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Addiction Flashcards

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1
Q

Three areas of the brain involved in addiction?

A

NUCLEUS ACCUMBENS- pleasure center, this is down-regulated over time with repeated stimulation

VENTRAL TEGMENTAL AREA- area of compulsion is unregulated

PRE FRONTAL CORTEX also undergoes changes

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2
Q

What are the four Cs of addition?

A

CONTROL-loss of control, and some attempts to stop
COMPULSIONS-feeling like you have to use the drug
CONTINUOUS-continued despite consequences
CRAVINGS

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3
Q

To do you treat spice

A

low dose of neuroleptics (anti-psychotics)

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4
Q

what class is cannabis and how does it make people feel?

A
  • Cannabis is current a class B drug in the UK

- It is addictive and can make people feel very giggly, relaxed and talkative

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5
Q

What are symptoms associated with cannabis withdrawal?

A
  • anxious and paranoid
  • irratable
  • sweaty
  • shakey
  • nausea
  • trouble sleeping
  • increased appetite
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6
Q

Adverse affects of cannibis?

A
  • affect cognition (memory and concentration)
  • anxiety and paranoia
  • psychotic episodes
  • precipitate psychosis
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7
Q 
What are amphetamines (class and pathway) 
 How do they make people feel?
A
  • Amphetamines are class B drugs
  • MONOAMINE AGONIST (stimulants)

Effects

  • talkative
  • full of energy/excited
  • reduced appetite
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8
Q

describe features of an amphetamine withdrawl?

A
  • poor concentration
  • irritibility
  • tiredness
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9
Q

adverse effects of amphetamines

A

Psych health

  • poor concentration
  • insomnia
  • psychosis
  • aggression
  • paranoia

physical health

  • cardiac problems
  • weight loss
  • immune system suppression
  • tremors/seizures
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10
Q

What is methamphetamine and what class?

A
  • same as amphetamine, however reaches brain more easily (lasts longer and quicker)
  • greater dopamine release
  • otherwise known as Ice, crystal, christina, tina, glass, crank, meth
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11
Q 
What is coccaine? (class and pathway)  
How does it make people feel?
A

COCAINE

  • Class A stimulant
  • Dopamine acting
  • People feel confident, full of energy, on top of the world, reduces hunger and is short acting
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12
Q

symptoms of withdrawal for coccaine?

A

WITHDRAWL

-generally unwell and poor concentration (psychological dependence)

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13
Q

side effects of coccaine

A 
SIDE EFFECTS 
psych symptoms 
-panic attacks 
-depression 
-anxiety

physical symptoms

  • Tachycardia
  • Hyperthermia
  • instant MI
  • heart failure
  • hypertension
  • seizure
  • bowel gangrene
  • ENT (nose bleeds, cartalidge damage)
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14
Q

What is heroin? What receptors does it act on?

A
  • Heroin is just a naturally occurring molecule of DIAMORPHINE. It is a class A drug that acts on opioid mu receptors in our brains
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15
Q

Signs of heroin use?

A
  • mild euphoria as well as sedation, drowsiness, analgesia and constricted pupils
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16
Q

signs of heroin withdrawal?

A

WITHDRAWAL

  • sweating
  • malaise
  • anxiety
  • depression
  • akathisia
  • excessive yawning or sneezing
  • tears
  • rhinorrhoea
  • sleep difficulties
  • cold sweats
  • muscle and bone aches
  • N&V&D
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17
Q

adverse side effects of heroin?

A
  • dependency
  • mental health illness
  • constipation
  • respiratory depression
  • psychosis
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18
Q

What type of drug is ketemin (class and mechanism)

A
  • Ketamine is a class B drug that is a NMDA ANTAGONIST
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19
Q

Effects of ketamine?

A
  • Causes relaxation, altered body sensations, floating feelings, dissociations, altered perceptions, delusions
20
Q

adverse effects of ketamine?

A
  • ulcerative cystitis
  • bladder pain
  • memory problems
  • dependency panic attacks
  • confusion and agitation
21
Q

What class is MDMA? (c

A

MDMA is a CLASS A drug

22
Q

effect of MDMA

A

MDMA makes you feel chatty, energized, alert, happy, have dilated pupils, and have increased affection

23
Q

withdrawal symptoms for MDMA?

A
  • In MDMA WITHDRAWAL people will experience lethargy, memory problems and depression
24
Q

Adverse effects of MDMA

A

MDMA

psych causes

  • anxiety
  • panic attacks
  • paranoia
  • psychosis

physical causes

  • tachycardia
  • hyperpyrexia
  • electrolyte disturbances (dehydration and overhydration)
25
Q

what are benzos? (class and mechanism)

A
  • Benzodiazpines are class C substances that are often prescribed for anxiety and panic disorders
  • GABA agonists (feel relaxed and ease anxiety)
26
Q

symptoms of Benzodiazepines withdrawal?

A

psych symptoms of withdrawal

  • relapse of anxiety
  • concentration
  • panic Attacks
  • little insight

physical

  • tremours
  • nausea and vomitting
  • headaches

*people often have very little insight when they are addicted to benzodiazepines and they are very difficult addicitions to treat

27
Q

Adverse effects of benzos?

A
  • respiritory depression
  • falls
  • feeling hungover
  • memory loss
  • death if injected
28
Q

Whats the maximum amount of alcohol units?

A

maximum of 14 units of alcohol a day

29
Q

How do you work out alcohol units ?

A

Units= %alcohol present in 1 liter

30
Q

what questionnaire is used for alcohol addiction?

A

AUDIT questionnaire (score of 8+ for men and 7+ women is worrying)

31
Q

name some metabolic side effects of alcohol addiction

A
  • Hypoglycaemia
    • Hyperlipidaemia (high fats)
    • Hyperuricaemia
    • Hypomagnesaemia, hypophosphataemia, hyponatraemia (low Mg, low phosphate, low Na)
      • Alcohol-induced pseudo-Cushing’s syndrome
32
Q

Name some haematological effects of alcohol addiction?

A
  • Red cell macrocytosis
    • Anaemia
    • Neutropenia
      • Thrombocytopenia
33
Q

What is delerium tremens? How common is it?

A

DELIRIUM TREMENS

This is an acute confusional state that occurs during the withdrawal of alcohol (4% in people withdrawing from alcohol)

34
Q

When does delerium tremens occur?

A
  • It usually starts three days into the withdrawal process and will last about 2-3 days
35
Q

what are the symptoms of delerium tremens?

A 
○ Agitation 
		○ Profound confusion 
		○ Hallucinations 
		○ Fever 
		○ Hypertension 
		○ Sweating 
                ○ HTN and tachycardia
36
Q

Biological treatment of alcohol withdrawal? (3)

A

CHLORDIAEPOXIDE (diazepam)

  • These help with comfort as well as reducing the seizure risk
  • Titrate the initial dose, depending on how severe the symptoms are and then slowly dial it down to nothing over the next 7-10 days

LORAZEPAM is first line treatment for DELIRIUM TREMENS

THIAMINE should always be given to reduce risk of Wernicke’s Encephalopathy

37
Q

What drugs help prevent RELAPSE of alcohol consumption and how do they work? (3)

A

RELAPSE PREVENTION DRUGS

  • ACAMPROSATE and NALTREXONE
    ○ Acamprosate appears to be neuroprotective
    ○ Naltrexone appears to reduce cravings
-DISULFIRAM 
                ○ Interferes with the metabolism of alcohol meaning that even if small amounts are consumed there is a large build up of ACETYL-ALDEHYDE giving very unpleasant symptoms 
-throbbing headache
-facial flushing
- palpitations
-dyspnoea
-tachypnoea
-nausea.
38
Q

Name some other features of alcohol withdrawal?

When will the symptoms occur?

A

Withdrawal symptoms occur 6-8 hours after the alcohol has stopped
○ Anxiety
○ Sweating
○ Tremor
○ Nausea and vomiting
○ Problem sleeping
○ Seizures (usually within first 24-48 hours)
- ***these symptoms usually peak after 10-30 hours and then begin to subside after 2-3 days

39
Q

what drugs are in the misuse drugs act 1971?

A

Misuse of Drugs Act 1971
A : Heroin, ecstasy, PCP,LSD, MDMA, cocaine (incl. crack), methamphetamine, psilocybin mushrooms, any class B drug prepared for injections
7 years possession…..life for supply

B : Cannabis, synthetic cannabinoids, ketamine, mephedrone, amphetamine, codeine, methoxetamine, methylphenidate
5 years possession…..14 years supply

C : Khat, GHB/GBL, benzodiazepines, tramadol, anabolic steroids
2 years possession…..14 years supply

40
Q

Psychoactive Substances Act 2016

A

Offence to supply/offer to supply any psychoactive substance…regardless of its potential for harm

POSSESSION IS NOT AN OFFENCE

EXEMPTIONS:
nicotine, alcohol, caffeine

41
Q

what is used to assess opiate withdrawal?

A

COWS questionaire (clinical opiate withdrawal scale)

42
Q

what drugs are used in opioid addiction

A 
Buprenorphine
Methadone 
Naltrexone (long acting)
Lofexidine
-alpha2-adrenergic receptor agonist
-used to relieve withdrawal symptoms, particularly those cause by noradrenaline
43
Q

what is wernikes encephalopathy

A

Wernicke’s encephalopathy is characterised by confusion, ataxia and ophthalmoplegia

PRE CURSER TO KORSACOFFS

44
Q

what is korsakoffs syndrome?

A

anterograde amnesia
confabulation
lack of insight
caused by chronic alcoholism

45
Q

Onset of alcohol withdrawal symptoms?
peak time of seizures?
peak time of delirium tremens?

A

symptoms: 6-12 hours
seizures: 36 hours
delirium tremens: 72 hours

Psych (22 decks)

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