chapter 7 pt 5 Flashcards
how do inhalants generally work
CNS depression
what are the effects of inhalants
perceptual disturbances paranoia lethargy dizziness N/V headache nystagmus TREMOR muscle weakness HYPOREFLEXIA ataxia slurred speech euphoria
what happens from inhaling overdose
may be fatal secondary to respiratory depression or cardiac arrhythmias
long term use of inhalants can cause what
permanent damage to CNS (neurocognitive impertinent, cerebellar dysfunction, Parkinson's) peripheral neruopathy myopathy aplastic anemia malignancy metabolic acidosis urinart calculi glomerulonephritis myocarditis MI hepatotoxicity
how is inhalant intoxication treated
monitor ABCs
oxygen in hypoxic states
identify solvent b/c may require CHELATION
what is seen in inhalant withdrawal
unusual but maybe: irritability, sleep disturbances, anxiety, depression, nausea, vomiting, craving
what is the most commonly use psychoactive substance in US
CAFFIENE
works via adenosine antagonist leading to increased cAMP and stimulating release of excitatory neurotransmitters
what is seen with over 250 grams of caffeine (2 cups of coffee)
anxiety insomnia muscle twitching rambling speech flushed face dieresis GI disturbances restlessness excitement tachycardia
what is with over 1g of caffeine
tinnitus
severe agitation
visual light flashes
cardiac arryhtmias
what is with over 10g of caffeine
death may occur secondary to seizure and respiratory failure
what is treatment to caffeine overdose
supportive and symptomatic
what is seen in caffeine withdrawal
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
how is nicotine addictive
effects in dopaminergic system
what is the leading cause of preventable morbidity and mortality in the US
smoking
what is current smoking prevalence in US
21%
what are effects of nicotine
restlessness, insomnia, anxiety, increased GI motility
what are withdrawal symptoms of nicotine
intense craving dysphoria anxiety poor concentration increased appetite weight gain irritability restlessness insomnia
what are some FDA-approved treatments of nicotine dependance
varenicline (chantix)
bupropion (Zyban)
nicotine replacement therapy (NRT): patch, gum, lozenge, nasal spray
behavioral support/counseling
what is varenicline (chantix)
alpha4beta2 nicotinic cholinergic receptor partial agonist
mimics the action of nicotine, reducing the rewarding aspects and preventing withdrawal symptoms
what is buproprion
antidepressant that is an inhibitor of dopamine and norepinephrine reuptake
helps reduce craving and withdrawal symptoms
what is gambling disorder
persistent and recurrent problematic gambling behavior as evidenced by 4 or more of the rolling in 12-month period:
- preoccupation with gambling
- need to gamble with increasing amount of money to achieve pleasure
- repeated and unsuccessful attempts to cut down on or stop gambling
- restlessness or irritability when attempting to stop gambling
- galling when feeling distressed
- returning to reclaim losses after gambling (get even)
- lying to hide level of gambling
- jeopardizing relationships or job b/c of it
- relying on others to financially support it
how is gambling disorder treated
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
