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Psychiatry > Addiction Disorders > Flashcards

Addiction Disorders Flashcards

1
Q

What is the ICD-10’s criteria for dependence?

A 
Strong desire
Difficulties controlling
Withdrawal
Tolerance
Neglect of alternative pleasures
Persistence despite harm
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2
Q

What is the main neurotransmitter in the mesolimbic (reward) pathway?

A

Dopamine

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3
Q

What effect does drug abuse have on the mesolimbic pathway?

A

Stimulation

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4
Q

Why do certain drugs (cocaine, nicotine etc.) cause addiction?

A

As they cause a massive increase in dopamine which the brain craves

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5
Q

What effect does repeated substance taking have on dopamine receptors?

A

Downregulation

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6
Q

What is the role of the pre-frontal cortex in terms of the mesolimbic pathway?

A

It controls it and allows us to make sound decisions

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7
Q

The prefrontal cortex is one the earliest developed areas of the brain. True/false?

A

False - one of the last

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8
Q

The earlier/later the age of drug experimentation the longer the drug relationship

A

Earlier

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9
Q

What role does the hippocampus and amygdala play in addiction?

A

They help the brain to learn drug associations and cue craving feelings

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10
Q

Why can acute stress cause seeking of addictive substance?

A

As it triggers the release of dopamine

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11
Q

Why is heroin so addictive?

A

Rapid onset of action

Short half-life

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12
Q

Heroin is morphine/diamorphine

A

Diamorphine

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13
Q

What are the two main ways to take heroin?

A

Intravenous

Smoking

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14
Q

Give some of the effects of heroin

A 
Euphoria
Analgesia
Respiratory depression
Constipation
Bradycardia
Pupillary constriction
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15
Q

What is the half-life of heroin?

A

6-8 hours

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16
Q

Give some of the withdrawal symptoms of heroin

A 
Dysphoria/cravings
Agitations
Tachycardia
Piloerection
Diarrhoea
Pupillary dilation
17
Q

Over half of the individuals who have died from heroin overdose lived in the 20% most deprived areas in Scotland. True/false?

A

True

18
Q

What drugs are increasing in involvement in drug related deaths?

A

Gabapentin

Pregabalin

19
Q

Diazepam presence in drug related death has decreased while etizolam presence has increased. True/false?

A

True

20
Q

What is involved in opiate substitution therapy?

A

Replacing a short acting opiate with a long acting opiate

21
Q

What drugs are used in opiate substitution therapy?

A

Buprenorphine

Methadone

22
Q

Give some of the pros of OST

A

Reduced mortality rate

Reduced HIV risk

23
Q

Give some of the cons of OST

A

Daily chemist visits

Stigma

24
Q

Is methadone given as a tablet or a liquid?

A

Liquid

25
Q

What occurs in opiate detoxification?

A

Giving patients a reducing dose of the drug until they are not on any at all

26
Q

What are the main negatives of opiate detoxification?

A

High mortality risk

High relapse rate

27
Q

What psychosocial interventions can be done for opiate misuse?

A

Rewarding positive behaviour

Behavioural couples therapy

28
Q

What is involved in heroin assisted treatment?

A

Allowing patients to safely inject heroin while also taking methadone

29
Q

How do you calculate units of alcohol?

A

(%ABV x volume) / 10

30
Q

What is defined as higher risk drinking?

A

Regularly consuming above 15 units per week

31
Q

What biological marker is most commonly raised in alcoholism?

A

MCV

32
Q

When should a patient be referred for specialist treatment in alcoholism?

A

Showing signs of moderate/severe dependence
Failed to benefit from previous advice
Showing signs of severe alcohol-related impairment

33
Q

Alcohol withdrawal causes excess GABA activity and reduced glutamate activity. True/false?

A

False - excess glutamate activity and reduced GABA activity

34
Q

Give some of the symptoms of delirium tremens

A 
Confusion
Disorientation
Agitation
Fever
Hallucinations
35
Q

How should short term alcohol withdrawal be managed?

A 
Benzodiazapines
Vitamin supplementation (thiamine/pabrinex)
36
Q

What psychosocial therapy is recommended for relapse prevention?

A

CBT

37
Q

What drugs can be used to prevent alcohol relapse?

A

Disulfiram (antebuse)
Acamprosate
Naltrexone

38
Q

What is the effect of drinking alcohol on disulfiram?

A 
Flushed skin
Tachycardia
N + V
Arrhythmias 
Hypotension
39
Q

What is the effect of acamprosate?

A

It reduces cravings

Psychiatry (23 decks)

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