Chapter 7 ( Substance Use Disorders )

Question 1

The addiction pathway in the brain ?

Answer 1

The Mesolimbic Dopamine pathway :

Stimulus—> cerebral cortex—> ventral tegmental area —>nucleus accumbens

Question 2

Fetal alcohol syndrome ?

Answer 2

1- growth problems 
2- mental or behavioral problems 
3- abnormal facial features :
Small head 
Low nasal bridge and short nose  
Small eyes and epicanthal folds 
Flat midface and smooth philtrum 
Thin upper lip and underdeveloped jaw

Question 3

The common stages by which people tend to change their behavior ?

Answer 3

1- Precontemplation 
2- Contemplation 
3- Preparation
4- Action 
5- Maintenance 
6- Relapse

Question 4

Lab indicator of recent alcohol intake ?

Answer 4

Increased gamma GT

Question 5

Alcohol signs and symptoms of intoxication ? Ttt of intoxication ? Signs and symptoms of withdrawal ? Ttt of withdrawal ? Effect of drug action ?

Answer 5

Talkative , gregarious , moody , disinhibited

Ttt: if severe consider mechanical ventilation

Tremors , hallucinations , seizures , delirium tremens

Ttt: thiamin , MVI, folic acid , benzodiazepines

Decreases glutamate and increases GABA

Question 6

Amphetamine and Cocaine signs and symptoms of intoxication ? Ttt of intoxication ? Signs and symptoms of withdrawal ? Ttt of withdrawal ? Effect of drug action ?

Answer 6

Euphoria , hyper vigilance , autonomic hyperactivity , weight loss, pupillary dilatation , perceptual disturbances

Ttt: antipsychotics , benzodiazepines , antihypertensives

Anxiety , tremors , headache , increased appetite , depression , risk of suicide

Ttt: antidepressants

Mesolimbic pathway , nucleus accumbens

Question 7

Bath salts signs and symptoms of intoxication ? Ttt of intoxication ? Signs and symptoms of withdrawal ? Ttt of withdrawal ?

Answer 7

Irritability , perceptual disturbances , agitation , symptoms can last up to 1 week

Ttt: antipsychotics or benzodiazepines

Anxiety and depression

Ttt: if suicidal consider SSRIs

Question 8

Cannabis signs and symptoms of intoxication ? Ttt of intoxication ? Signs and symptoms of withdrawal ? Effect of drug action ?

Answer 8

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

Ttt : antipsychotics

Irritability and anxiety

Inhibitory G protein , GABA , increased serotonin

Question 9

K2 / spice ( synthetic marijuana ) signs and symptoms of intoxication ? Ttt of intoxication ?

Answer 9

Perceptual disturbances , agitation , seizures

Ttt: antipsychotics , benzodiazepines

Question 10

Hallucinogens signs and symptoms of intoxication ? Ttt of intoxication ? Effect of drug action ?

Answer 10

Ideas of reference , perceptual disturbances , impaired judgment , dissociative symptoms

Ttt: place in quiet room , antipsychotics, benzodiazepines

Stimulate glutamate and serotonin

Question 11

Inhalants signs and symptoms of intoxication ? Ttt of intoxication ? Signs and symptoms of withdrawal ? Ttt of withdrawal ? Effect of drug action ?

Answer 11

Belligerence , apathy , aggression , impaired judgement , stupor
Nasal crusting , rash , drunken appearance , dilated pupils
Use can be fatal
Parkinsonism has been associated with huffing

Ttt: antipsychotics

Nausea , excessive sweating , muscle cramps , headaches , chills , agitation , shaking , hallucinations

Ttt: benzodiazepines , antipsychotics

GABA , cerebellum

Question 12

Opiates signs and symptoms of intoxication ? Ttt of intoxication ? Signs and symptoms of withdrawal ? Ttt of withdrawal ? Effect of drug action ?

Answer 12

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

Ttt: Naloxone , Naltrexone

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

Ttt: clonidine , methadone, buprenorphine ( suboxon )

Mu,kappa,delta receptors , nucleus accumbens