lect 2 Flashcards

1
Q

tobacco stats:
deaths:

A

480,000 deaths

41k due to 2nd hand smoke

it isnt banned bc the taxes help fund the economy

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2
Q

tobacco use disorder physiologic effects are?

A

stimulates the nicotinic cholinergic receptors in the brain

-HTN, tachy, vasoconstriction, inc. plt coag, decPaO2

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3
Q

tobacco use disorder prevention

A

-inc. price
-stop teen smoking
-penalties for sales to minor

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4
Q

tobacco use disorder tx:

the 5As to find who is willing to quit

A

-treat sx
-smoking cessation

-ask about tobacco at every visit
-advise pt to quit in strong, straightforward lang.
-assess pt willingness to quit in the next 30 days
-help pt if willing to quit
-arrange f/u

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5
Q

tobacco medication tx:

A

-nicotine replacement therapy (gum, patch, inhale), taper within time

-bupropion: blocks nicotine effect

-Varenicline: blocks effect of nocotine BUT cravings for alcohol occur

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6
Q

tobacco use higher in what populations:

A

-NA, white ppl, homos

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7
Q

cannabis use disorder:

what r its effects?

A

-tetrahydrocannibinol THC in weed

-euphoria, sedation, anxiolytic

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8
Q

cannibis use disorder effects when using?

A

chronic: lung dx, frequenct infxns

-no oral malignancies
-adolescents whp heavily use have hippocampal changes which is where it affects mood disorders

-linked to schizophrenia

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9
Q

what is cannabinoid hyperemesis syndrome?

A

-frequent users have cyclic nausea and vomiting

-relieved by hot showers and bath

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10
Q

cannabis use disorder withdrawal:

TX:

A

cessation can cause mild sx 3-7 days:
-insomnia
-irritability
-depression
-nausea
-anorexia

TX:
rehab counseling, no meds to help

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11
Q

Stimulant Use Disorder:
cocaine

A

-alkaloid derived from coca plant that enhances NE/dopamine/ serotonin in CNS/PNS

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12
Q

ppl who use cocaine stats:

A

-pure cocaine is usually 45-60% pure and mixed w other subs.

-crack cocaine is a highly biologically active form that has worsened the incidence of coc.use disorder

-most coc users are recreational users
-25% will have a stimulant disorder

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13
Q

Stimulant Use Disorders : cocaine
-dopaminergic effects:

A

-hyperstimulation
-alertness
-euphoria
-sense of increase energy, feelings of power

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14
Q

Stimulant Use Disorders : cocaine
-sympathomimetic effects due to NE:

A

-tachy
-htn
-mydriasis (pupillary dilation)
-diaphoresis
-hyperthermia

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15
Q

Stimulant Use Disorders : cocaine
-significant vasoconstrictive

A

-AFFECT ANY ORGAN

-mi
-cerebral
-ischemia/hemorrhage
-renal ischemia

in pregnant women:
-inc. risk of placental abruption
-inc risk of spontaneous abortion

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16
Q

cocaine inhaled: crack causes what … to your body ?

A

-inc. risk of pneumothorax and pneumomediastinum
-chest pain and dyspnea

17
Q

Physical signs of Cocaine use:

Toxicity:

A

-tachy
-htn
-mydriasis (pupillary dilation)
-diaphoresis
-hyperthermia

T: anxiety, panic, agitation, aggression, hallucinations
tremors, delirium, delusions, impaired judgement

18
Q

Cocaine w alcohol:

A
  • concurrent use w/ alcohol produces a condensation product cocaethylene= additive effect
19
Q

cocaine effect on severe overdose:

chronic effects:

A

-acute pyschosis
-rhabdomyolysis
-coagulopathy
-renal failure
-seizures
-severe hyperthermia
-death

20
Q

chronic effects of coc:

A

-Lheart issues lol (LVH, cardiomyopathy, myocardial fibrosis)

-chronic renal failure
-nasal septum perforation

21
Q

Cocaine acute overdose TX:

Rehab:

A

-IV benzodiazepines
-AVOID BB due to alpha adrenergic effects
- cooling therapy
-tx sx
-mechanical ventilation w propofol

R: outpt therapy such as support groups

INPT when its serious physical or mental comorbidity and fails tx

22
Q

approved tx for ADHD:

FYI: prescription stimulant same physio effects as coc

A

-dextroamphetamine
-amphetamine
-methylphenidate

illicit:
meth, MDMA, ectasy

23
Q

Hallucinogen definition:

A

false perception w/out sensory stimulation in the waking state

-auditory, visual, olfactory, tactile, somatic

23
Q

what are hallucinogens:

intoxication causes :

TX: supportive :/

A

group pf drugs that can cause highly unpredictable rxns

-hallucinations
-impaired judgement
-ideas of reference: random events in world relates to oneself

-depersonalization

24
traditional hallucinogens:
LSD- lysergic acid diethylamide [derived from fungus that contaminate wheat and rye flour] -Psilocybin "shrooms" -mescalin [peyote cactus]
25
signs and sx of tripping: long term and short term effects:
LSD FLASHBACKS -visual disturbances -persistent psychosis (paranoia, disorganized thinking, distored perception) -mood changes: pamic/fear/ anxiety -dizzy/arrthymia
25
synthetic "designer drugs"
-tryptamines -phenylethamines -ketamine -phencyclidine (angel dust) -dextromethorphan -MJ in large doses
26
Hallucinogen diagnoses:
pt presents to law enforcement/ED in acute psychosis
27
hallucinogen TX:
acute intox: -supportive care -anxiolytics for relief and anxiety --> BENZ persistant sx/flashbacks: -psychiatric care -antipsychotic use benz --> anxiety during flashbacks
28
inhalant use disorder: the solvents that your inhaling:
-acetates -alcohol -ether -ketones -aliphatic and aromatic -hydrocarbons
29
inhalent examples:
-adhesives -paints -paint strippers -cleaning prods
30
acute affects of inhalants:
-dizzy, drowsy, slurred speech, unsteady gait, hallucinate, delulu, death hypoxia, laryngospasm [airway obstruction], arrythmias
31
chronic effects of inhalants: TX:
-perioral eczema -hepatic/renal failure -dysrhthmias supportive care, relapse if frequent
32
most common misused benz:
-alprazolam -diazepam -clonazepam
33
Benz acute toxicity: chronic effect:
-sedation - respiratory depression -flumazenil -->benz agonist that reverse resp.depress CE: slow cognition, slurred speech, poor memory/faulty judgement -emotional lability
34
cessation sx of benz: TX:
mild withdrawal such as: tachypnea/cardia tremulousness confusion seizures TX: flumazenil to induce withdrawal tapering is better and LT cessation