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Psych > Clinical approach to substance abuse disorders > Flashcards

Clinical approach to substance abuse disorders Flashcards

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1
Q

What is addictophrenia spectrum?

A

a conceptual model used for risk assessment & treatment planning

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2
Q

Addictophrenia spectrum

A

GENETIC history of:

  • -addictive disorders
  • -intractable mood disorders
  • -personality disorder or habitual criminal behavior

PERSONAL history of:

  • -polysubstance use
  • -trauma (earlier=greater risk)
  • -chronic psychosocial stressors starting at young age
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3
Q

Criteria for substance use disorder

A
  • -using larger amounts or for longer time than intended
  • -persistent desire or unsuccessful attempts to stop
  • -great deal of time spent obtaining, using, or recovering
  • -craving
  • -fail to fulfill major roles
  • -social or interpersonal problems causes by use
  • -tolerance
  • -withdrawal
  • -use despite physical or psychological problems caused by use
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4
Q

neuroadaptation

A

CNS changes that occur following repeated use such that a person develops tolerance &/or withdrawal

  • -adaptation of metabolizing system
  • -ability of CNS to function despite high blood levels
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5
Q

symptoms of early alcohol withdrawal

A

anxiety, irritability, tremor, HA, insomnia, nausea, tachycardia, HTN

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6
Q

When do seizures generally occur during alcohol withdrawal?`

A

24-48 hrs

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7
Q

When does delirium tremens occur & what are the manifestations?

A

generally between 48-72 hrs (can be 3-10days)

–global confusion, hallucinations, fever, HTN, autonomic hyperactivity, tachycardia, sweating

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8
Q

Alcohol withdrawal tx

A
  • -benzos: reduce risk of seizures, provide comfort/sedation
  • -anticonvulsants: reduce risk of seizures
  • -thiamine supplement
  • -alcoholics anonymous
  • -naltrexone & acamprosate
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9
Q

signs of benzo/barbiturate intoxication

A

similar to alcohol but less cognitive/motor impairment

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10
Q

benzo withdrawal symptoms

A

anxiety, irritability, insomnia, fatigue, HA, tremor, sweating

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11
Q

symptoms of opioid intoxication

A

constricted pupils, sedation, constipation, bradycardia, hypotension

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12
Q

symptoms of opioid withdrawal

A

not life threatening

dilated pupils, lacrimation, goosebumps, n/v, diarrhea

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13
Q

opiate disorder treatment

A

support, education
methadone
naltrexone
buprenorphine

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14
Q

Which drug should you never mix with methadone

A

benzos
causes QTc prolongation

also avoid another CYP3A4 substrate

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15
Q

symptoms of stimulant intoxication

A

euphoria, enhanced vigor, hyperactivity, restlessness, anxiety, anger, paranoia
also tachy, pupil dilation, HTN, diaphoresis

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16
Q

symptoms of chronic stimulant intoxication

A

affective blunting, fatigue, sadness, social withdrawal, hypotension, psychosis

17
Q

symptoms of stimulant withdrawal

A

severe & even suicidal depression

18
Q

neuroadaptation with cocaine

A

prevents reuptake of DA

19
Q

stimulant use disorder tx

A

narcotics anonymous
support, education
no drugs are FDA approved

20
Q

neuroadaptation with amphetamines

A

inhibit reuptake of DA, NE, SE–greatest effect on DA

21
Q

symptoms of tobacco withdrawal

A

dysphoria, irritability, anxiety, decreased concentration

22
Q

neuroadaptation with tobacco

A

nicotine acetylcholine receptors on DA neurons in ventral tegemental area release DA in nucleus accumbens

23
Q

tx for tobacco use

A

CBT
nicotine gum, patch, etc
buproprion
varenicline

24
Q

symptoms of MDMA intoxication

A

illusions, hyperacusis, sensitivity to touch, euphoria, panic, paranoia

–also be cautious of very high fever!! tachycardia, sweating

25
Q

neuroadaptation with MDMA

A

affects serotonin, DA, NE (mostly serotonin)

26
Q

symptoms of withdrawal from MDMA

A

unclear syndrome–sleepiness & depression

27
Q

symptoms of withdrawal from cannabis

A

insomnia, irritability, anxiety, poor appetite, depression

28
Q

symptoms of PCP intoxication

A

severe dissociative reactions, paranoid delusions, hallucinations, can become very agitated/ violent
NYSTAGMUS
has no tolerance or withdrawal

29
Q

PCP abuse tx

A

antipsychotics or BZD

low stimulation environment

30
Q

neuroadaptation with PCP

A

opiate receptor effects

allosteric modulator of glutamate NMDA receptor

Psych (8 decks)

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