Addiction

Question 1

What is the NT and function of the prefontal cortex?

Answer 1

glutamine

• executive control over midbrain structures
• judgement and cost benefit analysis

Question 2

What is the function of the ventral tegmental area

Answer 2

location of dopamine cell bodies
projects to nucleus accumbens - reward center
projects to prefrontal cortex - executive control

Question 3

What is the function of the nucleus accumbens

Answer 3

integrates VTA and PFC

-reward center

Question 4

What does the dorsal lateral prefrontal cortex do as a whole? how is it affected in addiction?

Answer 4

top down control - prioritizing

-not functioning as well in addiction

Question 5

What is the function of the ventral medial prefrontal cortex

Answer 5

assigns emotional valience

• well thought out emotional decision
• cooperates with amygdala which assigns an emotional value to something

Question 6

what is the function of the orbital frontal cortex and how does it function in addiction?

Answer 6

prevents impulsive decisions

hypofunctioning

Question 7

what is the function of the anterior cingulates? how does it function in addiction?

Answer 7

vigilance

hyperfunctioning - scheme to get more beer, more drugs

Question 8

How are the functions of the D3 and D2 receptors different?

Answer 8

D3 - static levels of DA - energy

D2 - pulsatile - reward

Question 9

How does the limbic system and PFC circuits change in addiction?

Answer 9

increased limbic system circuitry

decreased PFC circuitry

Question 10

Is pharmacotherapy or counseling preferred for treatment for addicts?

Answer 10

combination of BOTH

-addiction is not at a conscious level which would be targeted by counseling

Question 11

What is the mechanism of benzos in the brain?

Answer 11

increase GABA receptors - allows for more hyperpolarization with chloride

Question 12

What are the symptoms of alcohol intoxication?

Answer 12

anxiousness, disinhibition, slurred speech, ataxia, sedation, respiratory suppression, coma and death

Question 13

When do withdrawal symptoms from benzos and alcohol appear and peak? what is the first symptom?

Answer 13

appear at 8 hours, peak at 24

first symptom is dry heaves

Question 14

what are the symptoms of withdrawal from alcohol and benzos?

Answer 14

agitation, insomnia, tremor , GI upset
inc pulse and HR, inc Bp
seizures
hallucinations, delirium and death

Question 15

What is the treatment for intoxication with benzos and alcohol?

Answer 15

support, restraint, protect airway, ventilate

benzos: reversal with flumazenil

Question 16

what is the treatment for withdrawal from benzos and alcohol

Answer 16

benzos until symptoms normalize

-usually lorazepam

Question 17

What are the symptoms of stimulant intoxication?

Answer 17

inc mood and irritability, insomnia, appetite loss
dilated pupils, inc HR, BP, Temp
vasospasm, hyperreflexia, psychosis, cardiac arrest

Question 18

What is the treatment for stimulant intoxication

Answer 18

support and specific meds that reverse specific intoxication symptoms

Question 19

What receptors do opioids target?

Answer 19

mu receptors

Question 20

What are the symptoms of opioid intoxication?

Answer 20

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)

Question 21

what is the treatment for opioid intoxication?

Answer 21

support and protect the airway

naloxone or narcan to reverse

Question 22

What are the symptoms of opioid withdrawal?

Answer 22

agitation, restless, flu symptoms, flushing
dilated pupils
inc HR, BP, GI distress

Question 23

What is the treatment for opioid withdrawal?

Answer 23

methodone - full agonist replacement

buprenorphine - partial agonist replacement

Question 24

What is the only drug to produce horizontal nystagmus?

Answer 24

PCP - a hallucinogen

Question 25

what does intoxication with cannabis produce

Answer 25

elevated mood, expansive thought, sedation, pupil constriction, red conjunctiva, inc appetite, panic

Question 26

what are the four stages of change?

Answer 26

1. precontemplation
2. contemplation
3. preparation
4. action
5. maintenance

Question 27

What form of fighting addiction is the 12 step program?

Answer 27

abstinence - must stop all drugs and not use ever

Question 28

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?

Answer 28

socratic teaching

Question 29

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?

Answer 29

clarification, reflexive listening

Question 30

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?

Answer 30

confrontation and double sided reflection

Question 31

What type of pharmacotherapy are nicotine and ecigs?

Answer 31

harm reduction
replace harmful inhaled tobacco with nicotine
full agonist replaced with full agonist

Question 32

how does the pharmacotherapy buproprion work?

Answer 32

antidepressant

-desensitizes reward circuitry so cigarette activation is not missed by patient

Question 33

What is the action of vareniciline?

Answer 33

full agonist replacement with partial agonist

-allows system to be active but not fully and avoids most withdrawal