Mental Health Flashcards
1
Q
The following is included in the test for cognition: A. Mood B. Hallucinations C. Delusions D. Memory
A
D. Memory
2
Q
An illusion is:
A. A sense perception in the absence of a stimulus
B. A false sense perception of a real stimulus
C. A false belief held in the absence of proof
D. A false perception in the auditory modality
A
B. A false sense perception of a real stimulus
3
Q
The following statement is true about delusion:
A. It is always accompanied by hallucination
B. It is classified as bizarre if it cannot be probable in the realm of possibility
C. It is something that can never happen in the realm of possibility
D. It means to hold an odd belief
A
B. It is classified as bizarre if it cannot be probable in the realm of possibility
4
Q
Life stresses play a role in psychiatric illness because they:
A. Must always be severe to lead to an acute illness
B. Can be a trigger for a breakdown leading to a need for hospitalisation
C. Cause the underlying illness
D. Must always be present with every illness
A
B. Can be a trigger for a breakdown leading to a need for hospitalisation
5
Q
The following statement is true for DSM IV – R:
A. It uses 4 axes to record diagnosis
B. It divides mental illness into 16 categories
C. It is a system that categorises both mental and physical illnesses
D. It is available in all the languages of the world
A
B. It divides mental illness into 16 categories
6
Q
The following statement is true for hallucination:
A. It can only occur in the visual or auditory modality
B. It is always present in depression
C. It can occur in any sensory modality
D. It can be classified as bizarre or non-bizarre
A
C. It can occur in any sensory modality
7
Q
I.Q. testing can demonstrate if someone has ........ A. Mental retardation B. a disorder of affect C. Long and short term memory D. Concrete thinking
A
A. Mental retardation
8
Q
Attention and concentration is tested by ………
A. giving a patient 3 objects to remember and testing recall
B. Asking a patient to explain a proverb
C. Asking a patient to link similarities
D. Doing the ‘Serial seven’s and serial three’s’ test
A
D. Doing the ‘Serial seven’s and serial three’s’ test
9
Q
People with cognitive deficit display possible …… A. Disturbances in affect B. Symptoms of de-realisation C. Deficits in short term memory D. Complex delusions
A
C. Deficits in short term memory
10
Q
In suspected dementia this test is essential ……… A. Serial seven's and serial three's B. Test for abstract thinking C. I Q testing D. Test for long and short term memory
A
D. Test for long and short term memory
11
Q
Match the listed examples with the DSM IV – R diagnostic axes below:
Axis I A. Physical illness B. Psychiatric diagnosis C. Personality disorder D. Global assessment of functioning
A
B. Psychiatric diagnosis
12
Q
Match the listed examples with the DSM IV – R diagnostic axes below:
Axis II A. Physical illness B. Psychiatric diagnosis C. Personality disorder D. Global assessment of functioning
A
C. Personality disorder
13
Q
Match the listed examples with the DSM IV – R diagnostic axes below:
Axis III A. Physical illness B. Psychiatric diagnosis C. Personality disorder D. Global assessment of functioning
A
A. Physical illness
14
Q
Axis V A. Physical illness B. Psychiatric diagnosis C. Personality disorder D. Global assessment of functioning
A
D. Global assessment of functioning
15
Q
Mental retardation is
A. Defined by having an IQ less than 70
B. Always accompanied by autism
C. Defined as being of moderate intensity if the IQ is less than 30
D. Defined by having an IQ less than 90
A
A. Defined by having an IQ less than 70
16
Q
Sexual Identity is defined as
A. A person’s biological sex
B. A person’s erotic response in real life or in their fantasies
C. A subjective feeling of being a man or a woman
D. A social display of their gender identity
A
A. A person’s biological sex
17
Q
A phobia can be
A. Treated with in depth psychoanalysis
B. Treated with antipsychotic medication
C. Treated with the therapy of flooding and electroconvulsive therapy
D. Treated with the therapy of flooding or systematic desensitization
A
D. Treated with the therapy of flooding or systematic desensitization
18
Q
A 78 year old lady complains that for some time she has had to rush to the toilet when she feels the urge to urinate as she wets herself if she delays. In the past week it has been much worse and she has had several episodes of wetting herself before she gets to the toilet.
The most likely reversible cause of urinary incontinence for which you should investigate this patient is; A. spinal chord lesion B. autonomic neuropathy C. urinary tract infection D. uterine prolapse
A
D. uterine prolapse
19
Q
A 70 year old diabetic man complains that for the past year he has had a poor urinary stream and must press to pass urine and more recently he dribbles small amounts of urine all the time.
The most likely kind of urinary incontinence in this case is: A. stress incontinence B. overflow incontinence C. urge incontinence D. functional incontinence
A
B. overflow incontinence
20
Q
Which of the following does an ADL (activity of daily living) scale such as the Barthel test: A. the ability to cook food B. the ability to work with money C. both B and C correct D. the ability to walk and transfer
A
D. the ability to walk and transfer
21
Q
IADL’s (instrumental activities of daily living) scales such as the Frenchay are most useful in assessing a patient’s;
A. Ability to take care of their basic grooming needs
B. ability to walk and climb stairs
C. ability to live independently in the community
D. need for full time frail care
A
C. ability to live independently in the community
22
Q
In a patient who is having recurrent falls which you think are due to a peripheral neuropathy the best functional assessment of this problem is
A. The reach test ( patient stands with feet together and distance they can reach with arm outstretched is measured)
B. The sternal nudge (push on sternum while patient stands with feet together)
C. The Rhomberg’s test (stand with feet together and eyes closed)
D. A thorough neurological examination
A
D. A thorough neurological examination
23
Q
You see an 80 year old woman who has fallen once and is now terrified of falling again. You assess her fully and find no cause for the fall.
Which of the following would be the most appropriate management of her fear of falling:
A. prescribe a mild benzodiazepine for anxiety
B. reassure her that there is nothing wrong with her
C. suggest that she uses a walking stick
D. refer her for physiotherapy for balance exercises
A
C. suggest that she uses a walking stick
24
Q
An 85 year old woman with moderate Alzheimer’s disease, on no medications, who was still able to bath and dress herself and walk to church nearby on her own deteriorates over 2 weeks to the point that she is disorientated in her own house, confused, restless at night, drowsy during the day, having falls and episodes of incontinence.
Which of the following would be the most likely cause for her deterioration?
A. rapidly progressive form of Alzheimer’s disease
B. delirium due to an underlying infection
C. delirium on its own
D. the multiple falls
A
A. rapidly progressive form of Alzheimer’s disease
25
Which of the following cognitive problems would be most likely to fulfil the DSM IV criteria for dementia?
A. poor executive function
B. Progressive impairment of language and memory
C. memory impairment alone with preserved function
D. stable memory impairment and apraxia
B. Progressive impairment of language and memory
26
Which of the following best describes a delirium?
A. slow onset of disorientation for time and place
B. agitation and restlessness plus cognitive impairment
C. sudden onset of poor concentration, disorientation and perceptual disturbances
D. sudden onset of memory impairment
C. sudden onset of poor concentration, disorientation and perceptual disturbances
27
```
Which of the following patient characteristics would make the MMSE (Minimental-state-examination) score unreliable or difficult to interpret in terms of dementia?
A. mild Alzheimer’s disease
B. severe Alzheimer’s disease
C. previous severe stroke
D. no formal schooling
```
D. no formal schooling
28
A patient in an acute psychiatric ward complains that there are voices talking to him/her. — Choose match
```
Hyperacousis
Hallucination
Expansive mood
Dissociation
Disorientation
Delusion
Dereailization
```
Hallucination
29
A patient was brought in for an assessment as she was causing a disruption in a supermarket. On evaluation you find that she expresses her feelings without restraint and overestimate her own importance. — Choose
```
Hyperacousis
Hallucination
Expansive mood
Dissociation
Disorientation
Delusion
Dereailization
```
Expansive mood
Individuals with an expansive mood may behave brashly or lavishly, assume a superior or grandiose attitude, or dress and act flamboyantly. They exhibit larger-than-life behaviors that can often be accompanied by (or result in) extreme bursts of irritability.
30
An elderly patient cannot tell you the date , time of the day, or month of the year. — Choose
```
Hyperacousis
Hallucination
Expansive mood
Dissociation
Disorientation
Delusion
Dereailization
```
Disorientation
31
A patient tells you that aliens have implanted a sensor in his head and are tracking all his movements. — Choose m
```
Hyperacousis
Hallucination
Expansive mood
Dissociation
Disorientation
Delusion
Dereailization
```
Delusion
32
A patient in an acute psychiatric ward tells you that he is seeing pink insects flying around in his room. — Choose
```
Hyperacousis
Hallucination
Expansive mood
Dissociation
Disorientation
Delusion
Dereailization
```
Hallucination
33
A male patient believes he is pregnant. — Choose
```
Hyperacousis
Hallucination
Expansive mood
Dissociation
Disorientation
Delusion
Dereailization
```
Delusion
34
A patient cannot tell you in which country he lives — Choose
```
Hyperacousis
Hallucination
Expansive mood
Dissociation
Disorientation
Delusion
Dereailization
```
Disorientation
35
The patient is restless and paces up and down — Choose match
```
hallucination appearance
pressure of speech
psychomotor agitation
cognitive impairment
mood
suicidal
sublimation
```
psychomotor agitation
36
The patient wants to end her own life. — Choose
```
hallucination
appearance
pressure of speech
psychomotor agitation
cognitive impairment
mood
suicidal
sublimation
```
suicidal
37
```
The patient is unkempt and dirty. — Choose
hallucination
appearance
pressure of speech
psychomotor agitation
cognitive impairment
mood
suicidal
sublimation
```
appearance
38
```
The patient feels sad /depressed most of the time. — Choose
hallucination
appearance
pressure of speech
psychomotor agitation
cognitive impairment
mood
suicidal
sublimation
```
mood
39
```
The patient’s memory is impaired. — Choose hallucination
appearance
pressure of speech
psychomotor agitation
cognitive impairment
mood
suicidal
sublimation
```
cognitive impairment
40
The patient is elated and feeling very happy. — Choose
```
hallucination appearance
pressure of speech
psychomotor agitation
cognitive impairment
mood
suicidal
sublimation
```
mood
41
The patient is hearing voices — Choose
```
hallucination
appearance
pressure of speech
psychomotor agitation
cognitive impairment
mood
suicidal
sublimation
```
hallucination
42
A 75 year old woman is brought to see you by her daughter who complains that the patient has been becoming very forgetful over the past year. She also confuses the days, gets lost in shopping malls and can no longer do her own shopping or cook for herself. There is no past history of any medical condition. The most likely diagnosis is:
a. delirium
b. Alzheimer’s dementia.
c. An underling medical illness
d. A frontal lobe tumour
b. Alzheimer’s dementia.
43
An 80 year old man has a history of long standing confusion and memory problems. He does not speak English and has no formal education. You suspect that he has a dementia. What is the most reliable way of making the diagnosis?
a. The Mini Mental State Examination (MMSE)
b. An MRI scan of his brain
c. A thorough neurological examination
d. A careful history documenting functional decline.
d. A careful history documenting functional decline.
44
When caring for patients with dementia which aspect of follow-up is the most important?
a. Regularly checking the Mini Mental State Examination (MMSE).
b. Finding out if the care giver is coping and receiving adequate support.
c. Performing a neurological examination regularly.
d. Checking the thyroid function regularly.
a. Regularly checking the Mini Mental State
45
A 68 year old woman is admitted to hospital for severe pneumonia. She has a history of moderate dementia, hypertension and diabetes. On admission she is agitated, trying to climb out of bed, disorientated, hallucinating and will not co-operate with the nurses. The most likely reason for her mental state is;
a. A new intracerebral medical problem.
b. The dementia itself.
c. A superimposed delirium due to the pneumonia.
d. Pneumonia complicated by a psychotic illness
c. A superimposed delirium due to the pneumonia.
46
A 90 old woman is brought in from the old age home. The nurse informs you that she recently had a urinary tract infection after which she was restless and wandering around confused at night. She was then put on a benzodiazepine to sleep. She has normal vital signs, no focal signs on CNS examination and no obvious injury but is drowsy and uncooperative. The most likely cause for her mental state is;
a. A rapidly progressive dementia aggravated by benzodiazepine use.
b. A delirium due to the infection and benzodiazepine use.
c. A subdural haematoma.
d. A stroke.
b. A delirium due to the infection and benzodiazepine use.
47
Doing formal cognitive testing in a patient with delirium is difficult and not informative. Which of the following is a diagnostic feature of delirium and makes cognitive testing (e.g. A MMSE) difficult.
a. Disordered language.
b. Poor short term memory.
c. Hallucinations
d. A deficit in attention (distractible/ poor concentration)
d. A deficit in attention (distractible/ poor concentration)
48
A well 78 year old woman lives on her own and has no social support. You are asked to assess her to see if she is fit enough to remain on her own and what social services she needs in order to do so. In order to do this which of the following would be the most useful?
a. Scoring her activities of daily living (ADL’s) e.g. Barthel Index
b. A detailed medical history and examination.
c. Scoring her instrumental activities of daily living (IADL’s) e.g. Frenchay Index.
d. Doing a fitness test such as a distance walked in 5 minutes.
c. Scoring her instrumental activities of daily living (IADL’s) e.g. Frenchay Index.
49
You are managing a 68 year old man who has had a severe stroke. In order to document his level of disability and anticipate the amount of care he will need to see to his basic needs which of the following would you do?
a. A full neurological examination.
b. A full cardiovascular and neurological examination.
c. Use an Instrumental Activities of Daily Living (IADL) scale to score his function e.g. Frenchay Index.
d. Use an Activity of Daily Living (ADL) scale to score his function e.g. Barthel Index.
d. Use an Activity of Daily Living (ADL) scale to score his function e.g. Barthel Index.
50
When trying to determine whether a frail elderly patient with multiple medical problems, and using multiple medications, is stable or whether there is a deterioration in one of her medical conditions or a new problem the most effective and efficient way to go about it is to;
a. Ask for a chest x-ray, electrolytes, liver functions and a full blood count.
b. Do a full systematic inquiry of each system.
c. Do a full examination.
d. Ask if there has been a decline in her function with regard to her Instrumental Activities of Daily living (IADL’s) and Activities of Daily living (ADL’s).
d. Ask if there has been a decline in her function with regard to her Instrumental Activities of Daily living (IADL’s) and Activities of Daily living (ADL’s).
51
A 78 year old woman is brought to see you after a fall. She tells you that she used to be steady on her feet but has now had 5 falls in the last month. You examine her and do not find any significant injuries. The most important thing you must now do is to;
a. An x-ray of her hips.
b. Treat her for osteoporosis.
c. Do a full assessment looking for the underlying cause of the falls.
d. Give her a walking stick.
c. Do a full assessment looking for the underlying cause of the falls.
52
A 70 year old man has had 2 falls. You find no cause for his falls. In order to assess his risk of falling again and therefore the need for intervention which of the following would be most useful and informative.
a. A neurological examination.
b. A CT scan of his head.
c. Sending an occupational therapist to his house to look for hazards in the house.
d. A get-up-and-go test.
d. A get-up-and-go test.
53
The reason that there is a decline in independence after most falls in the elderly is that;
a. The patients are frail.
b. There is back pain due to osteoporosis.
c. Even a minor fall causes a fear of falling and voluntary curtailment of activities.
d. There are injuries due to the fall.
c. Even a minor fall causes a fear of falling and voluntary curtailment of activities.
54
A 68 year old woman who has had 5 normal vaginal deliveries complains that she dribbles urine every time she coughs or sneezes. The most likely diagnosis is;
a. Detrusor muscle instability and urge incontinence
b. Functional incontinence.
c. Stress incontinence.
d. A urinary tract infection.
e. Overflow incontinence
c. Stress incontinence.
55
An 83 year old woman has, for a long time, had the problem that she has to rush to the toilet if she feels the urge to urinate other wise she wets herself before getting to the toilet. For the past week she has had the urge to urinate frequently, burning when she passes urine and is wetting herself before she gets to the toilet most of the time. Your assessment of the problem is most likely:
a. Stress incontinence with a urinary tract infection.
b. Overflow incontinence
c. Longstanding urge incontinence with a urinary tract infection .
d. Irritable bladder due to detrusor muscle instability
c. Longstanding urge incontinence with a urinary tract infection .
56
A 90 year old woman is severely demented and has been bed bound for some time. She is continent for faeces but had severe constipation. Her carer complains that for the last week she has been having frequent watery stools and that she is now incontinent of faeces. The most likely cause of the new incontinence is:
a. Faecal impaction with overflow incontinence
b. A neurological problem affecting the anal sphincter
c. An underlying medical problem which needs investigation
d. Infective diarrhoea.
a. Faecal impaction with overflow incontinence
57
Drugs with no abuse or addictive potential
Antipsychotic, Mood Stabilising and Antidepressant drugs have no abuse or addictive potential
58
Drugs having abuse or addictive potential
Sedative/Hypnotic drugs do have abuse and addictive potential
59
Antipsychotic drugs - mechanism
These drugs as a group block Dopamine receptors in the brain
The Typicals block Dopamine and the Atypicals block Dopamine and Seratonin
60
Typical antipsychotics (examples)
Chlorpromazine, Haloperidol and Trifluoperazine
61
Typical antipsychotics (side effects)
Dopamine is also needed for fluid movement of the body and as these drugs block dopamine it has unpleasant movement related side-effects
62
Atypicals (examples)
Risperidone, Clozapine and Olanzepine
63
Atypicals (side effects)
They have less movement side-effects but very concerning metabolic side-effects which can cause weight gain and its attendant problems
64
Clozapine - side effect
Clozapine has the potentially life-threatening side-effect of agranulocytosis, and thus those patients taking Clozapine require the regular monitoring of their white blood cell counts.
Agranulocytosis is a life-threatening blood disorder. It happens when the body doesn't make enough of a type of white blood cells called neutrophils.
65
Categories of mood stabilisers
Lithium and Anticonvulsant medications
66
Lithium side effects
Lithium has many side-effects like tremors, polyuria, acne, hypothyroidism and many more
It is also potentially lethal if the blood levels are above the normal therapeutic index
67
Anticonvulsants - potential harms
All the mood stabilisers have the potential of causing birth defects as they are teratogenic and must be used with caution in women of child-bearing age
68
Anticonvulsant drugs
Anticonvulsant drugs which are used to treat epilepsy, are also used to treat mood disorders
They work on neurotransmitters in the brain to effectively either increase inhibitory neurotransmission or decrease excitatory neuro-transmission
69
Anticonvulsant drugs (examples)
Carbamazepine, Sodium Valproate and Lamotrigine
70
Anticonvulsant drugs (side effects)
Their side-effects include sedation, pancreatitis, ataxia and skin reactions
71
Antidepressants - mechanism
They work by preventing the reuptake of monoamine neurotransmitters like noradrenaline and serotonin from the synapse
72
Tricyclic Antidepressants - examples
Amitryptiline, Imipramine and Clomipramine
73
Tricyclic Antidepressants - side effects
Their side-effects include weight gain and sedation and they are cardiotoxic and potentially lethal if taken in overdose
74
Monoamine Oxidase Inhibitors
Inhibits the enzyme irreversibly
Strict diet - metabolites tyramine
Tyramine is a potent vasopressor and a hypertensive crisis could develop with the risk of a stroke if it accumulates in the blood
75
SSRI
These drugs were developed to counter the cardiac side-effects of the tricyclic antidepressants
They prevent the reuptake of serotonin from the synapse
76
SSRI Examples
Fluoxetine(Prozac), Paroxetine, Citalopram and Sertraline
77
SSRI Side Effects
They are not lethal in overdose, but have their own side-effects like tremors, sleep disturbances and sexual difficulties
78
SNRI
These drugs prevent the reuptake of both Serotonin and Noradrenalin from the synapse
The drug Venlafaxine is an example from this group
79
Sedatives and Hypnotics
Addictive potential
In the past drugs like Barbiturates were used but now we largely use Benzodiazepines
80
Benzodiazepines
They have their own receptor in the brain and affect gamma-aminobutyric acid (GABA) transmission
These are drugs like Diazepam(Valium), Clonazepam and Lorazepam
They cause sedation and decrease anxiety
They are also used in anesthesia and to treat epilepsy
81
Non-Benzodiazepine sedative drugs
These drugs are called the Zdrugs
They also work on the benzodiazepine receptor in the brain
These are drugs like Zolpidem (Ambien) and Zopiclone
It is important to understand that all the hypnotic drugs have the potential to block memory consolidation and thus can have amnestic effects
82
Urge Incontinence
Uninhibited detrusor muscle contractions +/- irritation of bladder
Strong urge to void with urination before reaching toilet
83
Stress Incontinence
Weakness of pelvic floor muscles (external sphincter)
Leakage of urine with increased intra-abdominal pressure (cough, strain, laugh, exercise)
84
Overflow Incontinence
LMN/autonomic neuropathy OR physical obstruction of bladder outlet
Large bladder, incomplete emptying, dribbling, straining to urinate
85
Functional Incontinece
Physical, cognitive or psychiatric disability that prevents the person from getting to the toilet and undressed before bladder capacity is exceeded and urination occurs despite anatomically normal bladder and nervous innervation
86
Impairments
The abnormalities of body structure, organ or system function from any cause.
87
Disabilities
The consequences of impairments in terms of functional performance and activities by the individual; disabilities represent disturbances at the level of the individual
88
Handicaps
The disadvantages experienced by the individual as a result of impairments and disabilities; handicaps reflect the interaction with and adaptation to the environment or the individual’s surroundings.
89
ADLs
```
Basic self-care activities and include;
• Transferring from bed to chair to toilet/commode
• Walking on the flat
• Walking up or down stairs
• Continence
• Feeding oneself
• Grooming
• Bathing
• Dressing
```
90
ADLs measured by what index?
Barthel Index
91
IADLs
```
These are activities that are necessary to survive independently in the community such as;
• Managing finances and banking
• Transportation
• Shopping
• Cooking
• Housekeeping
• Gardening
• Maintaining social contact
• Pursuing hobbies or activities
```
92
IADLs measured by what index?
Lawton Scale
93
Agnosia
This is the inability to recognize objects despite adequate and intact vision (brain has forgotten what it is).
94
Apraxia
This is the inability to perform a learned motor action despite intact motor function (such as tying a shoelace, using a tooth brush or doing up buttons).
95
Weaknesses of MMSE
Does not test executive function
| Seven years of formal education required
96
Frailty
Frailty is a term used to describe older persons at increased risk of morbidity, dependence and mortality.
97
Four major factors leading to frailty
Sarcopenia
Cognitive Impairment
Malnutrition
Atherosclerosis
98
Frailty is due to reduced capacity in
i. Musculoskeletal function
ii. Aerobic capacity
iii. Cognitive and intergrative (balance and postural reflexes) neurological function
iv. Malnutrition
99
Frailty and falls - mechanism
Frail elderly people develop a typical wide based, shuffling gait where they are bent forward so have to lift the chin up. This leads to an abnormal centre of gravity and an increased risk of stumbling due to catching the forefoot on obstacles.
100
Delirum - DSMV definition
i. Disturbance of cosciousness
ii. Change in cognition
iii. Develops over a short period and fluctuates
iv. The disturbance is a caused by the direct physical consequence of a general medical condition
101
Spheres of cognitive function
Language
Memory
Apraxia
Executive Function
102
Causes of dementia
Alzheimers
Vascular
Infective - HIV, syphilis
Metabolics - hypothyroidism, B12 deficiency
Structural - frontal lobe tumour, normal pressure hydrocephalus
Lewy body dementia
Parkinsons with dementia
103
Normal pressure hydrocephalus presents with a triad of:
Confusion
Abnormal gait
Urinary incontinece
104
Lewy body dementia
Lewy body dementia has rapidly progressive cognitive decline with prominent executive and visuospatial deficits. It is recognized by rapid cognitive fluctuations like delirium and vivid visual hallucinations.
Neuroleptic antipsychotic drugs are contraindicated.
105
Fronto-temporal dementia
Fronto-temporal dementia leads to a lack of insight/judgement and disinhibition so they usually present with unacceptable social behaviours. They also have repetitive behaviours.
106
Treatment of depression
SSRI’s (serotonin reuptake inhibitors) are the agents of choice. Tricyclic antidepressants are contraindicated as they cause delirium and more rapid cognitive decline due to their anticholinergic effects.
107
Treatment for dementia
Cholinesterase Inhibitors - halts progression
| Memantine - no clinical proof
108
Nicotine
It acts directly on nicotinic cholinergic receptors
109
Caffeine
It is a stimulant which binds to adenosine receptors in the brain
It also prevents dopamine from being reabsorbed and thus induces that ‘feel good’ feeling
110
Cannabis
It has both sedative and stimulant properties
Its active metabolite is tetra hydroxy cannabinol (THC) and may act at endogenous THC receptors in the brain
111
Stimulants
Its major effect is to induce a feeling of euphoria
Examples of these drugs are Cocaine and Amphetamines
They both increase the central action of dopamine and both increase the central and peripheral action of noradrenaline
112
Alcohol
It initially causes disinhibition but is ultimately a central nervous system depressant
It is postulated that alcohol acts at a few different receptors which include opiod, GABA and glutamate receptors
113
Hallucinogens
Mediate their central action via dopamine and noradrenaline
Examples of these drugs are LSD, Psilocybin, MMDA ’Ecstacy’ and Magic Mushrooms
114
Benzodiazepines
It has its own receptor in the brain, and it is abused for it’s potential to cause feelings of calm
115
Sedative Hypnotics
Examples of these drugs are barbiturates (phenobarbital, secobarbital, amobarbital) and other substances such as chloral hydrate and meprobamate
In the South African context, Methaqualone (Mandrax) is abused
116
Opiates
These include natural substances like opium and morphine, semisynthetic drugs like heroin and hydromorphone and totally synthetic drugs like methadone
They act at specific opioid receptors in the brain and the body, as do the endogenous opioids (endorphins, enkephalins and dynorphins)
They induce intense feelings of euphoria
117
Hydrocarbons
These are inhaled and found in solvents(petrol), Toluene (paint and plastics), glue and other things like hairspray etc.
They produce a ‘giddy’ delirium
118
GHB (Gamma hydroxybutyrate)
It is a neurotransmitter that affects a variety of systems including sleep, memory and temperature regulation
It causes euphoria, disinhibition and increased libido
119
Phencyclidine (PCP) and Ketamine
These drugs were originally used in anesthesia and veterinary medicine
Ketamine is a derivative of phencyclidine and is a dissociative anesthetic which is sometimes abused by heath professionals with easy access
Phencyclidine can cause hallucinations and psychotic reactions
Phencyclidine is thought to work at glutamate receptors
