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NSB Biweekly 4 > Brooks- Substance Use Disorders > Flashcards

Brooks- Substance Use Disorders Flashcards

1
Q

Genetics + environment
Societal and family values

A

etiology of substance use

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2
Q

3 main parts of brain that deal with substance abuse

A

Dopamine
nucleus accumbens
ventral tegmental area

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3
Q

A problematic pattern of substance use leading to clinically significant impairment or distress, as manifested by 2 (or more) of the following occurring within a 12-month period

MAIN points: pattern leading to impairment or distress

A

Criterion A for substance use disorder

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4
Q

severity of 2-3 symptoms

A

mild

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5
Q

severity of 4-5 symptoms

A

moderate

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6
Q

severity of 6 or more symptoms

A

severe

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7
Q

Alcohol Use Disorder, Mild

A

Alcohol Abuse

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8
Q

Alcohol Use Disorder, Moderate to Severe

A

Alcohol Dependence

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9
Q

no criteria for > 3 months but < 12 months (except craving)

A

early remission

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10
Q

no criteria for > 12 months (except craving)

A

sustained remission

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11
Q

access to substance restricted (ex. Jail)

A

in controlled environment

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12
Q

is the diagnosis used to describe a syndrome (e.g. simple drunkenness) characterized by specific signs and symptoms resulting from recent ingestion or exposure to that substance

A

substance intoxication

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13
Q

Behavioral or psychological changes due to effects on CNS developing after use

A

substance intoxication

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14
Q

the diagnosis used to describe a substance-specific syndrome that results from the abrupt cessation (or reduction) of heavy and prolonged use of a substance

A

substance withdrawal

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15
Q

Causes clinically significant distress or impairment in social, occupational, or other important areas in functioning

A

substance withdrawal

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16
Q

Phencyclidine; other hallucinogens; inhalants

A

no withdrawal syndrome

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17
Q

The symptoms (like psychosis) developed during or soon after substance intoxication, substance withdrawal, or exposure to or withdrawal from a medication

A

substance-induced mental disorders

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18
Q

It is estimated that one in five intensive care unit admits in some urban hospitals is related to _____

A

alcohol

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19
Q

enhances effect of GABA

A

alcohol

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20
Q

impairs gluconeogenesis after glycogen stores are used up

A

alcohol

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21
Q

screening test for an alcohol use disorder

A

CAGE

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22
Q

Clinically significant problematic behavioral or psychological changes after ingesting alcohol

A

alcohol intoxication

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23
Q

Slurred speech
Incoordination
Unsteady Gait
Nystagmus
Impairment in attention or memory
Stupor or Coma

A

alcohol intoxication

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24
Q

Legal definition of intoxication in most states is ____ mg ethanol per deciliter of blood (mg/dL) which is the same as 0.08 g/dL

A

80 mg/dL

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25
Q

a sense of well being, sedation, tranquility (alcohol concentration)

A

0-100 mg/dL

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26
Q

coma and death (alcohol concentration)

A

> 350 mg/dL

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27
Q

the body is able to metabolize approximately ____ drink per hour

A

one

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28
Q

how to treat alcohol intoxication

A

supportive

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29
Q

Cessation of (or reduction in) alcohol use that has been heavy and prolonged

A

alcohol withdrawal

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30
Q

Autonomic hyperactivity
Increased hand tremor
Insomnia
Nausea or vomiting
Transient visual/tactile/auditory hallucinations or illusions
Psychomotor agitation
Anxiety
Generalized tonic-clonic seizures

A

alcohol withdrawal

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31
Q

can look like a pt comes in and says they are experiencing bugs crawling on them (moms patient at victory); visual and tactile most common

A

transient hallucinations/illusions during alcohol withdrawal

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32
Q

most feared alcohol withdrawal symptom

A

seizures

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33
Q

commonly known as “the shakes,” typically starts 12 to 18 hours after a person stops drinking. It reaches its peak intensity between 24 and 48 hours and generally resolves within 5 to 7 days (can be done outpatient)

A

uncomplicated alcohol withdrawal

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34
Q

Patients may experience a single episode of one to six generalized seizures

A

alcohol withdrawal seizures

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35
Q

involves vivid and distressing auditory, visual, or tactile hallucinations that begin within 48 hours after stopping alcohol consumption. These hallucinations occur while the individual is otherwise mentally clear and typically last about a week

A

alcoholic hallucinosis

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36
Q

also known as delirium tremens or “DTs,” affects about 5% of hospitalized patients with alcohol use disorder, but occurs in approximately one-third of those who experience withdrawal seizures. Symptoms include confusion, agitation, perceptual disturbances, fever, and autonomic hyperarousal

A

alcohol withdrawal delirium

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37
Q

______withdrawal requires careful monitoring and hospitalization

A

complicated

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38
Q

Rx w/ nutrient supplementation, and the use of benzodiazepines

A

alcohol withdrawal treatment

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39
Q

what are the nutrient supplementations used in alcohol withdrawal

A

thiamine, folic acid

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40
Q

alcohol use can cause this syndrome due to thiamine (vitamin B1) deficiency

A

Wernicke-Korsakoff syndrome

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41
Q

encephalopathy is characterized by symptoms such as confusion, ataxia, and ophthalmoplegia

A

Wernicke’s

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42
Q

______psychosis involves severe memory impairment and confabulation

A

Korsakoff’s

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43
Q

reversible cause of cognitive impairment if treated

A

Wernicke-Korsakoff syndrome

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44
Q

what to order and look at for patient who has wernicke-korsakoff syndrome

A

MRI— look at mammillary bodies

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45
Q

two main goals
1. that the patient remains sober
2. that coexisting disorders be identified and treated

A

rehab for alcohol use

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46
Q

A worldwide self-help group for recovering alcoholic persons founded in 1935. ____ uses a program of 12 steps.

A

AA

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47
Q

used for aversive conditioning (associate alcohol with feeling sick) and no longer do it

A

Disulfiram

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48
Q

inhibits aldehyde dehydrogenase (buildup of acetylaldehyde)

A

Disulfiram

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49
Q

an opioid antagonist, appears to reduce the pleasurable effects of and craving for alcohol

A

Naltrexone

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50
Q

a glutamate receptor modulator, helps curb urges to drink

A

Acamprosate

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51
Q

uncomplicated vs complicated treatment of alcohol disorder

A

uncomplicated: outpatient
complicated: hospital

52
Q

The most widely consumed psychoactive substance in the world

53
Q

1 cup of coffee = _____ mg caffeine

54
Q

average consumption of caffeine is ____ mg a day

55
Q

antagonism of adenosine receptors

56
Q

Restlessness
Nervousness
Excitement
Insomnia
Flushed Face
Diuresis
Gastrointestinal disturbance
Muscle Twitching
Rambling flow of thought and speech
Tachycardia or cardiac arrhythmia
Periods of inexhaustibility
Psychomotor agitation

A

caffeine intoxication

57
Q

main symptom of caffeine withdrawal

58
Q

how to treat caffeine intoxication

A

gradually eliminate it
NSAIDs for HA

59
Q

One most common and underrecognized cause of insomnia and anxiety
Can contribute to excess gastric acidity and thereby worsen esophageal and gastric disorders

60
Q

______is the most widely used illegal drug in the world

61
Q

is the primary component of cannabis with psychoactive effects

62
Q

Conjunctival Injection
Increased Appetite
Dry Mouth
Tachycardia

A

cannabis intoxication

63
Q

Irritability, anger, or aggression
Nervousness or anxiety
Sleep difficulty
Decreased appetite or weight loss
Restlessness
Depressed mood

A

cannabis withdrawal

64
Q

Self-limiting
Anti-anxiety meds
Support
Educate
Monitor outpatient

A

treatment for cannabis related disorders

65
Q

how long can urine drug screen detect cannabis

A

up to 4 weeks after use

66
Q

Throwing up, heavy _____ smoker, in ER, only thing that helps is a hot shower

67
Q

no known withdrawal symptoms

A

psychedelics

68
Q

moa of LSD

A

5HT2A agonist

69
Q

Perceptual changes occurring in a state of full wakefulness and alertness

A

hallucinogen intoxication

70
Q

pupillary DILATION
sweating tachycardia

A

hallucinogen intoxication

71
Q

Supportive care for duration of intoxication
Benzodiazepines for acute anxiety if necessary
Treat psychosis with short-term antipsychotics

A

treat hallucinogen-related disorder

72
Q

Phencyclidine aka

A

PCP (angel dust)

73
Q

Produce feelings of separation from mind and body

A

PCP (angel dust)

74
Q

moa of ketamine

A

NMDA antagonist

75
Q

Vertical or horizontal nystagmus
seen in patient in ED

A

PCP intoxication

76
Q

how to treat acute psychosis/agitation-

A

benzodiazepines

77
Q

Only substance use disorder that is more prevalent in kids than adults

A

inhalant-related disorders

78
Q

sniff paint thinner, airplane glue, typewriter correction fluid

A

inhalant-related disorders

79
Q

PE includes rash around nose or mouth

A

inhalant-related disorders

80
Q

what intoxication is hard to distinguish

A

inhalant intoxication

81
Q

Can get permanent neurologic damage due to ____ in inhalants

A

heavy metals

82
Q

There is no specific treatment for intoxication
This is no recognized withdrawal syndrome

83
Q

pain meds

84
Q

agonism of mu receptors

85
Q

pinpoint pupils
drowsiness
respiratory depression

A

opioid intoxication

86
Q

antidote for opioid overdose, and will put pt in opioid withdrawal

87
Q

basically patient will feel like they have a severe case of the flu

A

opioid withdrawal

88
Q

for withdrawal of ______can give long-acting opioids (why?) GOLD STANDARD
treat cravings and decrease drug seeking behavior
or clonidine (alpha2 receptors)
NSAIDs
loperamide for diarrhea

89
Q

most commonly used drug for opioid use disorder (an opioid substitution); hard to overdose on
partial mu agonist

A

Buprenorphine

90
Q

full mu agonist
easy to overdose on
but used for opioid use disorder

91
Q

really morphine with 2 acetyl groups (di-acetyl morphine)

92
Q

commonly see sexual dysfunction with this (they are anti-testosterone)

A

opioid use disorder

93
Q

nodding off

A

opioid intoxication

94
Q
A

skin popping

95
Q
A

track marks

96
Q

main complications of IV drug use

A

infective endocarditis
Hepatitis C
HIV

97
Q

4th wave of fentanyl overdose deaths in US involves what

A

fentanyl + methamphetamine

98
Q

sedative, hypnotic, or anxiolytic-related disorder
(very hard to overdose)
bind GABA A (increase frequency)

A

benzodiazepines

99
Q

sedative, hypnotic, or anxiolytic-related disorder
very narrow therapeutic window (overdosed and die easily)
bind GABA A (increase duration)
rarely used

A

barbiturates

100
Q

looks similar to alcohol intoxication
(these are used to help come off of alcohol)

A

benzodiazepines

101
Q

sedative, hypnotic, or anxiolytic withdrawal sx you worry about most

102
Q

give flumazenil, but really give ______ to make seizures go away if caused by flumazenil

A

benzodiazepine overdose

103
Q

best way to get off of benzodiazepines

A

gradual taper

104
Q

Effective for sedation and anxiolytic
but prescribed with caution

A

sedative-hypnotic drugs (benzodiazepines)

105
Q

increase dopamine release and block reuptake of neurotransmitters (blocks VMAT)

A

amphetamines

106
Q

DAT and NET blocker

107
Q

DAT and NET blocker

A

methylphenidates

108
Q

dilated pupils
tachy or bradycardia
N/V
sweating or chills
weight loss

A

stimulant intoxication

109
Q

Bad dental and gum disease for prolonged ____use

110
Q

CRASH: feeling sad, dysphoric, depressed

A

stimulant withdrawal

111
Q

Supportive care for intoxication and withdrawal as this is generally self limiting
Contingency Management has the most evidence for treatment of a methamphetamine use disorder (+ reinforcement)

A

treat stimulant use disorder

112
Q

new: can use ____ to help people stay off illicit stimulants (extended release)

A

stimulants

113
Q

people who use ____ can have myocardial infarctions (vasoconstriction and procoag effects)

114
Q

psychoactive component of tobacco

115
Q

stimulates presynaptic acetylcholine receptors thereby enhancing Ach release and metabolism (a4b2)

116
Q

most addictive
Biggest issue: people tend to gain weight with withdrawal

117
Q

first line treatment for nicotine use disorder

A

dual nicotine replacement (long and short acting)

118
Q

treat nicotine use disorder and helps with weight gain

119
Q

partial agonist at nicotinic Ach receptor a4b2 subunit

A

Varenicline

120
Q

What percentage of people with schizophrenia smoke?

121
Q

Stabilize schizophrenic pt on dose of clozapine, they get discharged, and they are psychotic again
what happened?

A

they smoked and increased metabolism of drug

122
Q

Have to do weekly blood draws to avoid neutropenia with what drug

123
Q

this disorder is becoming more culturally accepted
come in b/c family member is concerned

A

gambling disorder

124
Q

severity:
4-5 criteria met for this disorder

A

gambling
mild

125
Q

severity:
6-7 criteria met

A

gambling
moderate

126
Q

severity:
8-9 criteria met

A

gambling
severe

NSB Biweekly 4 (11 decks)

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