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Psychiatry > Addictions Psychiatry > Flashcards

Addictions Psychiatry Flashcards

1
Q

What type of illicit drugs are stimulants?

A

Cocaine

Amphetamine

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2
Q

How is cocaine consumed?

A

Coca leaves chewed or brewed
Cocaine hydrochloride is snorted or injected
Cocaine freebase or crack cocaine is snorted

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3
Q

What are the effects of cocaine?

A

Stimulant and euphoriant
Increased alertness and energy
Increased confidence and impaired judgement
Lessens apetite and desire for sleep

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4
Q

What are the complications of cocaine?

A 
Damage to nose and airway 
Convulsions with respiratory failure 
Cardia arrhythmias and MI 
Hypertension and CVA 
Toxic confusion 
Paranoid psychosis
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5
Q

What are the effects of cocaine withdrawal?

A 
Depression 
Irritability
Agitation
Craving
Hyperphagia
Hypersomnia
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6
Q

How is amphetamine consumed?

A

Sniffed, swallowed or injected

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7
Q

What illicit drugs are classed in the opiates group?

A 
Opium
Morphine
Heroin (diamorphine)
Methadone
Codeine and dihydrocodeine
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8
Q

How is heroin consumed?

A

Snorting
Smoking
Injection

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9
Q

What is the complications of heroin?

A 
Analgesia 
Drowsiness and sleep 
Mood change (euphoria, intense pleasure) 
Respiratory depression 
Cough reflex depression 
Sensitisation of the labyrinth with nausea and vomiting 
Decreased sympathetic flow (bradycardia and hypotension) 
Lowering of body temperature 
Pupillary constriction 
Constipation 
Respiratory arrest with a pulse 
Pinpoint pupils unreactive to light
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10
Q

What are the side effects of medium term opiate use?

A

Phlebitis
Anorexia
Constipation

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11
Q

What are the side effects of ling term opiate use?

A

Tolerance
Withdrawal
Social and health problems

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12
Q

What are the clinical features of opiate withdrawal syndrome?

A 
Craving 
Insomnia 
Yawning 
Muscle pain and cramps 
Increased salivary, nasal and lacrimal secretions 
Dilated pupils 
Piloerection
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13
Q

What are the pros of methadone maintenance?

A

Decriminalises drug use
Allows normalisation of lifestyle
Reduces IV misuse

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14
Q

What is the con of methadone maintenance?

A

Leakage on to the illicit market

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15
Q

What is the chemical name of ecstasy/

A

3,4-methylenedioxymethamphetamine

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16
Q

How is ecstasy consumed?

A

Orally

17
Q

What are the effects of ecstasy?

A

Euphoria followed by feeling of calm
Increased sociability
Inability to distinguish between what is an isn’t desirable

18
Q

What are the side of ecstasy?

A 
Nausea and dry mouth 
Increased blood pressure and temperature 
Club users risk dehydration 
Large dose can cause anxiety and panic 
Drug induced psychosis
19
Q

What is the psychoactive agent in cannabis?

A

Tetrahydrocannabinol

20
Q

How is cannabis consumed?

A

Smoked, but can be eaten

21
Q

What are the psychological effects of cannabis?

A 
Relaxing or stimulatory 
Euphoriant 
Increased sociability and hilarity 
Increases appetite 
Changes in time perception 
Synaesthesia 
Anxiety
Panic 
Persecutory ideation 
Hallucinatory activity
22
Q

What are the ill effects of cannabis?

A

Respiratory problems as with tobacco
Toxic confusion
Exacerbation of major mental illness

23
Q

What are anabolic steroids legitimately prescribed for?

A

Hypogonadism
Muscular dystrophy
Various anaemias
Wasting in AIDS

24
Q

What is the effect of anabolic steroid use?

A

Muscle hypertrophy particularly marked in he upper body (pectoralis, deltoid, trapezius, biceps)

25
Q

What are the side effects of anabolic steroid use?

A

Skin - acne, stretch marks, baldness
Feminisation in males with hypogonadism and gynaecomastia
Visualisation in females with hirsutism, deep voice, clitoral enlargement, menstrual irregularities, hair thinning
Increased cholesterol and hypertension
Growth deficits due to premature epiphyseal closure
Cholestatic jaundice, liver tumours

26
Q

What are the psychological side effects of anabolic steroid use?

A

Irritability and anger
Hypomania and mania
Depression and suicidality on withdrawal

27
Q

What is drug tolerance?

A

Reduced responsiveness to a drug caused by previous administration

28
Q

What is the mechanism of tolerance?

A

Less drug absorbed
Drug metabolised faster to inactive metabolites
Drug metabolised slower to active metabolites
More drug excreted
Fewer drug receptors
Less efficient drug receptors

29
Q

What is the reward centre?

A

Neurones project from the ventral tegmental area to the nucleus accumbens & prefrontal cortex
When VTA neurones are stimulated they release dopamine is released
This causes a sensation of pleasure/reward

30
Q

How do drugs affect the reward centre?

A

Heroin increases firing rate of dopaminergic neurones
Amphetamine increases dopamine release
Cocaine inhibits dopamine uptake
Alcohol

Psychiatry (17 decks)

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