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Phase 3a Psych > Addictive behaviours > Flashcards

Addictive behaviours Flashcards

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1
Q

what pathway does addiction act on?

A

mesolimbic pathway

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2
Q

How many dependence terms do you need to mean your dependent?

A

3+ means dependent (in 12 month period)

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3
Q

What are the terms of dependence?

A

withdrawal Sx - uses substance to avoid withdrawal Sx onset
Tolerance
Narrow repertoire (one type of drug/alcohol)
Craving
Loss of control
Rapid reinforcement - quick return to old level after stopping
Primacy - taken precedence over psychological need
Continued use despite harm

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4
Q

Substance abuse –>
Misuse –>

A

excessive use
2^ use

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5
Q

Alcohol:
what does it work on in the body?
what happens overall?
what Sx?

A

GABA ergic (inhibitory) CNS retardation - slows you down

high adipose mass
high cortisol
low co ordination (cerebellar Sx)
low Resp rate

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6
Q

Sx of alcohol intoxication?

A

high sexual arousal
ataxia
slurred speech
high confidence
irritable
change in GCS
Vomiting

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7
Q

Sx of alcohol withdrawal and time frames?
6-12hr
12-24hr
36hr
72hr

A

6-12hr: anxiety + fine tremor
12-24: hallucinations
36hr: seizure (gen tonic clonic)
72hr: delirium tremens (coarse tremor, altered mental state, change in GCS)

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8
Q

What would you see on the bloods in someone who drinks alcohol?

A

Non megaloblastic macrocytic anemia
High GGT
High ALP
High CDT

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9
Q

which 2 questionnaires are done in alcohol addiction?
why are they done?

A

CAGE - Screening
AUDIT - Dx

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10
Q

what are the CAGE questions?
what score is needed?

A

2+/4
should you Cut down?
Annoyed at others telling you to cut down?
Guilty?
Eye opener? (drink in the morning as an eye opener)

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11
Q

what score is needed from AUDIT?

A

8+/10

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12
Q

once stable, what diagnosis questionnaire is used for alcohol addiction?

A

CLWA - Ar
Clinical Withdrawal Assess - alcohol related

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13
Q

what blood alcohol concentration (BAC) makes it illegal to drive?

A

0.08%+

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14
Q

what % of alcoholics develop liver cirrhosis?

A

20%

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15
Q

What is acute Tx for alcohol withdrawal?
What do you give if a Px has liver sclerosis?

A

IV Chlordiazepoxide (med acting benzo) - Tx of withdrawal
IV lorazepam

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16
Q

what are the 3 long term withdrawal medications for alcoholics?

A

NAD
Naltrexone
Acamprosate
Disulfiram (Antabuse)

17
Q

What does naltrexone work on and do?

A

Opioid Inhibitor
decrease pleasure

18
Q

What does acamprosate work on and do?

A

NDMA inhibitor
decrease craving

19
Q

What does disulfiram work on and do?

A

Acid aldehyde dehydrogenase - inhibitor (AAD-i)
Induce hangover Sx with alcohol

20
Q

what is disulfiram CI in and why?

A

pregnancy and Alcohol
can cause severe hypo due to acetaldehyde

21
Q

Examples of opioids?

A

morphine, heroin, codeine, oxycodone, hydrocodone and fentanyl

22
Q

what are opioid overdose Sx?

A

sleepiness, relaxation
Constipated
N+V
Euphoric
Pinpoint pupils

23
Q

SE of opioid overdose?

A

resp depression

24
Q

Sx of opioid withdrawal?

A

yawning
dilated pupils
lacrimation
rhinorrhoea

25
Q

Tx for acute opioid overdose?

A

IV Naloxone 400mg

26
Q

Long term Tx for opioid withdrawal?

A

Methadone/Buprenorphine + naltrexone

27
Q

name 3 CNS stimulants?
what do they work on in which pathway?

A

NDMA
Amphetamines
Cocaine
High Dopamine in reward pathway (mesolimbic)

28
Q

Sx and Tx of NDMA?

A

Agitation
Htn + tachy
Hyperthermia
HypOnatremia
Low appetite

Tx = supportive

29
Q

examples of amphetamines?
Sx?

A

Meth, Methylphenidate

Agitation
Hyperthermia
Hallucinations
Dilated pupils

30
Q

What can cocaine cause?
Sx?

A

CA vasospasm (prinzmetal angina)
Tx = IV Benzos
QRS widening
Seizures
Ischemic colitis
Hyperthermia

31
Q

what type of drug is LSD?
How does it work?
Sx?

A

Hallucinogen, High 5HT-2 receptor agonist on prefrontal cortex

Psychosis, impaired judgement, ‘bad trips’ (panic attack), dilated pupils, hyperreflexia and hyperthermia

32
Q

Bad trip Tx?

A
  1. verbal de escalation
  2. Lorazepam
33
Q
A

Phase 3a Psych (11 decks)

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