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behavioral unit 3 > addiction > Flashcards

addiction Flashcards

1
Q

addiction

A

chronic, progressive behavioral disorder whose central feature is compulsive drug use despite adverse consequences. this involves the brains reward system and the alterations that reward enhancing drugs have on the system.

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2
Q

ventral tegmental area

A

location of the dopaminergic cells of the brain. they project to the nucleus accumbens. and the prefrontal cortex.

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3
Q

simplistically what is the NA? What is the PFC?

A

the reward center and the executive control center.

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4
Q

nucleus accumbens

A

the reward center. integrates VTA dopamine and PFC glutamate inputs to determine motivational output.

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5
Q

PFC

A

exerts the executive control over the midbrain structures. judgement, cost-benefit analysis.

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6
Q

what are the different sections of the PFC

A

dorsolateral PFC, ventromedial PFC, anterior cingulates PFC, orbitoPFC.

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7
Q

DLPFC

A

statistical analysis and prioritization. top-down control. this is the cold-calculating center.

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8
Q

ventromedial PFC

A

assigns emotional valiance or higher order emotional processing. drinking feels good, lowers inhibitions, less stress more social.

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9
Q

orbital PFC

A

impulse prevention. I can beat up that football player over there.

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10
Q

anterior cingulate cortex.

A

vigilance and focus. scanning the environment on a goal.

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11
Q

how is decision making processed in the brain?

A

it is a glutamate driven process all via structures within the PFC.

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12
Q

how is the limbic system driven

A

by dopamine. D3 govern static levels that allow neuronal activity, such as wakefulness, homeostasis, alertness. D2 are pulsatile depending on motivation and drive.

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13
Q

where do all drugs act?

A

on the limbic system and reward pathways. they either enhance DA release, enhance DA action on the NA, or are DA agonists.

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14
Q

what happens in chronic drug use?

A

leads to reward circuitry changes that promote future drug use. is actually enhances reward seeking behaviors due to increased limbic function and decreased PFC function.

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15
Q

role of the amygdala?

A

the amygdala also assigns emotional valiance to events and sensations.

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16
Q

how should the PFC respond?

A

OFC should suppress doing dangerous or addictive things. VMPFC should attach positive feelings to not doing dangerous things. DLPFC calculate true risk benefit

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17
Q

can the brain tell the difference between benzodiazepines and alcohol?

A

barely.

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18
Q

EtOH intoxication

A

anxiolysis, disinhibition, slurred speech, ataxia, sedation, stupor, respiratory depression, coma, death (500mg/dl).

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19
Q

EtOH withdrawal

A

agitation, insomnia, tremor, GI upset, inc pulse/HR/BP, seizures, hallucinations, delirium, death.

20
Q

how do we stop EtOH withdrawal symptoms.

A

use benzos!!!

21
Q

intoxication with sedatives (benzos)

A

anxiolysis, slurred speech, ataxia, sedation, stupor, respiratory depression, coma, death.

22
Q

how do we reverse benzo OD?

A

flumazenil -will not work for barbiturates or alcohol.

23
Q

withdrawal of benzos

A

agitation, insomnia, tremor, GI cramps, hyperreflexia, inc HR, seizures, hallucinations, delirium, death.

24
Q

how do stimulants work?

A

block DA uptake and may even reverse it. the net effect is an increase in DA within the limbic system that allows for more CNS activity and excitability.

25
Q

intox with stimulants

A

elevated mood and esteem, irritability, insomnia, appetite loss, dilated pupils, racing heart, inc BP, elevated body temp, hyperreflexia, psychosis, cardiac arrest, seizure. can cause vasospasm.

26
Q

withdrawal from stimulants

A

fatigue, anhedonia, depression, increased sleep, increased appetite. clonidine seems to work for relieving the symptoms.

27
Q

opiate examples

A

morphine, herion, codeine, hydrocodone, hydromorphone, methadone.

28
Q

what are downers?

A

EtOH, marijuana, opiates, benzos,

29
Q

what do opiates do?

A

activate the endogenous opioid system. mainly the mu receptors present within the brain and spinal cord. this reduces pain, increases positive emotional mild analgesia. they increase K influx and hyper polarize the cell. they activate the descending pain modulatory system and inhibit the ascending

30
Q

opiate intox

A

elevated mood, pupil constriction (pinpoint), respiratory suppression, gag reflex loss, low HR/BP, constipation! there is usually a cold-dope fiend presentation.

31
Q

withdrawal from opiates

A

restlessness, watery eyes, yawning, dilated pupils, goose flesh, runny nose and sneezing, inc HR/BP, GI distress, muscle cramps.

32
Q

hallucinogens

A

PCP, peyote, LSD, mescaline, psilocybin

33
Q

what distinguishing characteristic does PCP cause?

A

horizontal nystagmus

34
Q

intox with hallucinogens

A

perceptual distortion, hallucinations, depersonalization, nystagmus, tremors, hyperreflexia, racing heart, flashbacks, paranoia.

35
Q

cannabis intox

A

elevated mood, expansive thought, sedation, pupil constriction, red conjunctiva, increased appetite, panic, paranoia. amotivational syndrome and forgetting system are activated.

36
Q

what is the percentage of smokers that die from tobacco related illness?

A

50%

37
Q

why do people change?

A

because they are ready, willing and able.

38
Q

what are the stages of change?

A

precontemplation, contemplation, preparedness, active, maintenance.

39
Q

precontemplation to contemplation? how do we help?

A

consciousness raising through education. emotional arousal dramatic release. social liberation and environmental reevaluation.

40
Q

contemplation to preparedness

A

self-reevaluation. do i have the tools and support?

41
Q

preparation to action

A

self-liberation and commitment. beliefs, family, progression, courage. you have to give them the right perspectives, the ones that appeal to them and allow them to make the steps.

42
Q

action to maintenance

A

countering/counterconditioning, environmental control, rewards, helping relationships.

43
Q

abstinence models

A

you must stop all drugs. must not use at all, ever. 12 step model is the example.

44
Q

this tends to work through socratic teaching with the patient. examples

A

how do people who use tobacco die? do you know that your inhaling 20-sticks of dirt into your lungs everyday?-tell me about that.

45
Q

how does bupropion work?

A

blocks neuronal reuptake/recycling of NE and DA. cigarette effects are not missed. activation is not missed

46
Q

varenicline

A

partial nicotine agonist. replaces the full agonist with partial. the only drug to beat placebo.

behavioral unit 3 (17 decks)

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