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T2 - Phase 3 - Brain, Mind, and Behavior > BMB 3 - Substance Abuse > Flashcards

BMB 3 - Substance Abuse Flashcards

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1
Q

Substance abuse is responsible for ___ - ___% of healthcare costs.

A

Substance abuse is responsible for 20** - **30 % of healthcare costs

  • (Although, 1% of healthcare dollars are spent on treatment of abuse and addiction.)*
  • (60% - 80% of treatment happens in public sector.)*
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2
Q

What percentage of those who need treatment for substance abuse/addiction actually get it?

A

10%

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3
Q

Addiction is a _________ and not a chosen state.

A

Addiction is a disease and not a chosen state.

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4
Q

Is detoxification treatment for substance abuse?

A

No.

(It does nothing to treat the actual underlying pathology of addiction.)

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5
Q

True/False.

80% of persons between 18 and 21 years of age abuse substances

A

True.

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6
Q

What percentage of the population develops an addiction during their lives?

A

10%

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7
Q

Describe the diagnostic criteria for substance abuse disorders (think in terms of amounts, timeframes, efforts to quit, procurement, .

A

2 / 11 of the following:

Larger amounts than intended

Longer period than intended

Persistent desire or unsuccessful attempts to cut back

Large amount of time spent obtaining substance

Large amount of time spent recovering from use

Craving

Recurrent use inducing failure to meet major obligations

Continued use despite social drawbacks

Important social/recreational/occupational activities are given up

Physically hazardous and recurrent use

Continuance despite knolwedge of psychological or physiological repercussions

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8
Q

How important is strict abstinance in the process of recovering from substance abuse?

A

It is crucial to the recovery process

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9
Q

Name some of the major features of treatment that are common to all substance abuse disorders.

A

Abstinance

Social support

Life-long attendance

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10
Q

What is ‘stinking thinking’ in regards to substance abuse disorders?

A

A neuroadaptation characterized by self-centeredness, external locus of control, loss of empathy, and loss of spiritual connectedness

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11
Q

How can the ‘stinking thinking’ (self-centeredness, external locus of control, loss of empathy, and loss of spiritual connectedness) of substance abuse disorders be managed?

A

It resolves during abstinance

(but its presence indicates an increased likelihood of relapse)

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12
Q

What major developmental issue can develop in adolescents who drink alcohol or use illicit drugs as a method of modifying their emotional reactions?

A

It can stunt emotional development

(adolescence is a process of learning how to feel bad and good appropriately)

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13
Q

True/False.

Addictive dependencies on carbohydrates, gambling, religion, sex, aggression, stress, certain personality disorders, ADHD and novelty seeking are all associated with genetic predispositions.

A

True.

They may be evidences of a reward enhancement syndrome or reward deficiency syndrome.

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14
Q

What use do medications have in treating neuroadaptations?

A

They stabilize the neuroadaptations so abstinance/recovery can help reverse them

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15
Q

True/False.

For people with addiction involving the use of opioids the recovery rate is very high even without the use of medications.

A

False.

For people with addiction involving the use of opioids the recovery rate is very low without the use of medications.

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16
Q

List the components of the ‘opioid triad.’

A
  • Shallow breathing
  • Pinpoint pupils
  • Altered sensorium
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17
Q

What medication is the go-to method of reversing opioid intoxication?

A

Naloxone

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18
Q

What is the naloxone mechanism of action?

A

Opioid antagonism

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19
Q

The short-acting benzodiazepines end in what suffix?

A

‘-Lam’

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20
Q

The long-acting benzodiazepines end in what suffix?

A

‘-Pam’

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21
Q

What is the mechanism of action of benzodiazepines?

A

GABA agonist

(increases frequency of Cl- channel opening)

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22
Q

Benzodiazepine withdrawal side effects are more likely to be seen in ______-acting drugs.

A

Benzodiazepine withdrawal side effects are more likely to be seen in short-acting drugs.

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23
Q

True/False.

Stimulants such as amphetamines cause increases in Dopamine and other neurotransmitters.

A

True.

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24
Q

When a patient begins taking a __________, they can develop a drug-induced psychosis that looks similar to schizophrenia (positive symptoms: due to the now excess dopamine in the body).

A

When a patient begins taking a stimulant, they can develop a drug-induced psychosis that looks similar to schizophrenia (positive symptoms: due to the now excess dopamine in the body).

25
Q

A 19-year-old patient presents with symptoms similar to those of schizophrenia. She has recently begun taking Adderall for her ADHD.

What do you suspect?

A

Drug-induced psychosis

26
Q

The endocannabinoid system is a negative feedback system for __________.

A

The endocannabinoid system is a negative feedback system for glutamate (the endocannabinoids acting as an ‘auto-brake’ of sorts).

27
Q

Endogenous endocannabinoids 2AG & AEA act on ____synaptic neurons, reducing the firing rate by activating presynaptic ____ receptors.

A

Endogenous endocannabinoids 2AG & AEA act on presynaptic neurons, reducing the firing rate by activating presynaptic CB1 receptors.

28
Q

Name two of the major endogenous endocannabinoids involved in regulating glutamate activity.

A

Endogenous endocannabinoids 2AG and AEA

29
Q

Name the two cannabinoids which binds much longer and more strongly to the CB1 receptor than the endogenous endocannabinoids (resulting in a lot of downstream effects that aren’t fully known).

A

THC and spice/k2

30
Q

How can THC and spice/k2 be displaced from CB1 receptors without treatment?

A

They cannot.

31
Q

You come across an individual with pinpoint pupils and a pulse but who doesn’t appear to be conscious or breathing. What do you administer, and what do you do next?

A

Naloxone

Call EMS

32
Q

True/False.

Nasal naloxone wears off more quickly than IV naloxone.

A

True.

33
Q

At low doses, cocaine’s main effects involve ___________s.

At high doses, cocaine’s main effects involve _______toxicity.

A

At low doses, cocaine’s main effects involve neurotransmitters (norepinephrine, serotonin, dopamine).

At high doses, cocaine’s main effects involve cardiotoxicity (blocks cardiomyocyte Na+ and K+ channels).

34
Q

In what cases should cocaine-induced cardiotoxicity be treated with beta-blockers?

A

Never!

(Worsens vasospasms.)

35
Q

Name some of the effects of cocaine use on the body.

A

Euphoria,

mydriasis,

tremor,

talkativeness,

emotional instability,

seizures,

coma

36
Q

How should one treat acute cocaine use?

A

Benzodiazepines and bicarbonate

+

control of body temperature and monitor glucose levels

37
Q

True/False.

Cocaine use and amphetamine use have similar presentations.

A

True.

(Euphoria, talkativeness, energy, mydriasis, etc.)

38
Q

Which of the following mechanisms is used by amphetamines?

Weakly inhibits MAO

Increases monoamine release from storage

Competes with monoamine for reuptake

A

All three.

39
Q

Describe the reverse-transporter-exchange mechanism of amphetamine use.

A

Extracellular amphetamines are exchanged for intracellular monoamines (via DAT)

40
Q

Compare the strength of effects of amphetamines and methylphenidate on various neurotransmitter levels.

A

NET > DAT (>> SERT)

41
Q

Compare the strength of effects of MDMA on various neurotransmitter levels.

A

SERT > DAT (>> NET)

42
Q

MDMA mostly increases levels of which neurotransmitter(s)?

A

Dopamine

Serotonin

43
Q

What is the mechanism of action of MDMA?

A

5-HT2A-serotonin-receptor and D2-receptor agonists

+

serotonin and dopamine reuptake inhibitors

44
Q

A patient presents with euphoria, jaw clenching, teeth grinding, and increased empathy.

She is also hyponatremic. What explains this hyponatremia?

A

MDMA intake

(and subsequent increase in ADH levels)

45
Q

Describe the mechanism of bath salts as recreational stimulants (inducing euphoria, hallucinations, etc.).

A

Increased release of dopamine

+

decreased reuptake of epinephrine, norepinephrine, and sertraline

46
Q

What toxicities are associated with bath salt abuse?

A

Paranoia, violent behavior, suicidality

(overdose-related deaths have also been reported)

47
Q

True/False.

Both MDMA and bath salts are associated with potential hyperthermia as a result.

A

True.

48
Q

LSD is a partial agonist of what receptor(s)?

A

5-HT1; 5-HT2A

49
Q

What are the major effects of LSD use?

A

Hallucinations, enhanced sensory input, synesthesia;

increased HR and BP

50
Q

What is mescaline?

A

A hallucinogenic derived from peyote cactus

51
Q

What is psilocybin?

A

A hallucinogenic derived from mushrooms

52
Q

Describe the mechanism of action of phencyclidine use in terms of receptor and neurotransmitter interactions.

A

NMDA receptor agonism;

inhibits reuptake of dopamine, serotonin, and norepinephrine

53
Q

Which recreational drug is a dissociative anesthetic and one of the most dangerous hallucinogens available?

A

Phencyclidine

54
Q

Describe the effects of phencyclidine on an individual.

A

Euphoria;

clinical signs: hyperreflexia, catatonic posturing, seizures, nystagmus;

dissociation: loss of contact w/reality, inability to communicate, aggression, amnesia, insensitivity to pain

55
Q

Marijuana acts by partial agonism of which receptors?

A

CB1 and CB2

56
Q

What are the effects of marijuana use?

A

Giddiness, feeling of well-being, grandiosity, euphoria, relaxation,

altered perception of passage of time, drowsiness,

diminished coordination

57
Q

True/False.

High-potency strains and/or some delivery methods of marijuana use are associated with acute psychosis.

A

True.

Marijuana use is associated with increased risk of schizophrenia in users (and also low-birth weights in their children).

58
Q

True/False.

Marijuana is a partial agonist of CB1 and CB2 receptors.

Synthetic cannabinoids are full agonists of CB1 and CB2 receptors.

A

True.

T2 - Phase 3 - Brain, Mind, and Behavior (43 decks)

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