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3MB Psychiatry > Addiction and Substance Misuse > Flashcards

Addiction and Substance Misuse Flashcards

1
Q

List the ICD-10 criteria for dependence

A

Strong desire to take the substance
Difficulty in controlling substance use
Withdrawal state
Neglect other pleasures
Persistence despite evidence of harm

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2
Q

Which dopaminergic pathway, associated with reward, is involved in addiction?

A

Mesolimbic pathway

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3
Q

What is the effect of dopamine release upon behaviour?

A

Motivates us to repeat behaviour
Involved in pleasurable experience

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4
Q

What effect do drugs like amphetamine and cocaine have on dopamine?

A

Increase release of dopamine

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5
Q

If dopamine receptors are repeatedly stimulated, what can eventually develop?

A

Tolerance
due to downregulation/decreased sensitivity of receptors

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6
Q

What is the consequence of developing tolerance in addiction?

A

Threshold for feeling reward is increased; normal pleasurable experience don’t evoke enough of a reward response

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7
Q

Frontal lobe areas associated with executive functioning develop before those areas associated with emotion. True/False?

A

False
Other way around!

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8
Q

Which parts of the brain are associated with memory learning?

A

Amygdala
Hippocampus

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9
Q

Which parts of the brain are associated with inhibitory motor control?

A

Prefrontal cortex
Anterior cingulate gyrus

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10
Q

Which parts of the brain are associated with motivation/drive?

A

Orbito-frontal cortex
Subcallosal cortex

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11
Q

Which parts of the brain are associated with reward?

A

Nucleus accumbens
Ventral pallidum
[mesolimbic pathway]

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12
Q

How many ml of alcohol = 1 unit?

A

10ml

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13
Q

What is the equation for calculating no. of units of alcohol?

A

[% x volume]/10

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14
Q

What are the current guidelines for low risk alcohol drinking?

A

No more than 14 units per week, ideally spread over 3 or more days

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15
Q

What are the parameters of increased risk alcohol drinking?

A

Regular consumption of 15-35 units a week

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16
Q

What are the parameters of high risk alcohol drinking?

A

Regular consumption of over 35 units a week

17
Q

Which marker can be an indicator of alcoholic liver injury?

A

GGT

18
Q

Which marker identifies men who have been drinking 5+ units of alcohol a day for a year or more?

A

Carbohydrate deficient transferin

19
Q

What is the most common cause of a raised MCV?

A

Alcoholism

20
Q

What effect does alcohol have on excitatory glutamatory ion channels?

A

Inhibits action of glutamate receptors

21
Q

What effect does alcohol have on inhibitory GABA ion channels?

A

Potentiates action of GABA receptors

22
Q

Alcohol withdrawal leads to less/more glutamate activity and less/more GABA activity

A

Alcohol withdrawal leads to more glutamate activity and less GABA activity

23
Q

List clinical features of alcohol withdrawal

A

Restlessness, tremor
Sweating
Anxiety
Loss of appetite and sleep
Tachycardia
Seizure, delirium tremens

24
Q

Which drugs are used to manage alcohol withdrawal?

A

Benzodiazepine
Thiamine (parenteral)

25
Q

Which drug is the 1st line agent for alcohol detox relapse prevention?

A

Naltrexone

26
Q

Which drug should be started as soon as alcohol detox is complete?

A

Acamprosate

27
Q

Which alpha-2-receptor agonist can help with opiate detox?

A

Lofexidine

28
Q

What are the 2 main detox agents used for opiate misuse?

A

Methadone
Bruprenorphine

29
Q

What effect does mephedrone have on neurotransmitters?

A

Inhibits reuptake of serotonin, noradrenaline and dopamine

30
Q

What are the user effects of taking mephedrone?

A

Feeling of ecstasy, openness
Increased confidence and desires

31
Q

Taking mephedrone increases susceptibility to ladybird attacks. True/False?

A

True

32
Q

What is sympathetic toxidrome and which drug is it related to?

A

Amphetamines
Range of toxic autonomic effects e.g. tremor, sweating, pain, confusion, vomiting etc.

33
Q

What is serotonin syndrome?

A

Excess serotonin causes hypomania, agitation, myoclonus and hyperactive autonomic state

34
Q

What effect on neurotransmission does methamphetamine have?

A

Inhibits reuptake of noradrenaline and dopamine

35
Q

Synthetic cannabinoids can be more potent than cannabis. True/False?

A

True
800x more potent!

36
Q

Which legal high causes a detachment from reality, including depersonalisation and derealisation?
[dissociative]

A

Ketamine

3MB Psychiatry (17 decks)

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