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Pharm II > Exam 4 addiction/drug abuse > Flashcards

Exam 4 addiction/drug abuse Flashcards

1
Q

____ ___: Changes that have occurred in the body after repeated use of a drug that necessitates the continued administration of a drug to prevent a withdrawal syndrome

A

Physical dependence - NOT an addiction

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2
Q

_____ are usually physically dependent on the drug they are abusing

A

Addicts - pt’s who use opiates for chronic pain management are likely to be physically dependent

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3
Q

____ ____: perceived need or craving for a drug

A

Psychologic dependence - often feel they cannot function without continued use of that substance

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4
Q

Physical dependence disappears within ___ or ___ after drug use stops, but psychological dependence can last ___ ___.

A

days or weeks

much longer

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5
Q

Psychological dependence is primarily reason for ____

A

Relapse

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6
Q

_____: With repeated dosing, the dose of the drug must be increased to produce the same effect or with consecutive dosing, the same dose of the drug produces less of an effect and need a higher dose to produce the desired effect

A

Tolerance

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7
Q

_____ ____ produce “central” tolerance (function or behavioral)

A

Psychoactive drugs - definite decrease in the response of brain tissue to constantly increasing amounts of the drug

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8
Q

Central tolerance is NOT the same as ____ ____ which is caused by an accelerated rate of metabolism of the drug

A

metabolic tolerance - insignificant factor in tolerance observed in humans to most psychoactive drugs

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9
Q

Withdrawal syndrome can range from mildly unpleasant to life threatening, it is dependent on what 5 factors?

A
  1. drug used
  2. dose and route of administration
  3. concurrent use of other drugs
  4. frequency and duration of drug use
  5. Genetics of user (age, sex, health)
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10
Q

Addiction: _____ ___ ___ behavior where acquiring and using a drug becomes the most important activity in the user’s life. Loss of ___ regarding drug use. Continued use despite serious ____ and or ____ consequences. With addiction there is always ____ ____.

A 
Compulsive drug seeking
Control
medical
social
psychological dependence
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11
Q

7 Behavioral signs of addiction

A
  1. preoccupation with obtaining the drug
  2. compulsive use in spite of adverse consequences
  3. relapse following periods of abstinence
  4. anal retentive
  5. obsessive compulsive
  6. controlling
  7. maipulative
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12
Q

____: physiological tolerance to or psychological dependence on a drug, short of addiction

A

Habituation

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13
Q

____: The behavior of others who are associated with the drug addict that results in continued drug abuse

A

Enabling - inappropriate coping mechanism by the enabler that negatively reinforces the addicts behavior

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14
Q

The state of being free of drugs

A

Abstinence - goal of drug tx programs

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15
Q

____: when drugs are used in a manner or amount inconsistent with medical or social patterns of a culture

A

Abuse - non sanctioned used of controlled substances/use of legal pharmaceuticals outside of the scope of sound medical practive

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16
Q

Drugs are abused to alter what 4 things?

A
  1. mood
  2. thoughts
  3. feelings
  4. action of CNS - alleviate pain, anxiety, depression, induce sleep, energize
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17
Q

4 factors that increase potential for abuse

A
  1. potency
  2. quick/rapid onset
  3. inexpensive
  4. easy to obtain/distribute
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18
Q

Treatment - individual must have the desire to stop for best chance of success, what 3 other things are included in tx?

A
  1. counseling for behavioral change
  2. education
  3. self-help groups
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19
Q

Why are drugs absorbed more quickly and more easily in kids vs adults?

A

Increased membrane permeability

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20
Q

Typically children receive ___ of the adult dose

A

half

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21
Q

___ of a drug differs from abuse - implies that the drug is being used inappropriately for the patients disease state. Using the wrong drug for the wrong problem, or the wrong dose for a longer period than prescribed

A

Misuse

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22
Q

A primary, chronic, progressive, relapsing disease process with genetic, psychosocial and environmental factors influencing its development and manifestations

A

chemical dependency

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23
Q

What is the usual progression of addiction?

A

experimental -> social use -> abuse -> addiction

Gateway drugs = alcohol/nicotine

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24
Q

In a dental office, what 3 things should be avoided in a patient that has a history of drug abuse

A

Opiates, benzodiazepines, and NO2

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25
Q

When comparing drugs in the same group, the time required to produce physical dependence is ____ with a rapidly metabolized drug and ____ with a slowly metabolized drug

A

shortest

longest

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26
Q

primary reason for relapse

A

psychological dependence

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27
Q

What are 3 cardio side effects of inhalants? What is the chemical that causes these?

A

Difluoroethane

  1. Increases sensitivity to epi -> can lead to sudden death
  2. irregular heartbeat
  3. MI risks
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28
Q

IV injection of opioid drugs often results in what 4 things?

A
  1. Hep B
  2. HIV infection
  3. TB
  4. Damaged heart valves ( IV drug users require antibiotics premed prior to receiving and dental tx)
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29
Q

2 drugs used to tx narcotic/opiate overdose

A
  1. naloxone (Narcan) (acute)

2. methadone (long-term rehabilitation)

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30
Q

7 signs of opiate overdose

A
  1. fixed pinpoint pupils
  2. depressed respiration
  3. hypotension
  4. shock
  5. slow/absent reflexes
  6. drowsiness
  7. coma
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31
Q

antidote to BDZ overdose

A

flumazenil “blocker drug”

Will not block CNS effects from alcohol, barbiturates, general anes. or opiates

32
Q

What will flumazenil not reverse?

A

respiratory depression/hypoventilation it also may cause seizures

33
Q

Alcohol is eliminated by ___ ___ kinetics. A constant amount of alcohol is metabolized and eliminated per unit of time regardless how much alcohol has been ingested ___ g per hour. Excreted in ___ and ___.

A

Zero order
1g
lungs and urine

34
Q

7 oral complications of alcoholism

A
  1. glossitis
  2. loss of tongue papillae
  3. angular cheilitis
  4. fungal infections
  5. bleeding (liver damage)
  6. oral cancer (squamous cell)
  7. leukoplakia/ulceration of lateral borders of tongue
35
Q

Alcoholism in older adults considerations include: _____ body water and lean body ____ making alcohol more concentrated. Decline in ____ and ____ function. _____/weightloss. More injuries/falls. _____ alcohol more slowly therefore stays in body ____. May develop biological ____ disorder, _____ health problems, and _____ problems like depression, anxiety, isolation, and _____.

A 
decreased
mass
liver and kidney
malnutrition
metabolize
longer
brain
systemic
psychological
suicide
36
Q

6 signs/symptoms of biological brain disorder

A
  1. simple withdrawal
  2. delirium tremens
  3. seizures
  4. organic hallucinations
  5. psychosis
  6. dementia
37
Q

4 drugs what interact with alcohol

A
  1. aspirin/NSAIDS = GI bleeding
  2. acetaminophen = liver damage
  3. cold/allergy/antihistamines = drowsiness/impaired judgment/coordination
  4. CNS drugs = sleepiness/poor coordination/dyspnea/tachycardia/memory problems
38
Q

8 signs of chronic alcohol use

A
  1. arrhythmias
  2. hypertension
  3. liverdamage/cirrhosis
  4. hepatitis
  5. cancer
  6. peripheral neuropathy
  7. amnesic syndrome
  8. impotence
39
Q

Alcohol withdrawal occurs in stages, what are 8 of the symptoms

A
  1. psychomotor agitation
  2. ANS hyperactivity
  3. hallucinations
  4. paranoid behavior/delusions
  5. amnesia
  6. disorientation
  7. grand mal seizures
  8. delirium tremens
40
Q

7 treatments for alcohol withdrawal

A
  1. ventilation suppoprt
  2. fluids/electrolytes
  3. vit B6
  4. glucose
  5. sodium bicarb
  6. magnesium
  7. disulfiram (Antabuse)
41
Q

how does disulfiram (Antabuse) work?

A

inhibits metabolism of aldehyde dehydrogenase which increases the serum levels of acetaldehyde. When taken with alcohol, you vomit, thirst/palpitations/vertigo/headache - deters person from wanting to drink

42
Q

Symptoms of overdose with CNS stimulant

A
  1. dilated pupils
  2. hypertension
  3. elevated pulse
  4. cardiac arrhythmias
  5. extreme sweating
  6. hyperthermia (leads to brain damage/seizures/death)
  7. hyperactive behavior
  8. tremors
43
Q

what is a therapeutic use of amphetamine?

A

dextromethamphetamine (Desoxyn)

Treats ADHS, narcolepsy, and short term for obesity

44
Q

What are 4 desired effects of nicotine

A
  1. increased alertness
  2. muscle relaxation
  3. facilitation of concentration and memory
  4. decreased appetitie
45
Q

9 harmful effects of nicotine

A
  1. irritability
  2. hypertension
  3. camel face
  4. increased HR
  5. induces nausea/vomiting
  6. dizziness
  7. CAD
  8. lung cancer
  9. oral cancer
46
Q

8 withdrawal symptoms of nicotine

A
  1. anxiety
  2. irritability
  3. difficulty concentrating
  4. headaches
  5. drowsiness
  6. increased appetite
  7. sleep disturbances
  8. craving tobacco
47
Q

People often require _____ quit attempts before they are finally successful

A

5-8

48
Q

4 examples of hallucinogens

A
  1. diethylamine (LSD)
  2. phencyclidine (PCP)
  3. mescaline (peyote)
  4. marijuana
49
Q

3 problems with long term use of hallucinogens

A
  1. depression
  2. panic disorders
  3. schizophrenia
50
Q

Hallucinogens have ___ medical uses, they alter all ___ ___, cause perceived heightened ____ where ____ are brighter/clearer, ____ are more brilliant, and taste/smell/touch are more ____. Psychological _____ and _____ develops quickly.

A 
NO
sensory input
awareness
sounds
colors
acute
dependence
tolerance
51
Q

Hallucinogens are powerful CNS stimulants and can have what 4 effects

A
  1. adverse CNS effects
  2. delusions
  3. panic
  4. paranoia
52
Q

Hallucinogens are _____ and will have adverse cardio effects with mixed with ____.

A

sympathomimetics

epinephrine

53
Q

2 main chemical of the 500 chemicals in marijuana

A
  1. delta-9-tetrahydrocannabinnol (THC)

2. cannabidiol (CBD)

54
Q

8 effects of THC

A
  1. analgesic
  2. muscle relazation
  3. appetite stimulation
  4. tachycardia
  5. mood alterations
  6. cognitive/memory
  7. alertness/perception
  8. anticholinergic (at high dose)
55
Q

6 effects of CBD

A
  1. analgesic
  2. muscle relaxant
  3. anticonvulsant
  4. anxiolytic
  5. neuroprotective
  6. decrease psychotic effects of THC
56
Q

10 uses of medical marijuana

A
  1. antispasmodic
  2. analgesic
  3. anorexia
  4. nausea/vomiting
  5. incontinence
  6. seizures
  7. glaucoma (reduces intraocular pressure)
  8. pruritis
  9. sleep apnea
  10. Tourettes syndrome
57
Q

4 adverse short term effects of mj

A
  1. problems with memory/learning
  2. distorted perception
  3. difficulty in thinking/problem solving
  4. loss of coordination
58
Q

6 Problems with long term use of mj

A
  1. physical dependence
  2. withdrawal
  3. psychological dependence
  4. addiction
  5. increased risk for depression
  6. increased risk for and earlier onset of schizophrenia
59
Q

7 signs/symptoms a person is high on weed

A
  1. increased HR
  2. blood shot eyes
  3. slow to respond
  4. slurred speech
  5. glazed eyes
  6. order on breath or clothes
  7. paranoia
60
Q

4 oral complications of mj

A
  1. xerostomia
  2. gingivitis
  3. leukoplakia
  4. hyper keratinized tissues
61
Q

2 complications of chronic mj use

A
  1. chronic bronchitis

2. precancerous changes in bronchioles

62
Q

K2/spice causes similar effects to mj, what is it made of?

A

herbal mixture, incense/potpourri

63
Q

dronabional (Marinol) = what?

Is a schedule 3 drug and it is approved for what 2 things?

A

synthetic version of THC

  1. subsides nausea and vomiting from chemo
  2. appetite stimulate in AIDS patients
64
Q

A term used to identify drugs that can be used to facilitate sexual assault

A

predatory drug

65
Q

Name 3 predatory drugs

A
  1. rohyphol
  2. GHB
  3. ketamine
66
Q

rohnpnol is an benzo not approved for use in the US, aka?

A

flunitrazepam

67
Q

What happends when rohypnol is mixed with alcohol?

A

lethal

by itself causes: muscle relaxation, amnesia, and seadative

68
Q

GHB is a CNS depressants aka?

A

sodium oxybate (Xyrem) - analogue to GHB found in industrial solvents/cleaners not defected in tox screen

69
Q

3 effects of GHB

A
  1. euphoric
  2. sedative
  3. anabolic
70
Q

what may happen when GHB is taken with meth?

A

coma/seizure

71
Q

3 adverse side effects of GHB

A
  1. seizure
  2. difficulty breathing
  3. death
72
Q

4 withdrawal effects of GHB

A
  1. insomnia
  2. anxiety
  3. tremors
  4. sweating
73
Q

3 effects of ketamine

A
  1. sedative hypnosis
  2. analgesic
  3. hallucinogenic
74
Q

how is ketamine different from PCP?

A

more rapid onset and less potent

75
Q

ketamine is used as a general anesthetic usually in veterinary medicine. When abused it is generally snorted to cause?

A

pleasant weightlessness to full fledged out of body or near death experiences

Pharm II (18 decks)

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