol dependence?

A

screen
brief advice (intervention brief)
behaviour change counselling (extended intervention)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the audit C used for?

A

front line workers who meet patients with alcohol dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what equation can you use to work out the units of alcohol?

A

(total drink vol in ml x % abv ) / 1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what tools might you use for initial screening questions for alcohol?

A

audit c or sasq

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what would be your course of action if a patient has a audit c score of 5+ and or a sasq of never or less than monthly?

A

administer audit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

if a patient has a lower risk betwene 0-7, what might you provide the patient with?

A

information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

for patients with an increasing risk (8-15) or a higher risk (16-19) what would you provide the patient with?

A

brief advice and lifestyle intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

if a person has possible dependence they will have a score of around 20. What should be your course of action for these patients?

A

refer for specialist support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what does the FRAMES acronym for interventions stand for?

A

3 important things to DO

feedback,
responsibility,
advice,

3 important things to BE

menu,
empathy
self efficacy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the term given to the inability to resist urges and act without foresight?

A

impulsivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the term given to the stimulus (drug) that increases the probability of further drug taking?

A

positive reinforcement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the term given to the removal (withdrawal) of a stimulus that increases the probability of further drug taking?

A

negative reinforcement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the term given to repetitive behaviour despite the adverse consequences and reduces stress, anxiety and tension?

A

compulsivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

addiction is fundamentally about?

A

compulsive behaviour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

compulsive drug seeking is initiated outside of what

A

consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

normal flexibility of human behaviour is eroded to a state of compulsive behaviour.

4 symptoms of behavioural syndrome?

A

dyscontrol
slaience
neuroadaption
compulsive behaviour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

which part of the basal ganglia is associated with the reward pathway and motivation?

A

nucleus accumbens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what part of the basal ganglia is associated with forming habits and routine?

A

nucleus accumbens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what part of the basal ganglia is associated with forming habits and routine?

A

dorsal striatium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what part of the brain is associated with withdrawal, unease and anxiety?

A

extended amygdala

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what part of the brain is associated with executive function: planning, priotising, managing time, making decisions and control over substance taking?

A

prefrontal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

addiction (compulsive behaviour) is mediated by a ?

A

compulsive unit:
- nucleus accumbens
- ventral pallidum
- thalamus
- prefontal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

dopamine d2 receptors are lower or higher in addiction?

A

lower
(less DA receptors to then –> reward circuits)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

why do natural reqrds become devalued in drug abusers?

A

as drug associated cues usurp the motivational circuits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

the addiction cycle: 3 stages?

A

basal ganglia:
1) binge/intoxication

extended amygdala
2) withdrawal/ negative affect

prefrontal cortex
3) preoccupational/ anticipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

when executive function is disrupted in prefrontal cortex, what system inc and what dec?

A

inc GO system, release glutamate, strong urge

dec STOP system, compulsive drug seeking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what brain structure puts drug seeking into motion without conscious initiation?

A

nucleus accumbens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what 2 drugs can manage alcohol withdrawal?

A

chlordiazepoxide
thiamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

chlordiaepoxide is the benzodiazepine of choice for managing alcohol withdrawal. why is this drug class good for this purpose?

A

dampen noradrenaline response from alcohol withdrawal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is the rationale behind using thiamine for managing alcohol wtihdrawal?

A

b vitamin helps replace those not taken in diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what 5 drugs used for alcohol relapse prevention?

A

disulfiram
naltrexone
acamprosate
nalmefene
?baclofen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

2 drugs used for Opioid substitution therapy? (OST)

A

methadone
buprenorphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

drug that stops liver breaking down alcohol?

A

disulfuram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

anti craving drug?

A

acamprosate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

drug for managed withdrawal of opioids?

A

lofexidine
or clonidine?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

opioids relapse prevention drug?

A

naltrexone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

harm reduction:
antidote to heroin / opiates?

A

naloxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

antisychotics
bromocriptine
aripiprazole

all act on what?

A

dopamine neuron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

acamprosate
memantine
topiramate

all act on?

A

glutamate- excitatory input

((also GABA inhibitory neuron))

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

which antipsychotics are best to be used as co morbidity therapies? 3

A

clozapine, olanzapine and risperidone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

up to 1/3 of ppl w alcohol dependence will achieve abstinence following treatment in XX term

A

short - medium (3-12 months)

49
Q

less than 10% ppl w alcohol dependence/ opioid dpeendence will have XXXX

A

long term continuous abstinence following treatment

50
Q

after learning, what –> craving (conditioned response)?

A

needle (conditioned stimulus)

51
Q

which antipsychotic drug is the most effective at reducing alcohol, cocaine and cannabis abuse among patients with schizophrenia?

A

clozapine

52
Q

IPE reading…..
different types of substance misuse in order to enhance image and performance

A

Normally injected, taken orally, or applied topically using a cream or gel.
Most common type of IPED: anabolic steroids

53
Q

reasons for IPE drug abuse?

A
  • promote weight loss
  • change skin colour
  • build muscle
  • allow longer, more intense training
54
Q

what hormones are commonly included in injectable anabolic steroids?

A

hgh, epo and melanotan

55
Q

what might IPEDS that contain clenbuterol and DNP be used for?

A

fat burners

56
Q

what is the most popular IPED that is used amongst men?

A

methandrostenolone

57
Q

what are the most popular IPEDs used amongst women?

A

oxandrolone and melantonan

58
Q

list 6 psychological side effects?

A

addiction, depression, mood changes, paranoia, agression and euphoria

59
Q

list 6 physiological side effects?

A

male pattern baldness, acne, excess body hair, infertility, heart attack and stroke

60
Q

some IPED users do stacking which when several agents are used in a complex high dose regimen. Name one drug that these users may take additionally as they believe it will combat some of the side effects associated with steroid use?

A

tamoxifen

61
Q

name 2 dangers that users who inject steroids are exposed to?

A

HIV and hep B

62
Q

Workshop…..
infective endocarditis likely cause?

A

Staphylococcus aureus (found on the skin)- would help diagnosis and treatment.

63
Q

Drug + Px history (illicit and normal) that you need before making diagnosis of infective endocarditis?

A

drugs px misused and if administer themselves
- taken any IV: to check for infections.
- History of drug abuse: most likely heroin dependant. Injecting using dirty/ contaminated needles… bacteria ends up in bloodstream

Smoking, alcohol consumption, exercise (can affect heart)

Previous heart surgery/ prosthetic valves. Any trauma to heart valve.

64
Q

why ask a heroin dependant/ any px w suspected infective endocarditis if they’ve had precious heart surgery?

A

Previous heart surgery/ prosthetic valves. Any trauma to heart valve —> damage to endothelial cells on surface, becomes susceptible to infections

65
Q

Suspected infective endocarditis
Usually bacterial but may be due to
…

A

rickettsia, chlamydia or fungus

66
Q

why are symptoms alone not enough to diagnose IE?

A

vague. e.g.:
fever, anorexia, night sweats, weight loss, arthralgia

67
Q

why are IV drug users more susceptible to IE infection?

A

Staphylococcus Aureus
* Lives on skin making IV drug users more susceptible to this infection

68
Q

empirical first line antibiotic treatment for Staphylococcus Aureus infection (IE)?

A

guided by microbiology, local Trust guidelines

Initial blind therapy amoxicillin + low dose gentamicin BNF – gentamicin now may not be started until results of cultures available (synergistic activity)

69
Q

antibiotic treatment for Staphylococcus Aureus infection (IE) IF PX PENICILLIN ALLERGIC?

A

Vancomycin + gentamicin

70
Q

Longer courses of treatment (4-6 weeks) needed for staphylococcus Aureus infection (IE) why?

A

due to difficulty penetrating vegetations and biofilms

71
Q

synergistic meaning in context of antibiotics?

A

interaction of two or more drugs when their combined effect is greater than the sum of the effects seen when each drug is given alone.

72
Q

why give 2 different antibiotics for treating IE?

A

synergy.

Adding 2 antibiotics together different susceptibilities between the bacteria and work by disrupting cell wall

73
Q

Gentamicin: keep dose low why?

A

narrow therap window

74
Q

normal course antibiotics for infection?

A

3 days or 7 for UTI

75
Q

Staphylococcus is aerobic/anerobic bacteria?

A

aerobic

76
Q

gentamicin given for what type of bacteria treatment and why?

A

aerobic
as G needs oxygen to treat

77
Q

gentamicin 2 main SEs?

A

oto and nephrotox

78
Q

which group of patients are most at risk of developing IE?

A
  • congenital heart disease,
  • artificial heart or valves,
  • damaged heart valves,
  • hypertrophic cardiomyopathy,
  • valvular heart disease patients who are immunocompromised
79
Q

dental pxs = more likely to be susceptible to infective endocarditis caused by streptococci as …?

A

this bacteria lives in the resp. tract and mouth

80
Q

what is Neonatal abstinence syndrome (NAS)?

A

when babies exposed to drugs in womb before birth due to passage from mothers bloodstream, then experience withdrawal symptoms:
tremor, irritability (excessive crying and high pitched), seizures, poor feeding, diarrhoea

81
Q

Testing to find most appropriate management for NAS?

A
  • Urine test & meconium test
  • Blood test
  • Lipsitz Neonatal drug-withdrawal scoring system or Finnegan system
82
Q

guidelines to follow for NAS treatment?

A

Glasgow and Carlisle
Wales neonatal network guideline

83
Q

NAS management?

A
  • Wrap baby in blanket
    (swaddling)
  • Minimise sensory stimulation
  • Use of dummies

pharmacological:
- same class as those exposed to prior to birth (opiate only/ plus benzo)

84
Q

other drug classes commonly causing NAS?

A

Opioids: heroin, prescribed meds eg codeine, oxycodone

Stimulants: amphetamines /cocaine. effects on baby more likely from drug itself instead of withdrawal.

Antidepressants (SSRIs)

Depressants: barbiturates, or alcohol, or marijuana

Nicotine from cigarette smoking

85
Q

morphine half life is short/long and how does it compare w t1/2 of methadone?

A

morphine = long
but shorter than methodone

86
Q

problem with morphine in renal failure?

A

Variable bioavailability, glucuronide metabolites accumulate in renal failure (M6G toxicity) mu, kappa, delta

87
Q

methadone has low oral bioavailability as…

A

Highly bound to plasma proteins

88
Q

methadone is extensively metabolised by enzyme:

A

CYP3A4

89
Q

how are methadone metabolites excreted?

A

in urine

90
Q

methadone pharmacolical effects on px?

A

analgesia, depression of respiration, suppression of cough, nausea and vomiting (via an effect on the chemoreceptor trigger zone) and constipation.

91
Q

describe action of methadone

A

Strong opioid agonist with actions predominantly at the µ receptor. Also has some agonist actions at the K and δ (delta) opiate receptors.

92
Q

methadone half-life after a single oral dose is 12-18 (mean 15) hours, partly reflecting what?

A

distribution into tissue stores, as well as metabolic and renal clearance. With regular doses, the tissue reservoir is already partly filled, and so the half-life is extended to 13-47 (mean 25) hours reflecting only clearance.

93
Q

methadone is Xphilic and has Y Vd

A

lipophilic and high Vd

94
Q

methadone t1/2 compared w diamorphine (heroin)?

A

Longer
Accumulate in tissues on repeated dosing, potential for accumulation, complicated PK

95
Q

diamorphine half life is long/short and whats it metabolised into?

A

rapid: 2-3 minutes half life to be metabolised into morphine

96
Q

Prodrug for morphine?

A

Diamorphine (heroin)

97
Q

Buprenorphine
Interacts with what receptor?

A

opioid mu-receptor (binding sites in brain, SC, other tissues)

= Partial agonist (mu receptor and ORL-1)

98
Q

Buprenorphine route of admin and why?

A

SC/ IV = highest bioavailability

99
Q

buprenorphine metabolism and Vd?

A
  • High first pass metabolism on SL absorption
  • High Vd
100
Q

how does the sedation intensity and withdrawal symptoms of buprenorphine compare w full agonists? (as its only a partial agonist)

A

`Less sedation than full agonists but more likely to be associated with withdrawal symptoms

101
Q

naloxone MoA? it is a…

A

opioid receptor antagonist

102
Q

naloxone half life IV and clearance?

A

IV: 1.2 hours
.. and v high clearance 2500L/day

103
Q

naloxone half life compared w methadone?

A

comparative half life shorter than methadone

104
Q

preparations of medications for the management of opioid dependency?

A

Methadone formulations:1mg/ml

Suboxone (buprenorphine/ naloxone)SL tablets

105
Q

opioid dependency- why should buprenorphine not be given until at least 6hrs after heroin dose?

A

as it can cause withdrawal.

106
Q

Suboxone (buprenorphine/ naloxone) for opioid dependancy. describe the use of naloxone in this prep?

A

When taken SL, naloxone is not absorbed, but if tablets are crushed and injected naloxone will cause withdrawal effects. Naloxone was added to prevent diversion onto illicit market

107
Q

difference between the preparation of buprenorphine licensed for opioid dependence vs treatment of pain?

A

Preparations licensed for opioid dependency have higher doses (0.8mg-32mg)- due to tolerance

for pain have lower dose (average 450mcg)

108
Q

codeine side effects OTC and POM misuse abuse

A

confusion; constipation; dizziness; drowsiness; dry mouth

109
Q

what is lorazepam?

A

Short-acting benzodiazepine commonly used to treat panic disorders, severe anxiety, and seizures.

110
Q

describe lorazepam (benzo) half life

A

short half life (10 - 20 hrs) and short onset of action so will be difficult for patient to withdraw, will need to keep taking it.

111
Q

what type of drug is benzo: lorazepam?

A

is a GABA mimetic (usually GABA produces inhibitory functions in CNS)

112
Q

why use lorazepam (benzo) w caution in elderly px?

A

risk of falls, continuous use could cause respiratory depression. Should be used for short term symptomatic relief of severe and debilitating anxiety.

113
Q

how long after admin are peak lorazepam serum levels reached?

A

in 2 hours and half life is 12 hours

114
Q

lorazepam works by enhancing inhibitory effects of …

A

GABA, CNS depressant induces calm, sleep, drowsiness

115
Q

Lorazepam is metabolised by simple one-step process to ..?

A

a pharmacologically inert glucuronide. There are no major active metabolites.

116
Q

how high is the risk of excessive accumulation of lorazepam?

A

Elimination half-life is about 12 hours and there is minimal risk of excessive accumulation.

117
Q

how must benzos like lorazepam be stopped in px esp elderly?

A

Tapering: gradual reduction of dose (reduce seizure risk)
OR
switch to appropriate dose of diazepam (longer acting benzo so stays in the body longer and helps minimise withdrawal) + slowly withdraw

Non pharmacological: Bereavement counselling. CBT

118
Q

1mg lorazepam = 5-10mg diazepam
How to switch form the short -> longer acting benzo?

A

convert to longer acting drug and slowly withdraw

Reduce over greater than 4 weeks to over one year

Health 32 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions