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NMSP - Exam 3 > Approach to Substance Disorders > Flashcards

Approach to Substance Disorders Flashcards

1
Q

Primary chronic disease of brain reward, motivation, memory and related circuitry

A

Addiction

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2
Q

What 4 things should you look for when looking for Addictophrenia?

A
  • Acceleration and Escalation
  • Loss of control over use
  • Compulsive use
  • Cravings
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3
Q

What 4 things should you look for when looking for Addictophrenia?

A
  • Acceleration and Escalation
  • Loss of control over use
  • Compulsive use
  • Cravings
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4
Q

Does Physical Dependence = Addiction? Describe.

A

NO

  • physical dependence can occur with normal meds
    • ex. cannot abruptly stop beta blockers etc.
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5
Q

What genetic alteration has been associated with developing severe alcoholism?

A

A1 allele of DRD2 gene

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6
Q

The A1 allele of DRD2 gene can cause Reward Deficiency Syndrome. What neurotransmitter is low and what behaviors does that cause?

A

Hypodopaminergia

=> addictive, impulsive, compulsive behaviors

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7
Q

What can the Genetic Addiction Risk Score (GARS) predict?

A

Reward Deficiency Syndrome

– decreased DRD2 receptors

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8
Q

In general, what characterizes Alcohol Use Disorder?

A

Recurrent use/cravings despite the negative consequences

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9
Q

What is the CAGE screening for?

A

Alcohol use

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10
Q

CAGE screening questions

A
  1. Have you felt you should CUT DOWN?
  2. Do you ever get ANNOYED with criticism of drinking?
  3. Do you feel GUILTY about your alcohol use?
  4. Do you drink in the EARLY-MORNING?
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11
Q

Alcohol level of 0.05

A

Judgement and restraint impaired

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12
Q

Alcohol level of 0.08

A

Legally intoxicated

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13
Q

Alcohol level of 0.3

A

Stupor

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14
Q

Alcohol level of 0.4 and above?

A

Coma –> Death

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15
Q

What are 2 possible Alcohol Withdrawal conditions?

A
  1. Delirium Tremens

2. Wernicke-Encephalopathy

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16
Q

What are 2 possible Alcohol Withdrawal conditions?

A
  1. Delirium Tremens

2. Wernicke-Encephalopathy

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17
Q

What are the signs of Delirium Tremens that can occur with Alcohol Withdrawal?

A

Tremulousness (tremors)
Delusions
Seizures

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18
Q

Tremors, delusions and seizures that occur with Alcohol Withdrawal is what condition?

A

Delirium Tremens

19
Q

What are the signs of Wernicke-Encephalopathy with Alcohol Withdrawal?

A

Confusion
Ataxia
Ophthalmoparesis with nystagmus

20
Q

Confusion, ataxia and ophthalmoparesis with nystagmus after alcohol withdrawal is what condition?

A

Wernicke-Encephalopathy

21
Q

If a patient presents with severe Alcohol Withdrawal symptoms, you should admit to the detox unit and use what to guide treatment?

A

CIWA

22
Q

What 4 things can be used for treatment for Alcohol Withdrawal?

A
  • Benzodiazepines
  • Antipsychotics
  • IV fluids
  • Restraints
23
Q

When giving IV fluids (banana bag) to Alcohol Withdrawal patients, what things are included and what must be given AFTER Thiamine?

A

Mg++, K+, Thiamine, Folic Acid

* Glucose must be given after Thiamine *

24
Q

Acamprosate can be used to treat Alcohol Dependence. What is its MOA and effect?

A

(-) GABA

= Decreases ingestion and maintains abstinence from alcohol

25
Q

Naltrexone can be used to treat Alcohol Dependence. What is its MOA and effect?

A

Opioid Antagonist

= cuts cravings and improves abstinence

26
Q

GABApentin can be used off label for Alcohol Dependence treatment. When especially, is it good for treatment?

A

Especially with withdrawal symptoms

- Decreases ingestion

27
Q

Disulfram can be used to treat Alcohol Dependence. What are its effects?

A

Produces unpleasant adverse effects when the patient drinks alcohol

28
Q

What are some signs of intoxication with Amphetamines and Cocaine?

A

Increased alertness and agitation

Hyperthermia and Hallucinations

29
Q

What are some signs of withdrawal of Amphetamines and Cocaine?

A

Increased sleep, appetite and depression

– potentially SUICIDAL

30
Q

How do you treat withdrawal symptoms of Amphetamines and Cocaine?

A

Antidepressants and hospitalization

31
Q

What are some signs of intoxication with Benzodiazepines and Barbiturates?

A

Sedation, coma, respiratory depression

32
Q

What are some signs of withdrawal from Benzodiazepines and Barbiturates?

A

Agitation, tremors, sweating, delirium and seizures

33
Q

Can withdrawal be fatal with Benzodiazepines and Barbiturates?

A

YES

– Seizures, delirium, sweating

34
Q

What are some signs of intoxication with LSD and PCP (hallucinogens)?

A

Hallucinations and paranoia

35
Q

What extra symptoms besides hallucinations can be seen with intoxication of PCP?

A

Violent behavior
Muscle rigidity
Seizures

36
Q

What is a sign of withdrawal from LSD and PCP?

A

Flashbacks

– Re-experiences of hallucinogenic state

37
Q

With what drugs can flashbacks (re-experiences of hallucinogenic states) occur?

A

LSD

PCP

38
Q

Substance-Induced Mental Disorders are developed when?

A

Developed within 1 month of a substance intoxication

39
Q

What are 4 common agents that can cause Substance-Induced Mental Disorders?

A

LSD
PCP
Amphetamines and Cocaine

40
Q

What are some signs of intoxication with Opioids?

A

Analgesia +/- LOC

Itching and respiratory depression

41
Q

What are some symptoms of withdrawal from Opioids?

A

Sweating and lacrimation, irritability

YAWNING

42
Q

Can withdrawal from Opioids be fatal?

A

NO
– just miserable
= yawning, irritability, lacrimation and sweating

43
Q

How do you treat acute pain in opioid dependent patients if they are on Buprenorphinie/Naloxone?

A

STOP while they are in hospital

– Restart with discharge

44
Q

How do you treat acute pain in opioid dependent patients if they are on Methadone?

A

DO NOT STOP

– add additional opioid for the acute pain (ex. morphine)

NMSP - Exam 3 (22 decks)

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