Addiction

Question 1

How is alcoholic hallucinosis different from normal auditory and tactile hallucinations?

Answer 1

Patients are usually aware that hallucinations aren’t real

Question 2

A patient presents belligerent, paranoid, violent and hostile. He has slurred speech and vertical nystagmus. this is …

Answer 2

PCP intoxication

Question 3

What is the best treatment for someone with PCP intoxication?

Answer 3

don’t restrain, don’t give benzos except for muscle spasms and only if necessary (could slow down excretion), don’t give antipsychotic. hang low, maybe give antihypertensive

Question 4

What triad of symptoms would indicate PCP intoxication?

Answer 4

nystagmus, muscle rigidity, cannabinoids in urine

Question 5

What are the criteria for substance abuse?

Answer 5

Work affected
Interpersonal relationships
Legal issues
Dangerous situations

Question 6

When do signs and symptoms of alcohol withdrawal begin?

Answer 6

6-24 hours after last drink

Question 7

When do delirium tremens begin? What do they look like?

Answer 7

48-72 hours - hallucinations, autonomic instability,

Question 8

What are the characteristics of Korsakoff’s psychosis?

Answer 8

confabulations - false memories

Question 9

What BAL is associated with intoxication?

Answer 9

150

Question 10

What medications exist for alcohol dependence and how do they work?

Answer 10

antabuse (disulfuram) - blocks alcohol dehydrogenase
naltrexone - opioid receptor blocker, prevents high
Acamprosate - inhibits glutamatergic
Topiramate - anticonvulsant that potentiates GABA

Question 11

What is the mechanism of cocaine?

Answer 11

blocks dopamine reuptake

Question 12

How long do the withdrawal symptoms of cocaine last?

Answer 12

18 hours, give or take

Question 13

What are the consequences of chronic amphetamine use?

Answer 13

acne, dental problems

Question 14

What is a good treatment for benzo overdose?

Answer 14

flumazenil - short acting antagonist

Question 15

What is date rape drug?

Answer 15

GHB - depressant that causes memory loss

Question 16

What are the symptoms associated with opioid intoxication?

Answer 16

sedation, constricted pupils, respiratory depression

Question 17

What opioid drug actually produces dilation?

Answer 17

demerol dilates

Question 18

What are the symptoms associated with opioid withdrawal?

Answer 18

dysphoria, insomnia, lacrimation, rhinorrhea, sweating, dilated pupils, hypertension

Question 19

What treatments exists for opiod dependence?

Answer 19

methadone, suboxone (partial opioid agonist), naltrexone (competitive antagonist)

Question 20

Can people who take hallucinogens go through a withdrawal?

Answer 20

not really, but can have flashbacks

Question 21

What is the mechanism of marijuana?

Answer 21

inhibits adenylate cyclase

Question 22

How frequently does marijuana dependence occur?

Answer 22

5% of the time

Question 23

What is the mechanism of inhalants?

Answer 23

CNS depressent

Question 24

What are the potential consequences of inhalant overdose?

Answer 24

respiratory depression, cardiac arrhythmia, permanent damage to CNS

Question 25

What is the mechanism of caffeine?

Answer 25

adenosine antagonist

Question 26

How long do caffeine withdrawal symptoms usually last?

Answer 26

1 week

Question 27

What are the therapies currently available for nicotine dependence?

Answer 27

Chantix - nicotinic receptor agonist
Zyban - antidepressant that helps reduce withdrawal
Nicotine replacement therapy
Behavioral counseling

Question 28

What is the mortality rate of DT if untreated?

Answer 28

30%