Addiction and narcotics Flashcards
A BAC of 0.25-0.31 corresponds with what mental state?
Black out
kill zone is around 0.4
______ is a state of adaption in which chronic exposure to a drug induces changes that result in decreased effects
Tolerance
______ is a syndrome produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist. Symptoms opposite those produced by the drugs.
Withdrawal
The 11 substance use disorder (SUD) criteria: 1. 2. 3. 4. 5. 6. Continued use despite social or interpersonal problems 7. Activities given up 8. Recurrent hazardous use 9. Continued use despite medical or psychological problems 10. Tolerance 11. Withdrawal
- Takes more than intended
- Desire to cut down
- Great deal of time spent using
- Craving
- Failure to fulfill obligations
The 11 substance use disorder (SUD) criteria: 1. Takes more than intended 2. Desire to cut down 3. Great deal of time spent using 4. Craving 5. Failure to fulfill obligations 6. 7. 8. 9. 10. 11.
- Continued use despite social or interpersonal problems
- Activities given up
- Recurrent hazardous use
- Continued use despite medical or psychological problems
- Tolerance
- Withdrawal
The _____ is the site of dopaminergic neurons cell bodies, which tell the organism whether an environmental stimulus (natural reward, drug of abuse, stress) is rewarding or aversive.
VTA
The VTA-NAc pathway is part of a series of parallel, integrated circuits, which also involve several other key brain regions.
The _____, a major component of the ventral striatum, is a principal target of VTA dopamine neurons. This region mediates the rewarding effects of natural rewards and drugs of abuse.
nucleus accumbens
Alcohol reinforcement is mediated by ______ receptors to release opiate peptides and DA.
GABA-A receptors
DSMV criteria: Alcohol and sedative withdrawal requires ___ of the 8 criteria within hours to a few days
2 or more of the 8 criteria
What are the 8 criteria for DSMV to be diagnosed with alcohol or sedative withdrawal
Need 2 or more
- Autonomic hyperactivity (increased sympathetic tone)
- Hand tremor
- Insomnia
- Nausea or vomiting
- Transient hallucinations or illusions
- Psychomotor agitation
- Anxiety
- Gran mal seizure
Tx of choice for alcohol withdrawal
Benzodiazepines (the “-pams”)
Alprazolam, Chlordiazepoxide , Clonazepam, Diazepam, , Lorazepam
What meds do you use for relapse prevention in alcohol use disorder
- Disulfiram (causes flushing, nausea, diaphoresis when consuming alcohol)
- Naltrexone (blocks opioid receptors to diminish some of the pleasure and craving for EtOH)
- Acamprosate
How do you treat benzodiazepine dependence?
being by substituting short-acting BZ for a longer acting one, then taper gradually.
Alprazolam and lorazepam are examples of short-acting
Diazepam and Chlordiazepoxide are examples of longer acting
What is the classic triad of opioid overdose? What is the first-line tx?
Classic triad: unresponsiveness, pinpoint pupils, respiratory depression
Tx: naloxone
Opiod withdrawal is characterized by ___ or more of the ___ symptoms
What are the symptoms
3 or more of 9 symptoms
- Dysphoric mood
- Nausea vomiting
- Muscle aches
- Lacrimation or rhinorrhea
- Pupillart dilation, piloerection, sweating
- Diarrhea
- Yawning
- Fever
- Insomnia
How do you treat opioid overdose?
Tx for opioid withdawal (mild, moderate, severe)
Opioid overdoe: naloxone Withdrawal: Mild: clonidine Moderate: buprenorphine Severe: methadone
What are the pharmacological tx for nicotine dependence?
- Transdermal nicotine patch
- Nicotine prolacrilex gum
- Nicotine nasal spray
- Nicotine inhaler
- Bupropion
- varenicline
Of the 11 Substance Use Disorder (SUD), how many are needed for mild, moderate, and severe?
Mild: 2-3 Moderate: 4-5 Severe: 6-7 1. Takes more than intended 2. Desire to cut down 3. Great deal of time spent using 4. Craving 5. Failure to fulfill obligations 6. Continued use despite social or interpersonal problems 7. Activities given up 8. Recurrent hazardous use 9. Continued use despite medical or psychological problems 10. Tolerance 11. Withdrawal
A patient experiencing the following symptoms may be experiencing what?
Agitation, insomnia, tremor, GI cramps, delirium, hallucinations, seizures, increased HR
Benzo, barbiturates (sedatives) withdrawal
OR
Alcohol
Chronic drug use leads to reward circuitry changes that promote more future drug use by having what effect (increase or decrease) on limbic function and prefrontal cortex (PFC) fcn
Increased limbic function
decreased PFC function
