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NB3 (last of MS1) > LAST LECTURE OF YEAR 1 > Flashcards

LAST LECTURE OF YEAR 1 Flashcards

1
Q

intoxication

A

The DSM-5 term referring to the diagnosis of a reversible substance-specific syndrome due to recent ingestion of a drug and its effects on the CNS

Syndrome consists of significant maladaptive behavioral, psychological, physical changes

can be determined by blood, urine, or tissue drug levels

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2
Q

withdrawal

A

The DSM-5 term referring to the diagnosis of a
substance-specific syndrome that develops following
cessation of a substance after heavy/prolonged use

Syndrome consists of significant maladaptive
behavioral, psychological, physical changes

symptoms are usually the opposite of intoxication
symptoms appear 72 hours after cession and may last for weeks

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3
Q

substance use disorder (SUD)

A

A maladaptive pattern of substance use as manifested by >2 of 11 symptoms in a 12-month period

impaired control (cravings and time consuming)

social impairment (failure to meet role duties)

risk use (using despite consequences)

pharm criteria (tolerance and withdraw symptoms)
if only symptoms NOT SUD
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4
Q

Dependence

A 
A term referring to compulsive drug use despite
negative consequences (SUD)

with withdraw and dependence = physical depend

no withdraw and dependence = psychological depend

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5
Q

screening tools used for alcohol and drug use

A

CAGE = determine if it is clinically significant (2 or more yes)

AUDIT (alcohol related issues)

NIDA -modified ASSIST (drug/alcohol use in the last 3-12 months)

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6
Q

drug rehabilitation

A

in-patient setting
usually 90 days or more
recovery is lifetime

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7
Q

acute phase of drug rehab

A

detox

treat med and psych issues

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8
Q

recovery phase of drug rehab

A

preventing relapse

can use therapy (CBT, family therapy, med assist therapy, self-help groups)

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9
Q

schedule I drug

A

Drugs with a high harm risk and NO safe, accepted medical use

Ex: LSD, heroin

cannot prescribe

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10
Q

Schedule II drug

A

Drugs with a high harm risk but with safe and accepted medical use. These drugs are highly addictive

Ex: opioids, stimulant’s, barbiturate’s

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11
Q

Schedule III, IV, V drug

A

Drugs with a harm risk less than Schedule II drugs with safe and accepted medical uses

III: anabolic steroid, codeine, dronabinol

IV: benzos

V: liquid codeine (cough medicine)

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12
Q

initial cause of addition: psychosocial and biological reasons

A 
psychosocial: 
age of first use 
method of administering 
other mental illnesses 
coping strategies

genetic:
account for 40-60% vulnerability
unknown reason

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13
Q

continued and compulsive use of drugs…why?

A

the effects of the drug on brain functioning

  1. stimulation of the reward pathway
    overrides the punishing effects
    greater release of Dopamine in the NA, thus positive effects of the drug
  2. dysfunction of the prefrontal cortex
    alter in self-control- due to reward pathway stimulation
  3. acute withdraw symptoms
    discomfort may lead to relapse
  4. Protracted Abstinence Syndrome
    less dopamine is available due to the drug
    relapse may be triggered by anhedonia
  5. classical conditioning effects
    drug is paired with environmental cues
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14
Q

common features of sedative drug intoxication

A

sedation, sleepy, less anxiety, impaired judgement, slurred speech, incoordination

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15
Q

sedatives examples

A

alcohol
barbiturates
inhalants
benzos

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16
Q

withdraw symptoms from sedatives

A 
agitation 
insomnia 
anxiety 
tachycardia or hypertension 
nausea
vomiting 
hand tremors  
hallucinations
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17
Q

treatment for acute alcohol withdraw?

A

benzos (diazepam) for acute

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18
Q

Naltrexone

A

Opioid receptor antagonist that reduces the pleasurable effects of alcohol

reduce the amount of drinking

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19
Q

Acamprosate

A

Decreases the anhedonia of protracted abstinence → makes the person feel euthymic → decreases the cravings & helps to maintain abstinence

mechanism is not completely known (NMDA antagonist maybe)

reduce alcohol intake

20
Q

Disulfiram

A

Inhibits aldehyde dehydrogenase → acetaldehyde accumulates and causes a toxic reaction (e.g. nausea) for 30-60 min.

alcohol aversion agent

used short term due to compliance

21
Q

treatment for benzodiazepine overdose/toxicity

A

Flumazenil

competitive antagonist
high affinity for the benzo GABAa receptor

22
Q

inhalants

A

substances with psychoactive vapors
(paint, glue)

signs: rash, red and runny nose, chemical smell, face discoloration
intoxication is similar to sedative

23
Q

intoxication features of simulants

A

psych:
paranoia / hallucinations
psychomotor acceleration
euphoria

physical: 
loss of appetite
chest chain 
seizure 
dilated pupils 
tachy / hypertension

drug screen is needed to differentiate from schizo and bipolar I

24
Q

common features of simulant withdraw

A 
dysphoric mood 
fatigue 
slowing of psychomotor 
increased appetite
hypersomnia

sounds like MDD, but its not

25
Q

Methamphetamine vs Cocaine

A

both are addictive
direct action on the reward pathway
produce a rush due to euphoria

effects of cocaine are shorter

meth: meth mouth ( dry mouth and dental carries)
meth face = repetitive motor movements

26
Q

Ecstasy (simulant)

A 
empathy inducing 
perceptual changes (things are more interesting, time and sensory distortion)

increased thirst
increased temp
neurotoxic

27
Q

caffeine

A

DSM-5 does not recognize caffeine use disorder

effects on sleep, anxiety, mood,

28
Q

caffeine intoxication

A

more than 250mg

increased energy 
insomnia 
nervous 
rambling thoughts 
tachy 
GI disturbance
29
Q

caffeine withdraw

A

headache
dysphoria
fatigue
less concentration

30
Q

nicotine

A

DSM 5 does not recognize nicotine intoxication

stimulant

31
Q

nicotine withdraw

A 
dysphoric mood
restless, anxious 
irritable 
less concentration 
less HR
32
Q

treatment for nicotine abstinence

A

nicotine replacement therapy

medications

33
Q

hallucinogens

A

sympathomimetic drugs

visual distortions
auditory distortions

distorted thinking, trouble concentrating, working memory impairment

34
Q

classic hallucinogens

A

LSD, mescaline, psilocybin (mushroom)

high potency
effects last 8-12 hours
no withdraw symptoms
low addiction rates

intoxication: increased HR, increased BP, sweating, pupil dilation, dehydration, euphoria, hallucination

35
Q

side affects of classic hallucinogens

A 
irrational fears
anxiety 
panic 
paranoia
rapid mood swings 
hopelessness
intrusive thoughts of harming others or self
36
Q

psychoactive affects of cannabis

A

relaxation and slight euphoria
introspection and metacognition
increased appetite and HR

37
Q

cannabis intoxication

A

dry mouth, increased appetite, poor muscle coordination, delayed reaction time,

can have bad trips similar to LSD

38
Q

cannabis withdraw

A

irritability and nervous
dysphoric mood
sleep disturbance
decreased appetite

headache, shakiness

39
Q

Dissociative Anesthetics intoxication

A

PCP and ketamine

depersonalization
agitation and confusion 
impulsivity 
ataxia 
decreased pain response

rapid eye movements
increased HR, BP, and RR

no withdraw syndrome

40
Q

treatment for PCP intoxication

A

benzo/ antipsychotic

41
Q

opioids

A

analgesics to reduce pain

side effects / intoxication: 
euphoria 
decreased RR
Low BP
constipation 
drowsiness
miosis 
impaired cognition
42
Q

opioid withdraw

A 
dysphoria 
nausea, vomiting, diarrhea 
muscle aches 
pupil dilation 
sweating / fever
43
Q

Naloxone

A

used for acute overdose
not used at treatment
reverses CNS depression

44
Q

treatment for opioid addiction

A
  1. abstinence based therapy
    Naltrexone (blocks affects of opioid)
  2. replacement therapy
    methadone (opioid agonist) addictive

buprenorphine (partial opioid agonist) less addictive

45
Q

gambling disorder

A

Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting 4+ symptoms over 1 year

preoccupation with gambling 
unable to control, stop, or cut back 
lying 
used as an escape 
losing relationships or reliant on others to pay debt
46
Q

treatment for gambling disorder

A

SSRI
CBT
support group
family therapy

NB3 (last of MS1) (11 decks)

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