chapter 7 pt 5

Question 1

how do inhalants generally work

Answer 1

CNS depression

Question 2

what are the effects of inhalants

Answer 2

perceptual disturbances 
paranoia
lethargy
dizziness
N/V
headache
nystagmus
TREMOR
muscle weakness
HYPOREFLEXIA
ataxia
slurred speech
euphoria

Question 3

what happens from inhaling overdose

Answer 3

may be fatal secondary to respiratory depression or cardiac arrhythmias

Question 4

long term use of inhalants can cause what

Answer 4

permanent damage to CNS (neurocognitive impertinent, cerebellar dysfunction, Parkinson's)
peripheral neruopathy
myopathy
aplastic anemia
malignancy
metabolic acidosis
urinart calculi
glomerulonephritis
myocarditis
MI
hepatotoxicity

Question 5

how is inhalant intoxication treated

Answer 5

monitor ABCs
oxygen in hypoxic states

identify solvent b/c may require CHELATION

Question 6

what is seen in inhalant withdrawal

Answer 6

unusual but maybe: irritability, sleep disturbances, anxiety, depression, nausea, vomiting, craving

Question 7

what is the most commonly use psychoactive substance in US

Answer 7

CAFFIENE

works via adenosine antagonist leading to increased cAMP and stimulating release of excitatory neurotransmitters

Question 8

what is seen with over 250 grams of caffeine (2 cups of coffee)

Answer 8

anxiety
insomnia
muscle twitching
rambling speech
flushed face
dieresis
GI disturbances
restlessness 
excitement
tachycardia

Question 9

what is with over 1g of caffeine

Answer 9

tinnitus
severe agitation
visual light flashes
cardiac arryhtmias

Question 10

what is with over 10g of caffeine

Answer 10

death may occur secondary to seizure and respiratory failure

Question 11

what is treatment to caffeine overdose

Answer 11

supportive and symptomatic

Question 12

what is seen in caffeine withdrawal

Answer 12

HEADACHE
fatigue
irritability
N/V
drowsiness
muscle pain 
depression

usually resolved within 1.5 weeks

seen in 50-75% of caffeine uses if cessation is abrupt

Question 13

how is nicotine addictive

Answer 13

effects in dopaminergic system

Question 14

what is the leading cause of preventable morbidity and mortality in the US

Answer 14

smoking

Question 15

what is current smoking prevalence in US

Answer 15

21%

Question 16

what are effects of nicotine

Answer 16

restlessness, insomnia, anxiety, increased GI motility

Question 17

what are withdrawal symptoms of nicotine

Answer 17

intense craving
dysphoria
anxiety
poor concentration
increased appetite
weight gain
irritability
restlessness
insomnia

Question 18

what are some FDA-approved treatments of nicotine dependance

Answer 18

varenicline (chantix)
bupropion (Zyban)
nicotine replacement therapy (NRT): patch, gum, lozenge, nasal spray
behavioral support/counseling

Question 19

what is varenicline (chantix)

Answer 19

alpha4beta2 nicotinic cholinergic receptor partial agonist

mimics the action of nicotine, reducing the rewarding aspects and preventing withdrawal symptoms

Question 20

what is buproprion

Answer 20

antidepressant that is an inhibitor of dopamine and norepinephrine reuptake

helps reduce craving and withdrawal symptoms

Question 21

what is gambling disorder

Answer 21

persistent and recurrent problematic gambling behavior as evidenced by 4 or more of the rolling in 12-month period:

1. preoccupation with gambling
2. need to gamble with increasing amount of money to achieve pleasure
3. repeated and unsuccessful attempts to cut down on or stop gambling
4. restlessness or irritability when attempting to stop gambling
5. galling when feeling distressed
6. returning to reclaim losses after gambling (get even)
7. lying to hide level of gambling
8. jeopardizing relationships or job b/c of it
9. relying on others to financially support it

Question 22

how is gambling disorder treated

Answer 22

participation in gamblers anonymous (12-step program) is most common treatment
CBT show to be effective, particularly in combo with gamblers anonymous

important to treat comorbid mood, substance, and anxiety disorders