Addiction Flashcards
Which system of the brain is involved in addiction?
the reward system
What is the function of the VTA?
houses the dopamine cell bodies that project to the nucleus accumbens and the prefrontal cortex
What is the function of the nucleus accumbens?
integrates the signals from the VTA and the prefrontal cortex to determine motivational output
What is the function of the prefrontal cortex?
- executive control over midbrain structures
- judgement
- cost benefit analysis
What is the function of the DLPFC?
statistical analysis-risk/benefit ratio
What is the function of the VMPFC?
assigns emotional valence-attach positive feelings to not doing dangerous things
What is the function of the OFC?
impulse prevention- supresses doing dangerous things
What is the function of the ACC?
vigilance
What does chronic drug use do to limbic function? PFC function?
Limbic-increased with chronic use
PFC-decreased with chronic use
How do drugs effect the limbic pathway?
- enhance dopamine release
- enhance dopamine effects on nucleus accumbens
- produce effects similar to dopamine
What are of the brain might be strengthened from psychotherapy?
prefrontal cortex
What are the symptoms of alcohol intoxication and how is it treated?
lowered consciousness poor coordination ataxia nystagmus slurred speech stupor GI Bleed respiratory depression coma death Treated-supportive care, airway support **Tx belligerance with benzodiazepenes**
What are the symptoms of alcohol withdrawal and how is it treated?
agitation tremor sensitivity to sensory input nausea and vomitting anorexia anxiety/depression headache insomnia seizures hallucinations Treatment- Thiamine, benzodiazepens and multivitamines
What are the symptoms of cannabis intoxication and how is it treated?
euphoria sensory stimulation pupil constriction photophobia increased appetite nystagmus autonomic dysfxn gynecomastia airway disease decreased sperm count Treatment- d/c use, observation, bronchodilators **neuroleptics if panic/psychosis**
What are the symptoms of cannabis withdrawal and how is it treated?
**Only in chronic use** mild irritability agitation insomnia EEG changes Treatment-reassurance
What are the symptoms of hallucinogen intoxication and how is it treated?
perceptual distortion hallucinations nystagmus feelings of depersonalization mild nausea tremors tachycardia hypertension hyperreflexia flashbacks Treatment-reassurance and observation, and d/c of use **Benzos for panic, paranoia and psychosis**
What are the symptoms of hallucinogen withdrawal and how is it treated?
psychological
Treatment-reassurance
What are the symptoms of inhalant intoxication and how is it treated?
euphoria disorientation sedation acute toxicity to CNS, Liver and kidneys cardiac arrhythmia cardiac arrest Treatment-symptomatic, d/c of use, supportive therapy, chelation therapy, resuscitation and hospitalization
What are the symptoms of Inhalant withdrawal and how is it treated?
psychological
Treatment-reassurance and support
What are the symptoms of stimulant intoxication and how is it treated?
exhilaration restlessness irritability insomnia dilated pupils tachycardia arrhythmia hypertension anorexia hyperreflexia confusion sensory hallucinations paranoia depression Treatment- reassurance, observation, benzodiazepenes, external cooling, d/c of use
What are the possible pathological symptoms of stimulant intoxication?
sudden cardiac arrest
hypertensive crisis
seizures
treatment- resuscitation, Beta blockers, phentolamine, nitroprusside, diazepam or phenytoin
What are the symptoms of stimulant withdrawal and how is it treated?
In chronic users: severe depression prolonged sleep voracious appetite Treatment- close observation, reassurance
What are the symptoms of depressant intoxication and how is it treated?
CNS sedation constricted pupils disorientation slurred speech respiratory depression hypothermia coma death paradoxical disinhibition hyperexcitability Treatment- observation and supportive care, airway protection, possibly low dose benzodiazepenes
How is acute OD of depressants treated?
gastric lavage
ventilation
warming blanket
What are the symptoms of depressant withdrawal and how is it treated?
restlessness anxiety tremor abdominal cramps nausea vomitting hypertension headache insomnia seizures delirium hyperpyrexia hallucinations death Treatment- gradual reduction of the drug or phenobarbital substitution seizures (diazepam) hallucinations (haloperidol)
What are the symptoms of narcotics intoxication and how is it treated?
euphoria constricted pupils respiratory depression bradycardia hypotension constipation Treatment-airway protection, naloxone, d/c of use, intubation and ventilation
What is intoxication and withdrawal from fentanyl analogs similar to?
narcotics
What are the stages of change in tobacco cessation?
precontemplation contemplation preparation action maintenance
Name 5 ways to help a patient consider drug cessation in therapy.
- express empathy
- develop discrepancy-benefits of continuing drug use vs benefits of quitting
- roll with resistance
- support self efficacy
- avoid argumentation
What are the symptoms of stimulant withdrawal and how is it treated?
In chronic users: severe depression prolonged sleep voracious appetite Treatment- close observation, reassurance
What are the symptoms of depressant intoxication and how is it treated?
CNS sedation constricted pupils disorientation slurred speech respiratory depression hypothermia coma death paradoxical disinhibition hyperexcitability Treatment- observation and supportive care, airway protection, possibly low dose benzodiazepenes
How is acute OD of depressants treated?
gastric lavage
ventilation
warming blanket
What are the symptoms of depressant withdrawal and how is it treated?
restlessness anxiety tremor abdominal cramps nausea vomitting hypertension headache insomnia seizures delirium hyperpyrexia hallucinations death Treatment- gradual reduction of the drug or phenobarbital substitution seizures (diazepam) hallucinations (haloperidol)
What are the symptoms of narcotics intoxication and how is it treated?
euphoria constricted pupils respiratory depression bradycardia hypotension constipation Treatment-airway protection, naloxone, d/c of use, intubation and ventilation
What are the symptoms of narcotics withdrawal and how is it treated?
restlessness lacrimation yawning dilation of the pupils rhinorrhea sniffing sweating flushing tachycardia piloerection abdominal cramps nausea vomitting diarrhea Treatment-methadone, and clonidine
What is intoxication and withdrawal from amphetamine analogs similar too?
amphetamines
What is intoxication and withdrawal from PCP analogs similar too?
PCP
What is process 1?
precontemplation to contemplation
-raise consciousness about cessation
What is process 2?
conteplation to preparation
-self reevaluation (do I have the tools to make the change)
What is process 3?
preparation to action
-self liberation/committment (do you have the strength to do it)
What is process 4?
Action to Maintenance
