Addiction Flashcards
What is the NT and function of the prefontal cortex?
glutamine
- executive control over midbrain structures
- judgement and cost benefit analysis
What is the function of the ventral tegmental area
location of dopamine cell bodies
projects to nucleus accumbens - reward center
projects to prefrontal cortex - executive control
What is the function of the nucleus accumbens
integrates VTA and PFC
-reward center
What does the dorsal lateral prefrontal cortex do as a whole? how is it affected in addiction?
top down control - prioritizing
-not functioning as well in addiction
What is the function of the ventral medial prefrontal cortex
assigns emotional valience
- well thought out emotional decision
- cooperates with amygdala which assigns an emotional value to something
what is the function of the orbital frontal cortex and how does it function in addiction?
prevents impulsive decisions
hypofunctioning
what is the function of the anterior cingulates? how does it function in addiction?
vigilance
hyperfunctioning - scheme to get more beer, more drugs
How are the functions of the D3 and D2 receptors different?
D3 - static levels of DA - energy
D2 - pulsatile - reward
How does the limbic system and PFC circuits change in addiction?
increased limbic system circuitry
decreased PFC circuitry
Is pharmacotherapy or counseling preferred for treatment for addicts?
combination of BOTH
-addiction is not at a conscious level which would be targeted by counseling
What is the mechanism of benzos in the brain?
increase GABA receptors - allows for more hyperpolarization with chloride
What are the symptoms of alcohol intoxication?
anxiousness, disinhibition, slurred speech, ataxia, sedation, respiratory suppression, coma and death
When do withdrawal symptoms from benzos and alcohol appear and peak? what is the first symptom?
appear at 8 hours, peak at 24
first symptom is dry heaves
what are the symptoms of withdrawal from alcohol and benzos?
agitation, insomnia, tremor , GI upset
inc pulse and HR, inc Bp
seizures
hallucinations, delirium and death
What is the treatment for intoxication with benzos and alcohol?
support, restraint, protect airway, ventilate
benzos: reversal with flumazenil
what is the treatment for withdrawal from benzos and alcohol
benzos until symptoms normalize
-usually lorazepam
What are the symptoms of stimulant intoxication?
inc mood and irritability, insomnia, appetite loss
dilated pupils, inc HR, BP, Temp
vasospasm, hyperreflexia, psychosis, cardiac arrest
What is the treatment for stimulant intoxication
support and specific meds that reverse specific intoxication symptoms
What receptors do opioids target?
mu receptors
What are the symptoms of opioid intoxication?
elevated mood, inc HR, low BP, resp suppression
loss of gag reflex
constipation and pupil constriction
flat and unrelated
(essentially blocking Ach so anticholinergic effects)
what is the treatment for opioid intoxication?
support and protect the airway
naloxone or narcan to reverse
What are the symptoms of opioid withdrawal?
agitation, restless, flu symptoms, flushing
dilated pupils
inc HR, BP, GI distress
What is the treatment for opioid withdrawal?
methodone - full agonist replacement
buprenorphine - partial agonist replacement
What is the only drug to produce horizontal nystagmus?
PCP - a hallucinogen
what does intoxication with cannabis produce
elevated mood, expansive thought, sedation, pupil constriction, red conjunctiva, inc appetite, panic
what are the four stages of change?
- precontemplation
- contemplation
- preparation
- action
- maintenance
What form of fighting addiction is the 12 step program?
abstinence - must stop all drugs and not use ever
If you are a psychologist and start rattling facts off to a patient, what kind of method are you using to discourage them from smoking?
socratic teaching
if you are a psychologist and use phrases to help an addict like, “you are inhaling 20 sticks of dirt, carcinogen, and nicotine everyday, tell me about it?” and “is smoking like committing suicide?”
what method are you using?
clarification, reflexive listening
if you are a psychologist and use phrases to counsel an addict like, “ you have asthma but you still want to inhale dirt?” and “ you are starting to suffocate from smoking, but you don’t want to stop?”
what method are you using?
confrontation and double sided reflection
What type of pharmacotherapy are nicotine and ecigs?
harm reduction
replace harmful inhaled tobacco with nicotine
full agonist replaced with full agonist
how does the pharmacotherapy buproprion work?
antidepressant
-desensitizes reward circuitry so cigarette activation is not missed by patient
What is the action of vareniciline?
full agonist replacement with partial agonist
-allows system to be active but not fully and avoids most withdrawal
