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CADC1 > CADC1 exam > Flashcards

CADC1 exam Flashcards

1
Q

Where in the brain is the reward pathway located?

A

limbic system, this pathway includes the nucleus accumbens which is targeted by drugs of abuse

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2
Q

Endorphins

A

proteins in the body that motivate behavior by producing feelings of wellbeing in various situations

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3
Q

GABA

A

An inhibitory NT;

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4
Q

Drugs that cause pinpoint pupils

A

opioids, depressants like codeine, fentanyl, morphine, heroin, methadone; and antipsychotics

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5
Q

Short-term psychological effects of alcohol

A

distortions of vision, impairment of coordination, impaired judgment, altered emotions and perceptions

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6
Q

Long-term psychological effects of alcohol

A

Depression, memory loss, pseudo-dementia, loss of libido

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7
Q

Short-term psychological effects of stimulants

A

euphoria, insomnia, irritability, confusion, anxiety, paranoia

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8
Q

Long-term psychological effects of stimulants

A

hallucinations, formication (bug crawling feeling), depression, loss of appetite, stimulant-psychosis, paranoia

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9
Q

Short-term psychological effects of psychedelics

A

incoherent speech, tactile sensory impairment, insomnia, confusion

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10
Q

Long-term psychological effects of psychedelics

A

depression, paranoia, confusion, flashbacks, catatonic syndrome, pseudo-schizophrenia

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11
Q

Dependence

A

Occurs when a person persists in taking a substance to satisfy a feeling, mitigate psychiatric illness symptoms, avoid difficult feelings, or to meet emotional needs; Continued use despite increasingly negative consequences

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12
Q

Psychological dependence

A

Occurs when a person persists in taking a substance to satisfy a feeling, mitigate psychiatric illness symptoms, avoid difficult feelings, or to meet emotional needs; Continued use despite increasingly negative consequences

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13
Q

Physiological dependence

A

Occurs when one uses to avoid withdrawal symptoms

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14
Q

Acute withdrawal

A

lasts 2-7 days; characterized by the strongest symptoms

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15
Q

Post-acute withdrawal

A

may last for weeks or months

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16
Q

Drugs that require detoxification

A

depressants: alcohol, opiates, benzo’s

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17
Q

The most common drug interaction in overdoses

A

A sedative + another sedative because they depress the central nervous system

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18
Q

The liver breakdowns how many grams of pure alcohol per hour (for a 150 lb person)?

A

7 grams/hr

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19
Q

Effects of excessive alcohol consumption over time

A

liver cirrhosis, ruptured esophagus, impotence, stomach ulcers and inflammation, possible damage to every organ system, respiratory depression.

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20
Q

Alcohol withdrawal symptoms

A
  1. 6-8 hrs- tremors, agitation, anxiety, hypertension, nausea, vomiting, anorexia, headache, insomnia, craving
  2. 24 hrs-6 days - disordered perceptions, hallucinations, delusions
  3. 7-48 hrs - possible seizures, delirium tremens
  4. 3-5 days- DT, global confusion, hallucinations, autonimic hyperactivity (only 5-6% of patients progress to this stage)
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21
Q

Alcohol acts on which NT’s

A

GABA (enhances inhibitory function)

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22
Q

Treatments for alcohol use disorder

A
  • appropriate benzo’s to titrate symptom severity;
  • monitor fluids, electrolytes, vital signs;
  • detoxification in a hospital setting (usually lasts no longer than 5 days);
  • meds that minimize tremors, seizures, rapid heart rate, high blood pressure
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23
Q

Antabuse (Disulfiram) is used to treat…

A

A medication that causes patients to stop using alcohol because if they take this med and drink, they become sick; can be used with methadone

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24
Q

CNS depressants

A

Alcohol, sedative-hypnotics, antipsychotics, tranquilizers

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25
Q

Benzodiazepines

A

A short-acting tranquilizer commonly used for the tx of anxiety, panic attacks, and insomnia; limited danger of fatal overdose; effcts include extreme drowsiness; over-sedation can be delayed days because of accumulation in the fatty tissues

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26
Q

Sedative- hypnotic withdrawal effects

A

anxiety, insomnia, agitation, seizures, death

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27
Q

Barbiturates

A

A type of sedative-hypnotic; highly addictive; high risk of overdose; withdrawal requires medical supervision

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28
Q

Short term and long term effects of barbiturates

A

short term: occur 20 min after ingestion; similar to alcohol; euphoria, confusion, slurred speech, stupor, sleepiness

long term: nausea/vomiting, constipation, bradycardia, high blood pressure, insomnia, anxiety, confusion, apnea, hypoventilation, nightmares, ataxia, dizziness, hallucinations, distorted thinking

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29
Q

Barbiturate withdrawal effects

A

Can be life-threatening; symptoms experienced within 8-16 hours after last dose and can last up to 15 days;

symptoms include anxiety, insomnia, weakness, restlessness, dizziness, nausea;

severe effects include tremors, seizures, hallucinations, psychosis, possible death from hyperthermia or circulatory failure

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30
Q

Rohypnol

A

the date rape drug; a tranquilizer that produces strong amnesia for events surrounding ingestion

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31
Q

Benzodiazepine withdrawal

A

does not typically involve significant hypertension or tachycardia symptoms like alcohol withdrawal; symptoms include agitation, elevated psychomotor activity, delirium, muscular weakness, elevated blood pressure, tremors, heightened anxiety and depression, unexplained euphoria or grandiosity; disorientation, hallucinations

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32
Q

Antipsychotics

A

Tranquillizers used in the tx of major mental disorders characterize by psychosis; Disrupt or reduce rates of NT activity; slowing activity helps reduce intensity of intrusive thoughts, feelings of paranoia, hallucinations, delusions, thought disorder, loose associations, ambivalence, emotional lability

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33
Q

Cocaine

A

A stimulant; variations include freebase and crack; takes 15-30 min to feel effects, and high wears off in 30 min-2 hrs;

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34
Q

Cocaine withdrawal

A

paranoia, depression, exhaustion, anxiety, mood swings, fatigue, insomnia, intense cravings; possible symptoms related to schizophrenia

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35
Q

Reward deficiency syndrome

A

When the dopamine system in hyper or hypo-functioning leading to low levels of pleasure, inducing greater activity of behaviors that stimulate the dopamine reward system

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36
Q

Amphetamine

A

A stimulant that produces alertness, wakefulness, increased focus, and decrease in appetite (often used as ADHD meds). Produced in pill form.

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37
Q

Methamphetamine

A

A stimulant produced from amphetamine that has been methylated twice (so it has a much stronger and quicker effect). Meth has no legitimate medical use. Usually produced in powder or crystal form

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38
Q

Meth/amphetamine physical effects

A

dry mouth, facial flushing, blood-shot eyes, hyperactivity, dilated pupils, restlessness, teeth grinding, headache, hyper/hypotension, fever, diarrhea, blurred vision, twitching, numbness, dry/itchy skin, acne, aphasia.

Chronic use effects: seizure, stroke, coma, heart attack, possible death

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39
Q

Crystal meth

A

a form of meth that has been processed into clear crystals that can be smoked

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40
Q

Meth/amphetamine psychological effects

A

alertness, anxiety, euphoria, increased libido, elevated energy, enhanced self-esteem, grandiosity, sociability, aggression, psychosomatic disorders, psychomotor agitation, repetitive/obsessive behaviors, paranoia

Chronic use: psychosis can occur

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41
Q

Meth/amphetamine withdrawal

A

depression, mental and physical fatigue, increased appetite, hypersomnia, vivid or lucid dreams, suicidal ideation

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42
Q

Meth/amphetamines have the most dangerous interaction with which drugs?

A

MAOI antidepressants mixed with meth/amphetamines can be life-threatening; SSRI’s have problematic interactions too

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43
Q

Serotonin syndrome effects

A

headaches, agitation, confusion, hypomania, hyperthermia, hypertension, hallucinations, coma, shivering, sweating, nausea, muscle twitching, hyperreflexia, tremor

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44
Q

Nicotine

A

A highly addictive simulant found in tobacco; dopamine is released very rapidly

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45
Q

Nicotine withdrawal

A

depressed mood, insomnia, anger, anxiety, difficulty concentrating, restlessness, decreased heart rate, dizziness, cough, constipation, stress, increased appetite, sore throat/gums, postnasal drip, tightness in chest

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46
Q

How long does nicotine withdrawal last?

A

It’s usually the worst the first week, and can last about a month

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47
Q

Nicotine replacement therapy

A

provides nicotine without other chemicals found in tobacco smoke to help manage withdrawal symptoms

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48
Q

What are the 5 A’s of tobacco treatment?

A
  1. Ask (about tobacco use)
  2. Advise (about smoking cessation benefits)
  3. Assess (the willingness to stop in the next 30 days)
  4. Assist (with resources)
  5. Arrange (to assess progress at a follow-up appt)
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49
Q

PPA

A

A synthetic form of caffeine

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50
Q

How do opiates effect the central nervous system?

A

They depress the CNS. Excessive ingestion can cause cardiac irregularities (usually slowing of the heart rate), or respiratory depression.

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51
Q

What happens when someone overdoses from opiates?

A

The heartbeat/breathing may stop

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52
Q

What are naturally derived opiates?

A

opium, morphine, codeine

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53
Q

Morphine

A

a narcotic; derived from the poppy seed, it is used clinically as a sedative

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54
Q

Codeine

A

A derivative of morphine. It is less potent. Used as a cough suppressant, antidiarrheal, anti-anxiety, with sedative hypnotic qualities

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55
Q

What are some synthetic/semi-synthetic opioids?

A

meperidine, oxymorphone, oxycodone, and heroin

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56
Q

Hydromorphone

A

a synthetic opioid related to morphine (it is more potent and faster acting)

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57
Q

Oxycodone

A

a synthetic opioid derived from codeine

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58
Q

Heroin

A

opioid derived from morphine; considered one of the most addictive drugs in existence; the most abused and dangerous narcotic; enters the brain much faster than morphine

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59
Q

Methadone

A

A long-acting opioid that is useful in treating addiction to narcotics. It blocks the effects of narcotics

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60
Q

What is an opiate antagonist?

A

It reverses the effects of opiates. Any medication that blocks opiate receptors in the brain so the user does not feel the effects of an opiate.

They are often used to treat opiate overdoses or addiction

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61
Q

Naltrexone

A

An opiate antagonist (Vivitrol, Revia, Depade); blocks the feelings of euphoria, which reduced cravings. It does not help with opiate withdrawal symptoms, so it’s usually used after withdrawal

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62
Q

Naloxone

A

An opiate antagonist (Narcan) that is used most frequently in opiate overdoses. It acts within minutes to counteract the effects if opiate toxicity. It can restore breathing and blood pressure

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63
Q

Buprenorphine

A

A semi-synthetic opiate antagonist (Suboxone, subutex, temgesic, buprenex, norspan, butrans); it remains bound to opiate receptors longer than other opiates, offering more enduring pain relief and lower level of physical dependence ; helps avoid opiate withdrawal symptoms

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64
Q

Why can’t suboxone be injected?

A

It’s formulated with Naloxone to deter IV abuse

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65
Q

Physical effects of narcotics

A

They can both decrease the sensation of pain and increase the perception of pain. They depress the CNS and can even stop breathing; effects include slurred speech, lack of coordination, impaired reflexes, constricted pupils, constipation

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66
Q

Psychological effects of narcotics

A

euphoria, tranquility, impaired judgment

With long-term abuse mood swings, depression, anxiety and fear are common.

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67
Q

Narcotic withdrawal

A

sweating, watery eyes, tremors, excessive nasal discharge, nausea and vomiting, yawning, muscle aches, cramps, difficulty urinating, constipation, loss of apetite, hypertension, fever, goose bumps, insomnia, anxiety, mood swings, panic attacks; not usually lethal

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68
Q

Fentanyl

A

a fully synthetic opiate

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69
Q

What do hallucinogens to do the CNS and the brain?

A

They both excite and depress the CNS. They change the levels of neurotransmitters in the brain. They distort perception, altering mood and cognition

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70
Q

Which hallucinogens are synthetic?

A

LSD and PCP

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71
Q

Hallucinogens withdrawal

A

is not a thing hahahah because they do not create physical dependence; tolerance may be developed though

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72
Q

What are the main psycho-active chemicals in hallucinogenic mushrooms?

A

psilocybin and psilocin

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73
Q

What is the psychoactive chemical in peyote?

A

Mescaline

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74
Q

PCP

A

is recognized as a hallucinogen but can also be a stimulant and pain killer. It can be smoked, swallowed, or injected. It has been used as an anesthetic. Effects vary person to person.

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75
Q

LSD

A

measured in micrograms because it is extremely potent; 30-50 micrograms will produce a psychoactive effect; considered a schedule I substance because it has no medical purpose; tolerance builds rapidly; derived from ergot

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76
Q

What are some dangers of LSD?

A

It is not addictive, but users may experience Hallucinogen Persisting Perception Disorder, flashbacks, depression, psychosis, vulnerability, reduced attention span, distorted perception, problems with abstract thinking, suicidal thoughts

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77
Q

THC

A

Delta-9 tetrahydrocannabinol – The chemical responsible for the mood-altering effects of cannabis

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78
Q

Cannabis withdrawal

A

can be experienced for about a week but are not severe; effects can include aggression, anxiety, depression, decreased appetite

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79
Q

short-term physical effects of cannabis

A

hypertension, increased respiratory rate, red eyes, dry mouth, increased appetite, slow reaction time

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80
Q

What do inhalants do to the CNS?

A

They depress the CNS

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81
Q

How do anti-depressants work?

A

Antidepressants counteract depression by manipulating brain chemicals that elevate mood

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82
Q

How do anti-anxiety meds work?

A

anti-anxiety drugs manipulate brain chemicals like GABA

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83
Q

What is Pharmacokinetics?

A

the subfield of physiology that determines a drug’s effects and abuse potential by examining the way the drug is absorbed, distributed, metabolized, eliminated, and excreted by the body.

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84
Q

How do drugs get to the brain when you inhale them?

A

When inhaled, the drug is rapidly absorbed through capillaries lining the air sacs of the air passages→ capillaries connect to lungs and the drug-ladden blood travels back to the viens and enters the heart→ the heart pumps it to brain and other organs

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85
Q

What is the fastest route of administration?

A

inhalation

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86
Q

What is the most dangerous route of administration?

A

injection, because it bypasses the body’s natural defenses

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87
Q

What is mucus membrane absoprtion?

A

Snorting, putting the drug under the tongue, or through cheeks and gums

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88
Q

How does mucus membrane absorption work, and how fast does it take?

A

drugs are absorbed by capillaries and enmeshed in the mucous membranes; takes 3-5 minutes

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89
Q

What is sublingual absorption?

A

under the tongue

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90
Q

What is buccal absorption?

A

through cheeks or gums

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91
Q

When a drug is ingested orally, how does it get to the brain? How long does it take to feel the effects?

A

drug passes through the esophagus, stomach, small intestine, capillaries, veins, and liver where it is partly metabolized; effects delayed 20-30 minutes

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92
Q

How does contact absorption work? How long does it take?

A

drug-saturated adhesive patches applied to the skin allow drug to be passively absorbed for up to 7 days

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93
Q

What does bioavailability have to do with drugs?

A

The actual amount of drug that enters the brain depends on the bioavailability of the drug, which is the degree to which the active ingredients of a drug become available to the target tissues after administration

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94
Q

What factors effect how drugs are distributed in the body?

A

Distribution depends on blood volume of person and the characteristics of the drug

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95
Q

What happens when a drug reaches the CNS?

A

The CNS serves as a gateway to the blood-brain and blood-cerebral spinal fluid barriers;

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96
Q

The brain is fatty, so it absorbs what kinds of substances?

A

fat soluble substances

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97
Q

What is passive transport?

A

happens when fat-soluble drugs pass from an area of where there is a higher concentration of a drug to an area of lower concentration

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98
Q

What is active transport?

A

occurs when water-soluble drugs cross the blood-stream barrier by attaching to protein molecules

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99
Q

Which body part is the key metabolic organ that breaks down and alters the chemical structure of drugs making them less active?

A

The liver

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100
Q

Drugs are primarily excreted through which organ?

A

Kidneys

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101
Q

What are pro-drugs?

A

pro-drugs are transformed by the liver’s enzymes into 3+active metabolites; they are eliminated slowly; affecting the body for hours or days

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102
Q

What are some examples of pro-drugs?

A

Valium, gabapentin, aspirin, levadopa

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103
Q

Factors that affect half-lives of drugs include:

A

age, race, heredity, gender, health, emotional state, presence of other drugs, allergies, weight, hormones, environmental factors

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104
Q

What is a half life?

A

An estimate of the period of time for the drug concentrate to break down to exactly one half

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105
Q

Which body parts make up the CNS?

A

the brain and spinal cord

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106
Q

What does the CNS do?

A

CNS receives messages from PNS, analzyes and responds to them; also enables us to remember, create, and respond to any situation

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107
Q

What part of the brain is responsible for cravings?

A

The old brain (the limbic system)

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108
Q

How does memory relate to addiction?

A

The more psychoactive a drug, the more rapid the memory bumps it will produce, therefore more deeply imprinted the memory

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109
Q

What is euphoric recall?

A

the brain tends to remember positive memories than negative

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110
Q

In which part of the brain do most emotionally-tinged memories occur?

A

The amygdala

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111
Q

Which part of the brain is responsible for motivation and obsession (aka “the go switch”)?

A

The nucleus accumbens

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112
Q

What happens to the nucleus accumbens with regular drug use?

A

heavy drug use alters neurochemistry which makes the NA more sensitive than normal to the drug and relapse

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113
Q

What is long-term potentiation?

A

an increase in neural connections results in higher sensitivity to drugs , increasing the risk of relapse

When an experience or other stimulus induces LTP in a cell, the cell responds more strongly to future exposures to the same stimulus

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114
Q

How does the “stop switch” work in the brain?

A

there is a cluster of neuron fibers that usually communicates the stop messages once satiation occurs by limiting the release of dopamine; this part becomes damaged very early with chronic use

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115
Q

What is the neuron cluster in the brain that is considered the stop switch?

A

Fasciculus retroflexus

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116
Q

What is allostasis?

A

the changing of the brain to protect the body, but the changes are not always beneficial; through this process, the body establishes a new normal

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117
Q

What are neurotransmitters?

A

Molecular bits of messenger chemicals that send info between neurons; Neurotransmitters are converted to an electrical signal and fired to the synapse

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118
Q

What are neurons?

A

nerve cells; building blocks to the nervous system

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119
Q

What do drugs do to the neurons?

A

They flood the space between neurons, effecting the way neurons communicate

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120
Q

What is the difference between endogenous opioids and exogenous opioids?

A

Endo: originating or produced within the body (like endorphins and enkephalins); the body’s natural pain killers

Exo: externally produced painkillers (like morphine, heroin, opium)

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121
Q

What are agonist drugs?

A

It mimics neurotransmitters; facilitates the normal action of neurotransmitter and binds to receptors; does the same as the neurotransmitter is supposed to do

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122
Q

What are some examples of agonist drugs?

A

methadone (endorphin agonist); cocaine is the closest agonist to dopamine

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123
Q

What are antagonist drugs?

A

binds to a receptor but doesn’t activate; blocks neurotransmitters

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124
Q

What are some examples of antagonist drugs?

A

narcan, methadone

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125
Q

Which neurotransmitters are the most important in addiction?

A

dopamine, endorphins, serotonin, GABA, and glutamate

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126
Q

What does norepinephrine and epinephrine do for the body?

A

Function as stimulants when activated by the demand from the body for energy; they stimulate the autonomic nervous system, affect motivation, hunger, attention span, confidence, and alertness (aka adrenaline, noradrenaline)

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127
Q

What does dopamine do for the body

A

The most crucial neurotransmitter involved in both substance and process addictions; Helps regulates fine motor muscular activity, emotional stability, satiation, and the addiction pathway

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128
Q

When is dopamine released?

A

Dopamine is released when an effect is much better than expected

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129
Q

Which neurotransmitter sustains addiction?

A

Glutamate

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130
Q

What does histamine do for the body?

A

Controls the inflation of tissues, local immune responses, and allergic reactions;
also helps regulate sleep and emotional behavior

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131
Q

What does serotonin do for the body?

A

Helps control mood stability (including depression and anxiety), appetite, sleep, and sexual activity

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132
Q

What does GABA do for the body?

A

The brain’s main inhibitory neurotransmitter; controls impulses, muscle relaxation, arousal, and generally slows down the brain;

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133
Q

What does glutamic acid do?

A

Enhances the prominence of dopamines effects when it’s released in response to psychoactive drugs

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134
Q

Which amino acid is present in 80% of the brain’s neurons?

A

Glutamic Acid

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135
Q

When is a person considered tolerant to a drug?

A

when larger amounts must be taken as the body adapts to protect itself

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136
Q

What is dispositional tolerance?

A

the body speeds up the break-down of a drug to eliminate it; the body produces more enzymes to metabolize the drug, requiring greater quantities to achieve the same level of intoxication

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137
Q

What is pharmacodynamic tolerance?

A

nerve cells become less sensitive to the effects of drugs as the body produces an antagonist to it; the brain generates fewer receptor sites and more antagonists (aka downregulation)

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138
Q

What is behavioral tolerance?

A

the brain learns to compensate for the effects of drugs by using parts of the brain not affected

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139
Q

What is reverse tolerance?

A

as the drug destroys certain tissues or with age, the user can be more sensitive and less able to handle moderate amounts

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140
Q

What is acute tolerance?

A

the brain and the body begin to adapt almost instantly to the toxic effects of a drug

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141
Q

Experiencing minimal effects of a drug for months then suddenly experiencing an intense reaction is an example of what kind of tolerance?

A

inverse tolerance

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142
Q

Which kind of tolerance best describes this situation: when a person develops tolerance for alcohol and they also develop tolerance for marijuana without ever having used marijuana before

A

cross-tolerance

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143
Q

When a tolerance to sedatives to achieve an emotional high occur more rapidly than tolerance to their depressant effects, which kind of tolerance is happening?

A

Select tolerance

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144
Q

What is one sign of tissue dependence?

A

withdrawal symptoms

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145
Q

When is a person considered tissue-dependent on drugs?

A

when the body biological adapts to prolonged use of a drug, producing an allostatic state of the body

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146
Q

When is a person considered psychologically dependent on drugs?

A

when a desire for the positive effects of a substance or to avoid negative emotions or effects can reinforce use

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147
Q

What is the last phase of withdrawal that can last several months after last use?

A

post-acute withdrawal

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148
Q

What is considered drug abuse?

A

the continued use of a drug despite negative consequences

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149
Q

Which type of drugs force their release and infuse the body with large amounts of extra energy before the body needs it?

A

Stimulants

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150
Q

Why does weight loss occur with stimulant use?

A

they trick the body into thinking basic nutrition and hydration needs have been satisfied

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151
Q

What is down regulation?

A

A decrease the number of dopamine and serotonin receptor sites in the nucleus accumbens, causing the brain to crave even more of a drug to overstimulate the remaining receptors

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152
Q

How long is cocaine usually detectable in urine?

A

up to 36 hours

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153
Q

Which neurotransmitter are affected by cocaine and how?

A

Cocaine prevents the reabsorption of norepinephrine, epinephrine, and dopamine, thus increasing their concentration in the synapse, intensifying their effects; serotonin is also released and then quickly depleted; the fight center in the limbic system is overactivated;

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154
Q

What is formication

A

The imbalance in sensory neurons causes the feeling of bugs crawling on skin

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155
Q

How long does a meth high last?

A

4-6 hrs

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156
Q

Where in the brain are opiate receptors located?

A

in the brainstem

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157
Q

What is the differences between Hyperalgesia and Hyperpathia?

A

Hyperalgesia: temporary increase in sensitivity of nerve cells

Hyperpathia: an abnormal increase in pain

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158
Q

What physical sensations might a regular opioid user experience when they stop using?

A

pain expands all over the body because the body stops producing endorphins; long-term use makes pain worse

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159
Q

How does hyperalgesia work?

A

the body oversimplifies pain messages, warning the brain to do something to lessen the pain→ temporary pain increase due to increased sensitivity of nerve cells

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160
Q

Alcohol molecules are small and soluble in both water and fat, so it enters the capillaries in the walls of the small intestine, moving easily into any organ or tissue. This is an example of what kind of diffusion?

A

Passive diffusion

161
Q

How long does it take for the body to being eliminating alcohol?

A

immediately, because the body thinks its poison; 1-10% is immediately excreted, 90% is metabolized

162
Q

What blood alcohol content is considered legal intoxication?

A

0.08

163
Q

How many drinks is considered a binge?

A

consuming 5+ drinks in one sitting

164
Q

At what BAC does alcohol poisoning occur at?

A

BAC .40

165
Q

How does liver damage effect the body?

A

liver damage allows alcohol to travel to other organs in its original toxic form

166
Q

Inflammation of the liver due to alcohol use is called…

A

alcoholic hepatitis

167
Q

Cirrhosis

A

occurs when an excessive amt of liver cells are killed causing scarring; occurs because the metabolic process produces metabolites that are more toxic than the alcohol itself

168
Q

What is the most advanced form of liver disease?

A

Cirrhosis

169
Q

A long-term alcoholic who is experiencing symptoms of disorientation, memory failure, false memories may have which alcohol-induced syndrome?

A

Korsakaff’s syndrome

170
Q

When the liver becomes less able to metabolize alcohol with long-term use, this is an example of which tolerance?

A

reverse tolerance

171
Q

When a dependent alcohol user experiences shakiness about 2-3 days after quitting, this is called…

A

delirium tremens

172
Q

How long can delirium tremens last?

A

10-50 days

173
Q

Ketamine is considered what kind of drug?

A

a hallucinogen

174
Q

How does THC affect the brain?

A

THC has a strong impact on the amygdala, which is the emotions center

THC artificially stimulates the amygdala, making the mundane interesting

THC effects memory by acting as a an agonist of GABA, causing short-term memory impairment

175
Q

Marijuana can stay in fat cells for how long?

A

Around 3 months for chronic users

176
Q

Schedule 1 drugs

A

1: drugs with a high abuse potential and no approved medical use (heroin, LSD, peyote, psybicilin, mescaline, MDMA, and marijuana

177
Q

Schedule 2 drugs

A

2: substances with high abuse potential even though they have medical uses (including cocaine, meth, opium, morphine, oxycodone, and methylphenidate)

178
Q

Schedule 3 drugs

A

3: substances with less abuse potential (including buprenorphine, anabolic steroids, ketamine, and marinol)

179
Q

Schedule 4 drugs

A

4: drugs that have even less abuse potential (xanax, ativan, klonopine, valium, ambien)

180
Q

Schedule 5 drugs

A

5: substances with very low abuse potential because of very limited quantities of narcotic and stimulant drugs; generally used for antidiarrheal, antitussive, and analgesic purposes (cough medicine like Robitussin or lyrica)

181
Q

What is the MOST common symptom of Wernicke’s encephalopathy?

A

Confusion

182
Q 
Which of the following conditions does alcohol NOT induce?
 Cirrhosis
 Hepatitis
 Nephrosis
 Steatosis
A

Nephrosis

183
Q

What is diathesis?

A

A predisposition (to addiction)

184
Q

How much of susceptibility to addiction come from heredity? What does the other portion come from?

A

40-60%, the other 40-60% comes from the environment

185
Q

How many genes have been identified as having an effect on addiction?

A

At least 89

186
Q

Meth sets apoptosis in motion, what does that mean?

A

cell death because damaged cells are programmed to kill themselves

187
Q

Nicotine produces immediate and long-term changes in which neurotransmitters?

A

Dopamine and norepinephrine

188
Q

What does the peripheral nervous system control?

A

how the body responds to external stimuli

189
Q

What does cocaine do to which neurotransmitters?

A

Blocks norepinephrine, serotonin, dopamine, and other NT’s from being reabsorbed–> the chemical buildup of NT’s cause euphoria

190
Q

What is a prodrug?

A

an inactive form of a drug that is converted to a pharmacologically active drug within the body by metabolic processes.

191
Q

What does motivational interviewing primarily involve?

A

help client’s discover their own desire to change through reflective listening, identifying variances between behavior and personal goals, deflect arguments, redirect client resistance to desires and goals, nurture optimism

192
Q

What percentage of people with a dual diagnosis receive tx for their SUD and MH?

A

7.4%

193
Q

What factors affect screening instrument validity?

A

The setting in which the screening occur, the wording of instructions, the amount of privacy, and rapport

194
Q

What does GATE stand for?

A

Gather info, Access supervision, Take responsible action, Extend the action

195
Q

Name an alcohol abuse screening that is meant to be used with adolescents

A

CRAFFT

196
Q

What is the most important introductory statement in a suicide evaluation?

A

I need to ask you a few questions about suicide

197
Q

How must assessment info be handled to be the most effective?

A

Assessment info must be converted into clear goals, objectives, and action steps

198
Q

How many levels of treatment placement are recognized by ASAM?

A

Four

199
Q

The stage of change model addresses how many client stages?

A

Five (precontemplation, contemplation, preparation, action, relapse)

200
Q

What are SOAP notes?

A

Subjective, Objective, Assessment, Plan

201
Q

What are DAP notes?

A

Data, Assessment, Plan

202
Q

DIG-FAST evaluates which psychological state?

A

symptoms of mania

203
Q

According to ASAM, what is the minimum amtount of treatment time that intensive outpatient must provide?

A

9 hours a week

204
Q

What is the recommended minimum durations of days for intensive outpatient?

A

90 days

205
Q

What are the ASAM levels of care?

A

0.5- early interventions

1 - basic nonresidential outpatient, like counseling

2 - Intensive outpatient or partial hospitalization

3 - Residential/ inpatient, planed regimen of care in a 24 hr setting

  1. medically-managed intensive inpatient
206
Q
  1. Which of the following lack effective treatment medications?

Cocaine
Marijuana
Both
Neither

A

Both

207
Q

Antabuse is contradicted for clients whose dependence combines which drugs?

A

just alcohol

208
Q

What is the SDSS designed to measure?

A

the quantity and frequency of recent drug use (past 30 days)

209
Q

What is physiological dependence determined by?

A

if withdrawal is present; if there is a need for significantly more of a substance to reach desired effect or intoxication

210
Q

When behaviorally assessing for co-occurring disorders, what is the most important variable to consider?

A

drug toxicity or withdrawal symptoms

211
Q

What is the most effective treatment for adolescents in terms of less drug use at treatment completion?

A

family therapy

212
Q

What does culture-bound syndrome mean?

A

An illness unique to a certain group and/or an illness presenting or interpreted distinctly due to cultural influence

213
Q

What is the difference between AIDS and HIV?

A

HIV is the virus that causes AIDS. AIDS is the final stage in the HIV disease process

214
Q

What is the CAGE questionnaire a screening for?

A

alcohol use

215
Q

The most important service a case manager can provide is

A

referrals to the least-restrictive level of care and resource options that promote autonomy

216
Q

Aisha has completed her treatment at an in-patient facility and is ready to be discharged. She has asked her counselor to recommend a therapist to work with her and her husband on an out-patient basis. This process is BEST viewed as an example of :

A

A referral

217
Q

Which type of therapy is most directive, offering the greatest potential for abuse of power by the counselor?

A

Gestalt

218
Q

The primary purpose of professional credentialing for counselors is to:

A

Protect public safety by ensuring that counselors meet minimum standards of competency

219
Q

The concept of informed consent requires that before agreeing to accept treatment, clients should know their rights and obligations, therapeutic goals, fees for services and

A

The limits of their confidentiality

220
Q

Restlessness, nervousness, flushed face, muscle twitching, tachycardia, or cardiac arrhythmia are al signs or symptoms of:

A

caffeine intoxication

221
Q

Of all of the possible substance use disorders, which one is typically not seen in older children or adults

A

Inhalant Use Disorder

222
Q

Autonomic hyperactivity, hand tremor, nausea or vomiting, psychomotor agitation, grand mal seizures are all signs or symptoms of:

A

sedative, hypnotic, or anxiolytic withdrawal

223
Q

In the United States, the population that experiences the lowest prevalence of alcohol use disorder is:

A

AAPI’s

224
Q

Classical and operant conditioning are associated with __________________ therapy.

A

behavioral

225
Q

One basic principle of documentation requires the counselor to:

A

Describe events in objective terms, using measurable language that can be easily understood.

226
Q

The ______________________ model of addiction explains addiction as a consequence of personal choice.

A

moral

227
Q

How does solution-focused brief therapy differ from many of the other approaches to counseling?

A

Emphasis is placed on the present and future while devaluing the past

228
Q

The goal of complete abstinence is most consistent with the ______________ model of addiction

A

Disease

229
Q

Which kind of tolerance can develop between natural and synthetic opiates, but not between opiates and CNS depressants

A

cross tolerance

230
Q

The idea that people have an in-born desire to self-actualize is associated with:

A

humanistic theory

231
Q

The central focus or “charge” of the twelfth step of Alcoholics anonymous is:

A

Service to others

232
Q

In the DSM-5, for a substance use disorder severity indicator of mild, how many criteria must be present?

A

2-3

233
Q

CSAP

A

Center for Substance Abuse Prevention

234
Q

PCP Medical uses

A

vet anesthetic

235
Q

Phencyclidine

A

PCP

236
Q

Genetic model of addiciton

A

Based on the belief that individuals have a genetic predisposition to certain behaviors.

237
Q

Which theory would this statement fall under:

Problematic substance use results from deficits in learning, emotional dysfunction or psychopathology that can be treated by behaviorally or psychoanalytically oriented dynamic therapies.

A

psychological/psychodynamic model of addiction

238
Q

3 legacies of AA

A
  1. Recovery
  2. Unity
  3. Service
239
Q

Stages of addiction

A
  1. Use
  2. Misuse
  3. Abuse
  4. Dependency
240
Q

Therapy based on the idea that feelings and behaviors are caused by a person’s thoughts, not on outside stimuli like people, situations, and events. Goal is to teach the person to recognize situations in which they are most likely to drink or use substances, avoid these circumstances in possible, and cope with other problems and behaviors which may lead to their substance use.

A

CBT

241
Q

Addressing a crisis

A 
Crisis intervention
Is a process where a response team or individual identities, assesses and intervenes with the person in crisis to return the person to their prior level of functioning as quickly as possible and to lessen any negative impact.
Crisis intervention steps
- Assessing the severity of the crisis.
- Forming a connection.
- Exploring the problem.
- Dealing with feelings and emotions.
- Generating alternative solutions.
- Development of an action plan.
242
Q

Model that says that the adaptation to toxic effects of psychoactive drugs causes the development of tolerance, tissue dependence, withdrawal, psychological dependence, and ultimately addiction. Also referred to as allostasis.

A

Academic model

243
Q

Model that says the combination of heredity and environment creates a predisposition or susceptibility to chemical or behavioral dependency that can be triggered and aggravated by using psychoactive drugs or by acting out certain behaviors.

A

diathesis model

244
Q

The year the reusable hypodermic needle was invented.

A

1855

245
Q

An established pattern of alcohol use with no major negative consequences.

A

Habituation

246
Q

Pleasure/Euphoria is experience in this system.

A

limbic system

247
Q

Speedball

A

A mixture of heroin and cocaine.

248
Q

Mu receptors

A

Receptors that block pain transmission, trigger the reward/reinforcement pathway, and depress the autonomic nervous system, including respiration, blood pressure and purple constriction.

249
Q

Kappa receptors

A

Receptors that control pain at the spinal cord level and induce nausea and dysphoria rather than euphoria. They can also induce some psychedelic effects.

250
Q

Niciceptin Receptors

A

Receptors that are in involved with most somatic and visceral pain modulated by substance P

251
Q

Short-acting opioids

A

heroin, morphine, hydromorphone

252
Q

Long acting opioids

A

methadone

253
Q

Synergism

A

Occurs when two or more drugs interact in a way that magnifies their effects or side effects.

254
Q

LSD stands for

A

Lysergic Acid Diethylamide

255
Q

Psychedelics overload the ______, making the using acutely aware of every sensation.

A

sensory pathways

256
Q

12 step tradition step 1

A

We admitted we were powerless over alcohol and that our lives had become unmanageable.

257
Q

12 step tradition step 2

A

Came to believe that a power greater than ourselves could restore us to sanity.

258
Q

12 step tradition step 3

A

Made a decision to turn our will and our lives over to the care of God as we understood Him.

259
Q

12 step tradition step 4

A

Made a searching and fearless moral inventory of ourselves

260
Q

12 step tradition step 5

A

Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

261
Q

12 step tradition step 6

A

Were entirely ready to have God remove all these defects of character.

262
Q

12 step tradition step 7

A

Humbly asked Him to remove our shortcomings

263
Q

12 step tradition step 8

A

Made a list of all persons we had harmed, and became willing to make amends to them all.

264
Q

12 step tradition step 9

A

Made direct amends to such people wherever possible, except when to do so would injure them or others.

265
Q

12 step tradition step 10

A

Continued to take personal inventory and when we were wrong promptly admitted it.

266
Q

12 step tradition step 11

A

Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

267
Q

12 step tradition step 12

A

Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

268
Q

Wellbutrin and Manerix are examples of what kind of medication?

A

MAOI antidepressants

269
Q

Zoloft, Prozac, Luvox, and Paxil are examples of what kind of medication?

A

SSRI antidepressants

270
Q

Rispradol and Haldol are examples of what kind of medication?

A

antipsychotics

271
Q

Gabapentin and Klonopin are examples of what kind of medication?

A

Mood stabilizer (anticonvulsant)

272
Q

The Federal Confidentiality Act requires…

A

A client to sign an ROI before any info is shared, indicating exactly where the info will be shared and to whom. Clients can revoke ROI’s at any time.

Clients must have their rights explained to them

Confidentiality must be understood by support staff and visitors

273
Q

Exceptions to the Federal Confidentiality Act include…

A

If the counselor is a threat to self and others

In consultation with a supervisor, attorney, or medical personnel in an emergency

Suspected child abuse or neglect

274
Q

Helpful drugs in cocaine detox include…

A

buprenorphine, but no real pharmacotherapies have been used in cocaine treatment

275
Q

Goosebumps are most associated with withdrawal from which kind of substance?

A

Narcotics (opiates)

276
Q

Why is caffeine helpful for migraines/headcahes?

A

It causes the blood cells in the brain to constrict

277
Q

Dilaudid belongs to which category of drugs?

A

Semisynthetic opiates

278
Q

CNS Depressant barbiturate family chemical names usually end in which letter combo?

A

“Al” or “bital”

279
Q

Benzodiazepine chemical names usually end in which letter combo?

A

“am” (xanax is alprazolam, valium is diazepam)

280
Q

Stimulant chemical names usually end in which letter combo?

A

“ine” (nicotine, cocaine, amphetamine)

281
Q

Opiate chemical names usually end in which letter combo?

A

“Ine/one” (codeine, heroin, hydrocodone, morphine, oxycodone)

282
Q

Inhalant chemical names usually end in which letter combo?

A

“ane/ ene” (butane, propane)

283
Q

Anabolic steroid chemical names usually end in which letter combo?

A

“one” (nandrolone, methyl testosterone)

284
Q

Ecstacy or MDMA is a designer drug made from which two chemicals?

A

MDA (sassafras) and methamphetamine

285
Q

What are some elements of psychological addiction?

A

the need to get drugs is the most important thing in life, inability to function without drugs, life is not worthwhile without drugs, inability to abstain, preoccupation or depression, inability to control amount used , personality changes

286
Q

What is the most common treatment modality for addiction?

A

Intensive outpatient

287
Q

What is “angel dust”?

A

PCP (phencyclidine)

288
Q

ReVia is a brand name for…

A

Naltrexone (used for alcohol use disorder to reduce cravings)

289
Q

What is the difference between benzodiazepines and sedatives?

A

Benzo’s target anxiety rather than being general CNS depressants.

Benzo’s create less drowsiness and physical impairment

They are safer (larger amounts can be taken, while larger amounts of sedatives can be fatal)

The effects of anxiety reduction last longer

290
Q

What is the difference between benzodiazepines and barbiturates?

A

Benzo’s are tranquilizers, barbiturates are sedatives

291
Q

What is the most important element of barbiturate treatment?

A

Medical supervision because of the high-risk for a life threatening episode and determining if other drugs are being used

292
Q

What is free-basing?

A

A method of smoking crack cocaine that allows the chemical to enter the body in a pure form

293
Q

What are some “club drugs”?

A

Ecstacy, Ketamine, GHB, roypnol

294
Q

What is considered “recreational use”?

A

the use of drugs in a social setting, infrequently and with small amounts

295
Q

What is considered “circumstantial use”?

A

drug use to get a particular effect

296
Q

What is considered “compulsive use”?

A

use on a daily basis in larger amounts (classified as addiction)

297
Q

What is considered “intensifed use use”?

A

the use of drugs on a daily or almost daily basis, but in low amounts. Use is motivated by alleviating a problem or boosting levels of performance

298
Q

Schedule V drugs contain what level of abuse liability?

A

The least

299
Q

MAT works because it targets which kind dependence?

A

Cross dependence

300
Q 
Which 3 are NOT major classes of psychoactive chemicals?
CNS depressants
CNS stimulants
Narcotics
Sedatives
Hallucinogens
Cannabis
Tranquilizers
Solvents/Inhalants
Steroids
Psychotropics
Amphetamines
A

Sedatives (CNS depressant)
Tranquilizers (depressant)
Amphetamines (Stimulant)

301
Q

The autonomic nervous system is responsible for…

A

basic body functions like respiration, digestion, circulation

302
Q

List some aspects of the dependent delusional system

A

(basically any defense mechanism)

repression of feelings or incidents blocked from memory

blackouts- blocks memory

euphoric recall

denial

rationalization

projecting and blaming

intellectualizing

303
Q

Defense mechanisms are most associated with which model of addiction?

A

Psychodynamic

304
Q

What are some dangers of inhalant use?

A

hearing loss, CNS and brain damage, liver and kidney damage, blood oxygen depletion

305
Q

Analgesics are also known as …

A

opiate narcotics

306
Q

Talwin and Ritalin

A

Talwin is a painkiller and Ritalin is a simulant, combined they produce a euphoric high similar to speed balls

307
Q

What are the stages of the recovery prone style?

A

transition (when the need for abstinence is accepted)

stabilization (hope and motivation developed)

early recovery (acceptance of the disease of addiction)

middle recovery (lifestyle balance established)

late recovery (recognition of the affects of childhood problems)

maintenance (a recovery program is maintained)

308
Q

Which theory best describes these core principles:

  • focus on helping the client be who they want to be
  • “re-owning” oneself
  • change takes place when clients engage in their senses and are aware of movement in their life
  • focus only on present
A

Gestalt therapy

309
Q

Which theory best describes these core principles:

  • there is a purpose for all behavior
  • an imaginary goal directs all human bx (fictional finalism)
  • birth order affects a person’s bx
A

Alderian / Individual therapy

310
Q

Which theory best describes these core principles:

  • strength-based focus on successes
  • simple, straightforward methods that address solutions to a problem directly
  • focus on past and present
  • once you know what to do, do more of it
  • if something doesn’t work, do it differently
A

Solution-focused therapy

311
Q

Which theory best describes these core principles:

  • focus on motivating and mobilizing the conditions that enhance change
  • change occurs in stages (pre-contemplation-maintenance)
  • belief that clients are internally motivated
  • emphasis on personal choices
  • humanistic foundation
A

Motivational enhancement therapy (MI)

312
Q

Adolescent personality and social development is mainly centered around which element?

A

Identity

313
Q

Which theory best describes these core principles:

  • it’s not an actual event that disturbs people, but how they see it
  • uses the A-B-C model
  • therapist questions clients faulty or irrational thinking
A

Rational Emotive Behavior Therapy (REBT)

314
Q

Which theory best describes these core principles:

  • human functioning is guided by doing, thinking, feeling, and physiology
  • a person’s negative reaction to an event serves a purpose
  • focus on building self-worth and strength, taking control of one’s life
  • techniques of giving direction, making a plan and sticking to it
A

Control Theory / Reality Therapy

315
Q

Which theory best describes these core principles:

  • it’s the client’s responsibility to find a way to deal with reality
  • the better the client knows themselves, the better the more aware they will be and the better they will be able to identify their best behavior
  • the counselor tries to understand how the client sees themselves in the world
  • key elements are congruence, empathy, positive regard
A

person-centered therapy

316
Q

Which theory best describes these core principles:

  • humans are influenced by powerful unconscious drives
  • anxiety results from the powerful inner sexual drives encountering the external world
  • the ego engages in defense mechanisms
  • a person uses to deal with internal pain
A

psychoanalytical theory

317
Q

Which theory best describes these core principles:

  • use of modeling
  • appropriate behavior can be learned through observation, practice, and reinforcement
A

Behavioral modification theory

318
Q

Which theory best describes these core principles:

  • therapy is used to understand conflicts that are present in a family setting
A

dynamic family therapy

319
Q

Which theory best describes these core principles:

-based on the concept that conflict, emotions, and boundaries within a family or fused or entangled

A

Bowenian family therapy

320
Q

Which theory best describes these core principles:

  • the counselor tries to change the dysfunctional structure of the family
A

Structural family therapy

321
Q

Intimacy vs Isolation is considered a task for what stage of life?

A

Young adulthood

322
Q

Time of integrity vs Despair is considered a task for what stage of life?

A

Late adulthood

323
Q

Research shows that ___% of persons in the US age 65+ are addicted to alcohol

A

2-10%

324
Q

__ out of 5 people who is being treated for a medical or psychiatric problem is also having problems with alcohol

A

1 out of 5

325
Q

What are the differences between guilt and shame?

A

Shame: refers to what one believes about themselves internally

Guilt: has to do with behavior, refers to the feeling that they’ve done something wrong

326
Q

What is the PAC of NAADAC?

A

the peer assistance committee

327
Q

What is PAC’s objective?

A

to make treatment available for professionals and their families

to work with ethics committees to address impairment

provide education and support

328
Q

What happens if a professional refuses to get treatment?

A

The counselor will be notified by mail from the PAC and will be told that an assessment will proceed if they do not comply and they will be reported to the ethics committee.

329
Q

Not believing that there is a connection between one’s life problems and drug use or that one is addicted is called…

A

denial

330
Q

_______ is the feeling of contradictory emotions or feelings at the same time.

A

ambivalence

331
Q

What are the first steps when treatment is intiated?

A

Establish rapport, give an introduction to treatment, get a drug usage history, develop a plan with the client

332
Q

An important skill of preventing relapse is…

A

Recognizing triggers and negative changes in thoughts, feelings, behaviors

333
Q

What are some primary tasks in the “maintaining abstinence” stage?

A

Recognizing triggers that cause use, developing and using healthy coping skills, addressing the dangers or relapse,

334
Q

What is the criteria for “early remission”?

A

Not meeting any of the SUD criteria (except craving) for 3 months to 1 year.

335
Q

What is the criteria for “sustained remission”?

A

Not meeting any of the SUD criteria (except craving) for 1 year or longer

336
Q

A condition where another individual is controlled by another individual. Acceptance, security, and love is hinged on how the addict wants you to behave

A

Codependence

337
Q

How does drug use affect adolescents’ social and emotional development?

A

May create reliance on drugs rather than people to create relationships or as a primary relationship

They are usually academically under-achieveing and don’t feel the need to set goals

Rules, morals, values are usually avoided

338
Q

How does drug use affect adolescents’ cognitive development?

A

Interferes with the maturation of abstract thinking

Development of reasoning an thinking skills is impaired

Problems with recall and short-term memory

More use of avoidance rather than language to deal with conflict

339
Q

_____% of adolescent suicide had drug use as a factor

A

67%

340
Q

What are some primary developmental tasks of adolescence?

A
  1. developing an identity separate from parents
  2. comfortableness with body image and psychology; ability to be intimate
  3. development of a sense of purpose
  4. develop social problem solving skills, controlling impulses, and self confidence; develop feelings of empathy and skills to maintain friendships
  5. ability to express oneself with abstract ideas and thoughts
341
Q

What is sequential treatment?

A

A method of treating dual disorders characterized by treating one disorder followed by the second disorder

342
Q

What is parallel treatment?

A

A method of treating dual disorders characterized by treating all disorders at the same time, involving two different treatment programs

343
Q

What is integrated treatment?

A

A method of treating dual disorders characterized by a program that addresses all disorders

344
Q

What barriers exist that prevent the identification and treatment of the elderly with SUD?

A

Ageism and the idea that problems that exist with an elder is only because of aging.

Professionals are often slow to identity substance use as a problem because many of the symptoms of substance use and aging are the same

The existence of both medical and psychiatric conditions can hamper the dx

345
Q

What are some considerations for elderly people using prescription drugs?

A

Dementia and delirium is often diagnosed as alzheimer’s

Older people experience an increase in the severity of side effects of rx drugs (memory, daytime sleeping, and attention are affected)

346
Q

A client over-identifying with a counselor of the same ethnic background is an example of …

A

transference

347
Q

How a counselor feels about the client

A

countertransference

348
Q

What are action responses?

A

probes, questions, confrontations

349
Q

What aspects are important in assessing the degree of lethality in a suicide screen?

A

specific and current plans of suicide, plans to obtain tools for suicide, location, timeline, commitment

350
Q

When is crisis counseling appropriate?

A

When there is a total loss of coping skills, extreme dysfunction

351
Q

Therapeutic communities

A

residential treatments lasting 6-12 months

352
Q

What are best practices around self disclosure?

A

Do not disclose if it will cause the client anxiety or may burden the client. Look at the benefits of disclosure for the client before speaking out.

353
Q

What are some psychiatric symptoms that can be present with people with HIV?

A

insomnia, dementia, personality disorders, depression

354
Q

Why is replacing an addiction not super helpful?

A

There is still compulsive behavior present, and that takes away control over one’s free choice.

355
Q

What is the counselor’s primary tasks in motivational enhancement therapy?

A

help the client see the connection between their behavior and their goals.

help the client make self-motivational statements about change

356
Q

What is a necessary factor in creating behavior change?

A

Intrinsic motivation

357
Q

Opiates vs Opioids

A

Opiate – narcotic analgesic derived from an opium poppy (natural)

Opioid – narcotic analgesic that is at least part synthetic, not found in nature

358
Q

one reason why gases are used as general anesthetics is because

A

their blood levels are easy to control because they can be exhaled

359
Q

What is an example of a street drug that belongs to the cathinone family of drugs?

A

bath salts

360
Q

What fraction of children with ADHD are prescribed methylphenidate?

A

2/3

361
Q

Why is it problematic that cocaine remains classified as a narcotic by the U.S. Drug Enforcement Administration?

A

Narcotics are defined as a sleep-inducing drug

362
Q

The salt form of psychostimulants is necessary for the insufflation (snorting) route because drugs must be _____ for proper absorption through membranes of the nose, throat, and lungs.

A

water soluble

363
Q

methylecgonidine

A

byproduct of the freebase synthesis process

364
Q

Sandro uses both alcohol and cocaine. What effect is this likely to have?

A

Production of the metabolite cocaethylene, and Na+ channel blocking in high concentration causing serious adverse effects and possibly death

365
Q

Psychostimulants reduce hunger through actions in the _____.

A

hypothalamus

366
Q

Amber uses cocaine during her pregnancy. What is the greatest risk that this poses to her unborn child?

A

Lower fetal growth and severe injury to the fetus including hemorrhage, ischemia and neuronal death caused by limited oxygen availability and nutrient delivery

367
Q

What is a physiological change associated with methamphetamine usage that contributes to meth mouth?

A

Activation of the sympathetic nervous system which reduce salivation and causes dry mouth

368
Q

Drugs that facilitate GABA neurotransmission may be effective in preventing psychostimulant relapse because they may _____.

A

interrupt associative addiction

369
Q

The reinforcing features of psychostimulants rely on the activation of dopamine D2 receptors. For cocaine in particular, two other mechanisms are also responsible for its reinforcing properties: _____.

A

Dopamine D1 and serotonin receptors

370
Q

What are three primary causes of tobacco-related deaths that occur each year?

A

Cancer, pulmonary disease, and cardiovascular disease

371
Q

Heather smokes a cigarette. When will she likely experience peak absorption of nicotine?

A

7 minutes

372
Q

How does the brain compensate for the repeated closing of nicotinic-receptor channels caused by nicotine binding?

A

Upregulation - the increased production of proteins

373
Q

What is the link between cigarette smoking and stroke?

A

Nicotine causes arteries and blood vessels to narrow and constrict, increasing heartrate. This increases risk of stroke and diseases associated with impoverished blood flow.

374
Q

A disruption of which enzyme would lead to the build up of alcohol in your body?

A

Alcohol dehydrogenase

375
Q

Sean is a chronic user of alcohol. What types of changes on the GABAenergic would we expect to find in Sean’s brain?

A

Chronic administration reduces the number of GABA(A) receptors, receptors become less effected by alcohol, and alcohol produces a lower increase in endorphin levels resulting in less inhibition of GABA receptors

376
Q

What hypothesis did Conger (1956) develop to explain habitual alcohol use?

A

Tension reduction hypothesis

377
Q

Tyler finds himself in the emergency room after suffering from alcohol poisoning. Tyler’s BAC must have been at least _____.

A

.25

378
Q

Barry, an alcoholic, suffers from alcoholic cardiomyopathy. What are the characteristics of this disorder?

A

Low cardiac output because of enlargement of the heart and dilation of the heart chambers. This leads to congestive heart failure, the inability to adequately supply blood to the body.

379
Q

Derek, an alcoholic, was just diagnosed with Korsakoff’s syndrome. A possible cause and a symptom of this syndrome is _____.

A

Vitamin B deficiency (memory loss, false memories, poor insight, apathy, and tremor)

380
Q

Gamma-hydroxybutyrate (GHB) is both a drug and a neurotransmitter that has what type of effects on the central nervous system (CNS)?

A

depressant

381
Q

Why is GHB hard to detect?

A

It remains in detectable levels only for about 4-8 hours, and in the urine for 8-12

382
Q

GHB is most associated with which NT?

A

GHB is a natural metabolite of GABA

383
Q

Studies find that strong doses of GHB lead to _____.

A

increased blood pressure

384
Q

What pharmacological characteristic do most inhalants have?

A

High lipid solubility for rapid absorption and penetration and rapid elimination.

385
Q

The primary naturally occurring opioids found in opium are _____.

A

Morphine and codeine

386
Q

How do opioids increase dopamine levels?

A

Primarily by binding to Mu opioid receptors on GABA neurons

387
Q

Aside from its analgesic properties, opioids are also commonly used to treat _____.

A

Diarrhea, cough

388
Q

The first step in the metabolism of alcohol is its conversion to

A

Acetaldehyde

389
Q

An intense withdrawal syndrome after long-term heavy drinking that includes irritability, convulsions, and hallucinations would be considered

A

Delirium tremens

390
Q

A blood alcohol level of _______% is lethal in half of the population, but because unconsciousness occurs at a BAC of around _______%, drinking is often stopped before the lethal level is reached.

A

0.45; 0.35

391
Q

Buprenorphine vs methadone

A

Methadone is a full opioid agonist. It binds fully to mu-opioid receptors allowing it’s effects to be felt fully, and increase as the dose increases.

Buprenorphine is a partial mu-opioid agonist, so while it binds fully to receptors, it does not produce the same intensity of effect as methadone and other full agonists. The ceiling effect makes buprenorphine a safer option . Bup includes naloxone

392
Q

The approach of a contingency management program involves reducing _______ while increasing _______, and is based on the idea that drug-taking is an operant response.

A

drug reinforcement; non-drug reinforcers

393
Q

Ephedrine

A

active ingredient in ephedra; used to treat asthma by dilating bronchial passages by stimulating sympathetic branch of autonomic nervous system

394
Q

Benzedrine

A

brand name for drug was used to treat stuffy noses due to colds (amphetamine)

395
Q

Pseudophedrine

A

ingredient in cold medicines that can be used to make methamphetamine

396
Q

synthesis

A

the forming of neurotransmitter by the action of enzymes

397
Q

enzyme

A

large molecule that assists in either the synthesis or metabolism of another molecule

398
Q

metabolize

A

to break down or inactivate a neurotransmitter through enzymatic action

CADC1 (1 decks)

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