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