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Kaplan: Behavioral Science and Social Sciences Part II > Chapter 7: Substance Use Disorders > Flashcards

Chapter 7: Substance Use Disorders Flashcards

1
Q

How is dopamine thought to cause addictive behavior?

A

increases desire for stimulus.

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2
Q

CAGE questions?

A

Have you ever tried to Cut down on alcohol intake and not succeeded?

Have you ever been Annoyed about criticism concerning your drinking?

Have you ever felt Guilty about your drinking behavior?

Have you ever had to take a drink as an Eye-opener in the morning to relieve the anxiety and shakiness?

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3
Q

What are some lab indices of alcohol use?

A
  • Increased transaminases (AST/ALT) ( typically 2:1 ratio)
  • Increased bilirubin
  • increased gamma GT (recent alcohol intake)
  • Breathalyzer
  • blood alcohol level
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4
Q

Be able to draw out the stages of behavioral of change.

A

Refer to diagram

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5
Q

Intoxication

A

impairment due to acute drug use

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6
Q

Withdrawal

A

effects of cessation or reduced drug use once patient develops tolerance for the drug

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7
Q

Substance use disorders

A

continued use of substance despite adverse consequences, negative impact on home, work, and social setting

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8
Q

What is tolerance?

A

diminished efficacy of a drug after repetitive use; requires increased dosage for the same effect

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9
Q

Compare and contrast naltrexone and acamprosate?

A

both effective at reducing cravings, but naltrexone may be used while the patient is still using alcohol

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10
Q

What are signs and symptoms of alcohol intoxication?

A

talkative, gregarious, moody, disinhibited

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11
Q

What is the treatment for alcohol intoxication? (if severe)

A

If severe, consider mechanical ventilation

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12
Q

What are the signs and symptoms of withdrawal from alcohol?

A

tremors, hallucinations, seizures, DTs

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13
Q

How would you treat alchol withdrawal?

A

thiamine, MVI, folic acid, bennzodiazepines

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14
Q

Effect of alcohol action on glutamate and GABA?

A

decreases glutamate and increases GABA

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15
Q

What are the signs and symptoms of amphetamine/cocaine (NE releaser) intoxication?

A

euphoria, hypervigilance, autonomic hyperactivity, weight loss, pupillary dilation, perceptual disturbances

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16
Q

How would you treat one with amphetamine intoxication?

A

antipsychotics and benzos, antihypertensives

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17
Q

What are signs of amphetamine withdrawal?

A

anxiety, tremors, headaches, increased appetite, depression, risk of suicide

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18
Q

What are the treatments for withdrawal from amphetamine?

A

if suicidal, consider antidepressants

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19
Q

Where is the location of cocaine/amphetamine activity?

A

mesolimbic pathway, nucleus accumbens

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20
Q

Other names for bath salts?

A

synthetic cocaine, flakka

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21
Q

What are some signs and symptoms of intoxication of bath salts?

A
  • irritabiilty, perceptual disturbances, agitation
  • symptoms can last up to 1 week
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22
Q

How do you treat bath salt intoxication?

A

antipsychotics and /or benzos

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23
Q

What are signs and symptoms of bath salt withdrawal?

A

anxiety and depression

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24
Q

How do you treat bath salt withdrawal?

A

if suicidal: consider SSRIs

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25
Q

Signs and symptoms of cannabis intoxication?

A

impaired motor coordination, slowed sense of time, social withdrawal, increased appetite, conjunctival injection, psychosis

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26
Q

How do you treat cannabis intoxication?

A

antipsychotics if needed

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27
Q

What are the signs and symptoms of withdrawal from cannabis?

A

irritability, anxiety

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28
Q

Where is the action of cannabis at in the body?

A

inhibitory G protein, GABA, increased serotonin

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29
Q

What are the signs and symptoms of K2/ spice *synthetic marijuana?

A

perceptual disturbances, agitation, seizures

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30
Q

How wold you treat intoxication with K2 spice?

A

antipsychotics and/or benzodiazepines

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31
Q

What are some signs and symptoms of hallucinogens?

A

ideas of reference, perceptual disturbances, impaired judgement, dissociative symptoms

32
Q

How do you treat hallucinogens intoxication?

A
  • place in a quiet room
  • antipsychotics, benzos
33
Q

Where is the location of action of hallucinogens?

A

stimulate glutamate and serotonin

34
Q

What are some signs and symptoms of inhalant intoxication?

A
  • belligerence, apathy, aggression, impaired judgement, stupor or coma
  • nasal crusting, rash, drunken appearance, dilated pupils
  • use can be fatal
  • Parkinsonism has been associated with huffing
35
Q

What is the treatment for intoxication with inhalants?

A

antipsychotics

36
Q

What are the signs and symptoms of withdrawal from inhalants?

A

nausea, excessive sweating, muscle cramps, headaches, chills, agitation, shaking and hallucinations

37
Q

What is the treatment of withdrawal from inhalants?

A

benzodiazepines, antipsychotics

38
Q

What is the location of inhalant in the body/ site of action?

A

GABA, cerebellum

39
Q

What are the signs and symptoms of using opiates?

A

apathy, dysphoria, pinpoint pupils, drowsiness, slurred speech, coma, death

40
Q

What is the treatment for opiate intoxication?

A

naloxone

41
Q

What are the signs and symptoms of opiate withdrawal?

A

fever, chills, runny nose, diarrhea, muscle spasms, cramps

42
Q

How would you treat those withdrawing from opiates?

A

clonidine, methadone, buprenorphine

43
Q

Where is the location of action of opiates in the body?

A
  • mu, kappa, and delta receptors
  • nucleus accumbens
44
Q

What are the signs and symptoms of using Krokodil?

A

skin, blood vessel bone, and muscle damage leading to gangrene, phlebitis, and sepsis

45
Q

Other names for Krokodil?

A

desomorphine

*synthetic opiates

46
Q

Treatment for intoxication of Krokodil?

A

symptomatic

47
Q

Signs and symptoms of PCP?

A

belligerence, psychomotor, agitation, violence, nystagmus, hypertension, seizures

48
Q

PCP stands for what?

A

phencyclidine

49
Q

How would you treat someone with PCP intoxication?

A
  • place in a quiet room
  • antipsychotics/ benzodiazepines
50
Q

What are the signs and symptoms of PCP withdrawal?

A
  • elevated body T, seizures, muscle breakdown
  • muscle twitching, agitation, hallucinations
51
Q

How do you treat withdrawal of PCP?

A

benzodiazepines, antipsychotics

52
Q

What is the location of action of PCP?

A

antagoinist of N-methyl D-aspartate glutamate receptors

53
Q

What are the signs and symptoms of intoxication with anabolic steroids?

A

irritability, aggression, mood instability, psychosis

54
Q

How do you treat intoxication with anabolic steroids?

A

administer antipyschotics

55
Q

What are the signs and symptoms of anabolic steroid withdrawal?

A

depression, headaches, anxiety

56
Q

How do you treat withdrawal from anabolic steroids?

A

if depressed consider SSRIs

57
Q

Where is the action of drugs when one is treated with anabolic steroids?

A

may activate dopamine and serotonin release

58
Q

Other names for ecstasy?

A

MDMA, Molly, E, X

59
Q

What are the signs and symptoms of ecstasy intoxication?

A

euphoria, mile hallucinations, visual disortions, enhanced sensations, hyperthermia, bruxism, autonomic hyperactivity, seizures, dry moth

60
Q

How do you treat intoxication with ecstasy?

A

dantrolene, benzodiazepines, hydration

61
Q

What are the signs and symptoms of withdrawal from ecstasy?

A

depression, anxiety, and panic attacks

62
Q

How do you treat withdrawals from ecstasy?

A

SSRIs

63
Q

What is the location of the effects of X?

A
  • increases serotonin and dopamine
  • affects hypothalamus (drinking behavior/body temp); motor neurons of spinal cord (muscle spasms and jaw clenching)
64
Q

What is the addiction pathway named?

A

mesolimbic dopamine pathway or Nucleus Accumbens pathway (NAc) pathway

65
Q

Draw out a schematic for the NAc pathway.

A

refer to page 84

66
Q

Some features of child with fetal alcohol syndrome?

A
  • small head
  • low nasal bridge
  • epicanthal folds
  • short nose
  • flat midface
  • thin upper lip
  • smooth philthrum
  • Underdeveloped jaw
67
Q

Signs and Symptoms of benzodiazepine intoxication.

A
  • slurred speech, confusion, memory deficits, falls
  • respiratory depression (rare)
68
Q

Treatment for benzodiazepine intoxication?

A

supportive flumazenil or mechanical ventilation if needed

69
Q

Withdrawal signs and symptoms of benzodiazepine use.

A
  • increased anxiety, tremors
  • insomnia
  • seizures
70
Q

Where is the location/ effect of drug action of benzodiazepine use?

A

GABA

71
Q

What are the signs and symptoms of barbiturate intoxication?

A
  • Restlessness, agitation, insomnia, N/V, anxiety
  • Tremors, seizures, hallucination, increased heart rate
  • Respiratory depression
72
Q

How do you treat intoxication with barbiturates?

A

supportive mechanical ventilation

73
Q

What are the signs and symptoms of withdrawal from barbiturates?

A
  • anxiety, depression
  • cognitive impairment
  • memory deficits, lack of attention
  • seizures and delirium
74
Q

Treatment for barbiturate withdrawal?

A

phenobarbital

75
Q

Location/ effect of drug action of barbiturates?

A

GABA

Kaplan: Behavioral Science and Social Sciences Part II (14 decks)

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