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Pharm Test 2 > Chapter 17 Substance Abuse > Flashcards

Chapter 17 Substance Abuse Flashcards

1
Q

Physical Dependence

A

A condition characterized by physiologic reliance on a substance, usually indicated by tolerance to the effects of the substance and development of withdrawal symptoms when use of the substance is terminated

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2
Q

Psychologic Dependence

A

A condition characterized by strong desires to obtain and use a substance

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3
Q

Habituation

A

Development of tolerance to a substance following prolonged medical use but without psychologic or physical dependence(addiction)

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4
Q

Addicition

A

Psychologic or physical dependence on a drug or psychoactive substance

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5
Q

Opioids

examples

A
  • heroin
  • codeine
  • hydrocodone
  • hydromorphone
  • meperidine
  • morphine
  • oxycodone
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6
Q

Stimulants

examples

A
  • racemic amphetamine
  • dextroamphetamine
  • methamphetamine
  • cocaine, methylphenidate, dextroamphetamine, phenmetrazine, and methamphetamine
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7
Q

Depressants

A
  • Benzodiazepines
  • Barbiturates
  • Marijuana
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8
Q

Opioids

A

-Also known as narcotics
-Intended drug effects: relieve pain, reduce cough, relieve diarrhea, and induce anesthesia
-Abuse and psychological dependency: opioids promote relaxation and euphoria
-Affect areas outside the central nervous system (CNS)
Skin, gastrointestinal tract, genitourinary tract

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9
Q

Methadone

A
  • Used to treat opioid dependence
  • Goal: reduce the patient’s dosage gradually so that eventually the patient can live permanently drug free
  • Relapse rates are often high; the drug can be abused.
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10
Q

Opioids: Adverse Effects

Central Nervous System

A
  • Diuresis
  • Miosis
  • Convulsions
  • Nausea, vomiting
  • Respiratory depression
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11
Q

Opioids: Adverse Effects

Non–central nervous system

A
  • Hypotension
  • Constipation
  • Urinary retention
  • Flushing of the face, neck, and upper thorax
  • Sweating, urticaria, and pruritus
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12
Q

Opioid Drug Withdrawal

Peak Period

A

1 to 3 days

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13
Q

Opioid Drug Withdrawal

Duration

A

5 to 7 days

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14
Q

Opioid Drug Withdrawal Signs

A

Drug seeking, mydriasis, diaphoresis, rhinorrhea, lacrimation, diarrhea, elevated blood pressure (BP) and pulse

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15
Q

Opioid Drug Withdrawal Symptoms

A

Intense desire for drug, muscle cramps, arthralgia, anxiety, nausea, vomiting, malaise

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16
Q

Opioid Drug Withdrawal: Treatment

A
  • Block opioid receptors so that use of opioid drugs does not produce euphoria
  • Naltrexone—an opioid antagonist
  • Vivitrol—injectable form of naltrexone
  • Naloxone combined with buprenorphine (Subutrex) or used alone (Suboxone)
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17
Q

Stimulants

A
  • Elevation of mood
  • Reduction of fatigue
  • Increased alertness
  • Invigorated aggressiveness
18
Q

Stimulants: Adverse Effects Gastrointestinal

A 
Gastrointestinal
Dry mouth
Metallic taste
Anorexia
Nausea
Vomiting
Diarrhea
Abdominal cramps
19
Q

Stimulant Overdose

A 
-Death results from:
       Convulsions
       Coma
       Cerebral hemorrhage
-May occur during periods of intoxication or withdrawal
20
Q

Stimulant Withdrawal Peak Period

A

1 to 3 days

21
Q

Stimulant Withdrawal Duration

A

5 to 7 days

22
Q

Stimulant Withdrawal Signs

A

Social withdrawal, psychomotor retardation, hypersomnia, hyperphagia

23
Q

Stimulant Withdrawal Symptoms

A

Depression, suicidal thoughts and behavior, paranoid delusions

24
Q

Depressants

A

-Drugs that relieve anxiety, irritability, and tension when used as intended
-Also used to treat seizure disorders and induce anesthesia
-Two main pharmacologic classes
Benzodiazepines
Barbiturates
-Marijuana (“pot,” “grass,” “weed”)
-Flunitrazepam (“roofies”)

25
Benzodiazepines and barbiturates
increase the action of GABA an amino acid in the brain, which inhibits nerve transmission in the CNS
26
Benzodiazepines
reduce anxiety, induce sleep, to sedate, and prevent seizures
27
Barbiturates
sedatives and anticonvulsants and to induce anesthesia
28
Depressants: Adverse Effects
-CNS: Drowsiness, sedation, loss of coordination, dizziness, blurred vision, headaches, and paradoxical reactions -Gastrointestinal: Nausea, vomiting, constipation, dry mouth, and abdominal cramping -Pruritus and skin rash -Marijuana: “amotivational” syndrome
29
Depressants Withdrawal Peak Period
- 2 to 4 days for short-acting drugs | - 4 to 7 days for long-acting drugs
30
Depressants Withdrawal Duration
- 4 to 7 days for short-acting drugs | - 7 to 12 days for long-acting drug
31
Depressants Withdrawal signs
Increased psychomotor activity; agitation; hyperthermia; diaphoresis; delirium; convulsions; elevated BP, pulse rate, and temperature; others
32
Depressants Withdrawal Symptoms
Anxiety, depression, euphoria, incoherent thoughts, hostility, grandiosity, disorientation, hallucinations, suicidal thoughts
33
Depressant Withdrawal treatment
involves tapering of the drug over a course of a 7 to 10 or 10 to 14 days
34
Alcohol (Ethanol)
- More accurately known as ethanol (ETOH) - Causes CNS depression by dissolving in lipid membranes in the CNS - Few legitimate uses of ethanol and alcoholic beverages - Used as a solvent for many drugs - Systemic uses of ethanol: treatment of methyl alcohol and ethylene glycol intoxication (e.g., from drinking automotive antifreeze solution).
35
Ethanol: Drug Effects
- CNS depression - Respiratory stimulation or depression - Vasodilation, producing warm, flushed skin - Increased sweating - Diuretic effects
36
Effects of Chronic Ethanol Ingestion
-Nutritional and vitamin deficiencies (especially B vitamins):Wernicke’s encephalopathy Korsakoff’s psychosis Polyneuritis Nicotinic acid deficiency encephalopathy -Seizures -Alcoholic hepatitis, progressing to cirrhosis -Cardiomyopathy -Fetal alcohol syndrome (FAS)
37
Ethanol Withdrawal Signs and Symptoms
- Elevated blood pressure, pulse rate, and temperature - Insomnia - Tremors - Agitation
38
Ethanol Withdrawal Treatment
-Benzodiazepines are the treatment of choice -Diazepam (Valium), lorazepam (Ativan), or chlordiazepoxide (Korsakoff’s psychosis) -Dosage and frequency depend on severity -For severe withdrawal, monitoring in an intensive care unit is recommended
39
Treatment for Alcoholism
``` -disulfiram (Antabuse) Acetaldehyde syndrome -naltrexone -acamprosate (Campral) Newest treatment -Counseling Individual Alcoholics Anonymous ```
40
Nicotine: Drug Effects
- Transient stimulation of autonomic ganglia - Followed by more persistent depression of all autonomic ganglia - CNS and respiratory stimulation followed by CNS depression - Increased heart rate and BP - Increased bowel activity
41
Nicotine Withdrawal
-Manifested by cigarette craving Irritability, restlessness, decreased heart rate and BP -Cardiac symptoms resolve in 3 to 4 weeks, but cigarette craving may persist for months or years
42
Nicotine Withdrawal Treatment
-Treatments provide nicotine without the carcinogens in tobacco Nicotine transdermal system (patch) Nicotine polacrilex (gum) Inhalers Nasal spray -bupropion (Zyban): may be prescribed to aid in smoking cessation -varenicline (Chantix): Stimulates nicotine receptors

Pharm Test 2 (8 decks)

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