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addictions > midterm > Flashcards

midterm Flashcards

1
Q

psychoactive drug

A

substance that when ingested, alters mental processes such as cognition or affect

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2
Q

addiction

A

bio-psycho-social phenomenon, multi-faceted process of drug dependency

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3
Q

physical dependency

A

physiological state of cellular adaptation that occurs when the body becomes as accustomed to a drug that it can only function normally when the drug is present

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4
Q

psychological dependency

A

believing they can’t manage without the substance - may escalate to feelings of loss or desperation if the drug is unattainable

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5
Q

withdrawal

A

negative bodily reaction = physical disturbances or illness that occurs dueing the process of ceasing to take a drug

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6
Q

4 c’s of addiction

A

craving, compulsion, loss of control, use despite consequences

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7
Q

addiction means

A
  • change in level of functioning
  • interfereing with life, work, family
  • psychological consequences
  • increase use despite interference in life
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8
Q

american society of addiction medicine (asam) characterizes addiction w/ ABCDE

A
  • inability to abstain
  • impairment in behavioural control
  • craving
  • diminished recognition of sig problems with behaviours
  • dysfunctional emotional response
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9
Q

substance dependence

A

Chronic requirement for substance Cognitive and physical symptoms Evidence of tolerance Evidence of withdrawal syndrome

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10
Q

intoxication

A

the state in which the body is poisoned by alcohol or another substance and the person’s physical and mental control is significantly reduced

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11
Q

withdrawal state

A
  • sx occur when stop drugs
  • may have signs of physiological dependence
  • one indicator os SUD
  • onset & course r/t the drug
  • withdrawal features opposite of intoxication sx
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12
Q

nursing goal of withdrawal

A
  • safe withdrawal
  • pt be drug free
  • protect pt dignity
  • prepare pt for ongoing treatment & recovery
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13
Q

cross tolerance

A

tolerance for a substance one has not taken before as a result of using another substance similar to it

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14
Q

cross dependence

A

dependence on a drug can be relieved by other similar drugs

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15
Q

synergistic effect

A

interaction of two or more medicines that results in a greater effect than when the medicines are taken alone

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16
Q

paradoxical effect

A

the opposite of the intended drug response

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17
Q

rebound affect

A

form of withdrawal; paradoxical effects that occur when a drug has been eliminated from the body

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18
Q

delirium tremens

A

a disorder involving sudden and severe mental changes or seizures caused by abruptly stopping the use of alcohol (Very serious)

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19
Q

post acute withdrawal syndrome

A

cluster sx occuring for 1-2 weeks

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20
Q

teratogenic effect

A

Effect of a drug administered to the mother that results in abnormalities in the fetus.

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21
Q

REM rebound

A

the tendency for REM sleep to increase following REM sleep deprivation (created by repeated awakenings during REM sleep)

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22
Q

half life of drug

A

the time it takes for the amount of a drug’s active substance in your body to reduce by half

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23
Q

drug agonists

A

activates receptor site by being able to mimic or enhance the actions of a neurotransmitter (morphine)

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24
Q

antagonists

A

able to fit into the receptor site, without activating it (naloxone)

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25
Q

partial agonists

A

able to only weakly activate receptor sites, while preventing other drug molecules the opportunity to bind at that receptor site (suboxone)

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26
Q

neurotransmitters

A

chemicals found in hte brain that are used to relay, amplify, and modulate signals b/w a neuron & another cell

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27
Q

common neurotransmitters

A

dopamine, endocannabioids, endorphins, GABA, glutamate, norepinephrine, serotonin

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28
Q

tolerance

A

body’s adaption to presence of drug, resulting in loss of sensitivity to it; requires increased amounts to produce the same outcome as originally experienced

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29
Q

pharmacokinetics

A

deals with how psychoactive drug administered, absorbed, distributed, metabolized, elimiated

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30
Q

whats the fast route of admin

A

inhalation

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31
Q

bio theories mean

A

pre-existing or induced chemical, physiological, or structural abnormality is the cause of substance abuse

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32
Q

disease model

A

the belief that people abuse alcohol because of some biologically caused condition

  • firmly places substance use disorders as an illness
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33
Q

popularity of disease model

A
  • simple solution to complex problem
  • provides foundation for popular model of recovery: AA
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34
Q

Epigenetics

A

the study of environmental influences on gene expression that occur without a DNA change

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35
Q

Neurobiology of Addiction

A

-have a connection the the Ventral Tegmental area dopanergic responses and the Nucleus accumbens ?
-for reward response to food, water and sex usually but drugs lead to pleasurable responses as well

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36
Q

Behaviour/psychological model

A

This model focuses on the reinforcement and reward systems in the brain. Substance use is viewed as an adaptive strategy to seek balance and to respond to life stressors

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37
Q

Stress-Diathesis Model

A

Internal genetic predisposition and environmental factors play a role in risk for person to become addicted to a substance

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38
Q

Neurobiological model

A

Substances disrupt various parts of the mesolimbic dopamine system in the brain

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39
Q

ventral tegmental area

A

a group of dopamine-containing neurons located in the midbrain whose axons project to the forebrain, especially the nucleus accumbens and cortex

A.K.A the reward center

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40
Q

components of the VTA

A

Mesolimbic, hippocampus, amygdala

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41
Q

what is harm reduction

A
  • practical strategies aimed at reducing negative consequences associated with drug use
  • safer use, managed use, abstinence
  • meets ppl “where they’re at”
  • non-judgemental & non-coercive
  • strong commitment to public health & human rights
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42
Q

SAVE ME protocol

A

stimulate (911)
airway
ventilate
evaluate
medication
evaluate

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43
Q

examples of harm reduction

A

needle exchange, supervised injection site, methadone maintenance & treatment, suboxone, heroin assisted treatment, controlled drinking

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44
Q

general effects of cns depressants if large amounts are consumed

A

euphoria
relaxation
sedation
drowsiness
stupor
unconsciousness
coma

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45
Q

depressants produce a

A

reduction of arousal & activity in CNS; slowing metabolism & functioning of central & peripheral nervous system

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46
Q

depressants are used therapeutically as

A

anaesthetics, sleeping aids, anti-anxiety agents, sedatives

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47
Q

examples of depressants

A

barbiturates
non-barbiturate sedative hypnotics
benzodiazepines
antihistamines
solvants/inhalants
alcohol

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48
Q

all CNS depressants share same ….

A

mechanism GABA inhibitors

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49
Q

large doses of barbiturates lead to

A

impaired judgement
loss of coordination
delayed reaction time
slurred speech
decreased respiration
impaired short-term memory

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50
Q

do barbiturates disrupt REM sleep

A

TRUE

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51
Q

is physical or psychological dependence common in barbiturates

A

BOTH

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52
Q

benzos enhance

A

actions of GABA causing excessive, inhibitory influence on neurons

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53
Q

Barbiturates have greatest effect on

A

RAS & Medulla

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54
Q

Barbiturates have a ________ of causing overdose

A

High risk

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55
Q

Level of intoxication in barbiturates

A

Mild- Sedation, Moderate-Coma, Severe-Deep coma with absent gag reflex (shock or resp arrest)

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56
Q

barbiturates work on which neurotransmitter

A

GABA

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57
Q

medical uses for barbiturates

A

treating seizure disorder, neonatal withdrawal, insomnia, preoperative anxiety, and induction of coma for increased intracranial pressure. They are also useful for inducing anesthesia.

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58
Q

side effects of benzo

A

drowsiness.
light-headedness.
confusion.
unsteadiness (especially in older people, who may fall and experience injuries)
dizziness.
slurred speech.
muscle weakness.
memory problems.

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59
Q

Therapeutic Window/Index

A

measure of drug safety; relationship between beneficial and adverse effects (lithium has a small therapeutic window)

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60
Q

CIWA

A

Nausea, tremors, anxiety, agitation, sweats, headache, tactile visual or auditory hallucinations
EXAM

(0-7 for each)

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61
Q

Alcohol is considered ___ because it affects each and every organ

A

dirty

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62
Q

With the use of alchohol ________ the substance turns alchohol to ACETALDEYDE (this substance causes organ issues

A

Dehydrogenase

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63
Q

Alchohol _______ REM cycles

A

Decreases

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64
Q

MAOIs

A

antidepressants, happy pills (Cause lots of reactions)

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65
Q

How much alchohol is metabolized per hour?

A

15 cc’s

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66
Q

ALCOHOL USE DISORDER

A

(Function, tried to quit, binging, daily use)
Require use of alcohol to function
Make attempts to limit heavy alcohol use to a specific time with periods of abstinence
Engages in continuous binges lasting for days, weeks, or months interspaced with periods of abstinence
Engages in daily use of alcohol in excess of what is prudent for health or social norms.

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67
Q

Alchohol dehydrogenase are located in the ________

A

stomach

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68
Q

Acetaldehyde is then turned into

A

Aldehyde dehydrogenase

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69
Q

Signs and symptoms of Alchohol Withdrawal

A

Tremors, increased bp, insomnia, nausea, vomitting, psychomotor aggitation, seizure (tonic clonic)-DT concern & diaphoresis

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70
Q

Dt’s are most common in the first _______ hours

A

48-96

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71
Q

Wernicke’s syndrome

A

condition characterized by loss of memory and disorientation, associated with chronic alcohol intake and a diet deficient in thiamine. (reversible)
Thiamine deficiency

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72
Q

alcohol withdrawal syndrome occurs how long after cessation of alcohol?

A

6-24 hours

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73
Q

Phenobarbital (Luminal)

A

Antiseizure med. Precautions/interactions: contraindicated in history of substance use disorder. Side effects: drowsiness, hypotension, respiratory depression.

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74
Q

Side effects of benzodiazepines

A

Sedation, tolerance, dependence, respiratory depression

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75
Q

Benzodiazepines

A

Gold standard for treating withdrawal symptoms of alchohol dependency

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76
Q

Flumenazil

A

Benzodiazepine antagonist

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77
Q

rohypnol

A

“roofies”
memory blackouts & often loss of consciousness
inhibit movement & speech once ingested

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78
Q

inhalants

A
  • depressant & minor hallucinogenic effects
  • volatile gases, substances that exist in gases form at body temp
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79
Q

volatile substance abuse (VSA)

A

sniffing solvents contained in plastic model glues and nail polish removers

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80
Q

initial effect of inhalants

A

euphoria, light-headedness, excitation

other side effects: nausea, increased salivation, sneezing, coughing, loss of coordination, depressed reflexes, sensitivity

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81
Q

antihistamines therapeutic use

A

combat allergy sx
anti-nauseants
sleeping aid
anti-spasmodic
treat persons with excessive stomach acid

82
Q

antihistamines can be used as

A

mood-altering agents or to enhance the effects of other CNS depressants (abuse potential remains moderate)

83
Q

clinical triggers for alcohol

A

medical, mental, psychosocial

84
Q

biotransformation begins in the … by …

A

stomach by alcohol dehydrogenase

85
Q

alcohol dehydrogenase creates

A

acetaldehyde

86
Q

acetaldehyde is broken down by … to produce

A

aldehyde dehydrogenase = CO2, water & fatty acids

87
Q

physical complications of chronic AUD

A

hangover, liver, circulation, CNS, digestive system, sleep cycle, peripheral nervous system, emotions, respiratory, sexuality

88
Q

medical complications for AUD

A
  • cerebellar damage
  • vitamin deficiency
  • decrease brain size
  • alcohol induced dementia
  • wernicke’s syndrome
  • korsakoff’s syndrome
89
Q

sleep and AUD

A
  • decreases REM
  • decreases restful sleep
  • decrease melatonin production
  • insomnia
  • REM rebound-dreaming
90
Q

2 main complications of AUD

A

respiratory depression, aspiration pneumonia

91
Q

alcohol withdrawal sx

A
  • sweating
  • tachycardia
  • hand tremor
  • insomnia
  • nausea & vomiting
  • hallucinations
  • psychomotor agitation
  • seizures
92
Q

PAWSS

A
  • useful screening tool for predicting pts risk of developing severe complications from alcohol withdrawal
    (10 item)
  • can be used before pt stops using alcohol & on admission to detox/hospital
93
Q

CIWA

A

measures severity of alcohol withdrawal
- vomiting
- tremor
- sweating
- anxiety
- agitation
- hallucinations
- orientation or clouding
- hypertension
- tachycardia
- hyperthermia
- nausea
- anxiety
- headache

94
Q

What are some dangers of barbiturate drugs

A

Suicide risk. Very lethal in OD. Suppresses breathing

95
Q

What are benzodiazepines?

A

anti-anxiety medications used to treat depression, anxiety, and schizophrenia

96
Q

What do Benzodiazepines act on

A

Acts on the GABBA neurotransmitter

97
Q

What are some current medical uses of benzodiazepine drugs?​

A

Used in short term bases. Mixed with haldol to calm someone that is agitated.

98
Q

Benzos have a narrow therapeutic window

A

false

99
Q

Common side effects of benzos

A

Decrease in anxiety, speech slurring, decrease in blood pressure, dizziness, insomnia, decrease in REM sleep

100
Q

What are some neurocognitive impairment risks and symptoms of benzodiazepine drugs?​

A

Older pts are higher risk: signs and symptoms of dementia but not really dementia, falls risk, dizziness. Nothing longer than 2 wks for adults, very addictive, can cause tolerance right away.

101
Q

What are some dangers of mixing CNS depressants with alcohol?​

A

ODing mostly

102
Q

phenobarbital

A
  • seizure disorders
  • alcohol withdrawal syndrome
  • benzo withdrawal
  • CNS depressant
  • decrease neurotransmission in CNS
  • metabolized by liver
  • long half life = 2-6 days
103
Q

thiamine

A

assess in clients with alcohol related disorders
- anorexia
- irritable mood
- tachycardia
- muscle weakness
- memory loss
- wernicke’s syndrome

104
Q

benzos

A
  • gold standard in treatment for alcohol withdrawal & delirium tremens
  • all benzo effective in reducing alcohol withdrawal sx
  • effective in preventing seizures & DT
  • increased risk sedation, memory deficits, respiratory depression
105
Q

how must benzo be used to end up getting off them

A

taper method

106
Q

disulfiram (antabuse)

A
  • alcohol deterrent agent
  • inhibits aldehyde dehydrogenase that breaks down alcohol
  • build up of acetaldehyde = noxious reaction
  • occurs 5-10 mins of mixing alcohol
107
Q

disulfiram side effects

A
  • facial flushing
  • vasodilation
  • throbbing headache
  • sweating
  • dry mouth
  • palpitation
  • chest pain
  • dyspnea
  • hypertension
  • tachycardia
108
Q

Naltrexone

A

opioid antagonist-*is recommended for patients who have a goal of a reduction of alcohol consumption or abstinence.

109
Q

acamprosate (campral)

A
  • alcohol dependence treatment
  • decreases excitatory glutamate neurotransmission & increases GABA
  • side effects: diarrhea, nausea, anxiety & depression
  • not hepatically metabolized
110
Q

clonidine (adrenergic agonists)

A
  • suppress persistant noradrenergic sx like anxiety, hypertension, tachycardia not resolved with benzo or anticonvulsant
111
Q

what does clonidine not prevent

A

seizures or delirium tremens

112
Q

clonidine may cause what?

A

hypotension = BP must be measured and monitored regularly

113
Q

adults with moderate to severe alcohol use disorder 1st line treatment

A

naltrexone or acamprosate should be offered

114
Q

acamprosate is recommended for pts who

A

goal is abstinence

115
Q

pharmacology of narcotics

A
  • alters pain perception
  • mimics action of endogenous opioid peptides (endorphins)
  • anticonvulsant effect
  • effect BP, smooth muscle, cardiac rate, breathing
  • brain-reward mechanism (dopamine)
  • GABA activation
116
Q

many factors that increase vulnerability to addiction…

A

family history, trauma, early exposure, exposure to high risk environment, psychiatric disorders

117
Q

assessment of OUD

A
  • nursing assessment
  • psychiatric nursing treatment plans
  • history & psychiatric nursing diagnosis
  • substance use
  • compulsive behaviours
  • history of withdrawal attempts
  • treatment history
  • abstinence
118
Q

assessment tools for OUD

A
  • clinical opioid withdrawal scale (COWS)
  • subjective opioid withdrawal scale (SOWS)
119
Q

COWS

A

assess degree of withdrawal from opioids in order to determine readiness to be started on buprenorphine/naloxone

120
Q

SOWS

A

self-administered tool used to determine degree of opioid withdrawal for potential inductions of suboxone outside of a medical setting (individuals home)

121
Q

spectrum of treatments exist for OUD

A
  • withdrawal management alone
  • opioid agonists (suboxone, methadone)
  • 24 hr slow-release oral morphine
  • inject hydromorphone
  • psychosocial treatment interventions
  • residential treatment
  • harm reduction
122
Q

short-acting opioids withdrawal time

A
  • 12 to 16 hr since last dose
    (heroin, morphine)
123
Q

intermediate-acting opioids withdrawal time

A
  • 17 to 24 hrs since last dose
    (slow-release oral morphine)
124
Q

long-acting opioids withdrawal time

A
  • 24 to 48 hrs or more since last dose (methadone)
125
Q

clonidine for OUD

A
  • decreases sympathetic outflow in response to narcotic withdrawal
  • tachycardia
  • hypertension
  • sweating
  • pilo-erection
  • doesn’t decrease drug cravings
  • decreases physiological sx
  • taper
  • rebound syndrome
  • CAUSES HYPOTENSION
126
Q

methadone indications

A
  • metabolized by liver
  • once daily dose
  • half life is 25 hrs
  • single dose lasts for 24 hrs
  • blocks opioid receptors
  • decreases euphoria from opioid use
  • doesn’t block effect or cravings from other drugs (coke)
127
Q

whats the initial dose of methadone

A

30mg/day

128
Q

methadone safety

A
  • drug interactions, age, history of respiratory disease, other prescribed sedatives contribute to increased harm with methadone
  • tolerance is rapidly lost if doses are missed, or treatment is discontinued (3 days)
  • doses need to be adjusted or pt can suffer over sedation or respiratory depression
129
Q

naltrexone (revia)

A
  • reduces cravings
  • semi synthetic opioid antagonist
  • blocks opioid receptor sites
  • maintenance drug
  • opioid free 7-10 days before first dose
  • suicidial thoughts
  • caution with psych history
  • motivation important
130
Q

buprenorphine

A
  • partial agonist
  • long duration of action
  • indicated for opioid addiction
  • abuse potential
  • sedation
  • drowsiness
  • resp depression concern
131
Q

buprenorphine/naloxone

A
  • 4:1 ratio
  • SL route
  • naloxone component is induced only to prevent diversion & injection use
132
Q

why is naloxone included in the tablet?

A
  • only to prevent diversion and injection (has poor oral & SL bioavailability = not absorbed when tablet is taken as directed
  • if buprenorphine/naloxone is injected = naloxone component become active and results in rapid onset of withdrawal
133
Q

facts about suboxone

A
  • increased functional state
  • increased attendance at appointments
  • decrease drug use
  • increased work attendance
  • increase adherence to programs
  • decreased disease transmission
  • safer in OD
  • less euphoric, hypotension, resp depression, low sedation, decrease drug cravings
134
Q

opioids and benzos both

A

decrease respiratory drive & should not be co-precribed

135
Q

co-occurring substance use may include

A

various combos of legal, prescription, over the counter, and legal substances

136
Q

co-occurring substance use is associated with

A

younger age, lower educational attainment, lower socioeconomic status, childhood abuse, and males

137
Q

whats the most common diagnosis in those with multiple substance use disorders

A

alcohol use disorder

138
Q

concurrent use of sedatives is associated with

A

increased risk of respiratory depression, overdose, and death

139
Q

screening for co-occurring substance use disorders

A
  • ASSIST (clinician-performed screening tool to identify high risk substance use in adult pts)
  • TAPS (tobacco, alcohol, prescription medication, and other substance use tool)
  • AUDIT-C1 (alcohol screener used to identify hazardous drinking or an active alcohol use disorder)
140
Q

principles for treating co-occurring substance use disorders

A
  • treatment concurrently
  • severity of each substance should guide treatment
  • should be triaged according to which carriers highest risk of mortality (prioritize OUD over weed disorder)
  • safety should be prioritized!!!!
141
Q

examples of common presentations of co-occurring substances

A
  • benzo & opioids
  • cocaine & alcohol
  • opioids & alcohol
  • tobacco & other substances
142
Q

benzo use is associated with

A

higher risk of hep C, seroconversion, higher risk of HIV, increased risk of death

143
Q

what happens when alcohol and cocaine are combined?

A
  • cocaethylene formed
144
Q

what happens with cocaethylene

A
  • same pharmacologic action of cocaine & causes similar but more intense effects = increased heart rate, more euphoria, drug liking, and longer half life
145
Q

current smoking is associated with

A

increased alcohol consumption

146
Q

hallucinogens primarily effect

A

serotonin

147
Q

what neurotransmitter does cannabis work on

A

endocannabinoids (anandamide)

148
Q

LSD-like hallucinogens

A
  • indolealkylamines (similar to serotonin)
  • colourless, tasteless, odourless
  • semi synthetic
  • most powerful of all known hallucinogens
149
Q

initial effects of LSD hallucinogens are felt in & last for

A

less than an hour & last 8-12 hrs

150
Q

physical sx of LSD

A
  • increased heart rate & blood pressure
  • elevated body temperature
  • reduced appetite
  • nausea & vomiting
  • abdominal discomfort
  • rapid reflexes
  • motor incoordination
  • pupil dilation
151
Q

what is hallucinogen persisting perception disorder

A

flashbacks from the hallucination trip

152
Q

short term effects of psilocybin

A
  • increased BP, HR, temp
  • nausea & vomiting
  • cramping
  • hallucinations
  • distortions of time, space, body image
  • heightened sensory awareness
153
Q

psilocybin is one of several hallucinogens being

A

option to treat anxiety, cluster headaches, depression, addiction

154
Q

what is the only natural hallucinogen

A

mescaline (peyote)

155
Q

high doses of mescaline can cause

A
  • headache
  • hypotension
  • cardiac depression
  • slowing resp rate even tho has secondary stimulant properties
156
Q

what is mda

A

serotonin-releasing chemical related to mescaline & amphetamines

157
Q

what are the serious effects of mda

A

sizures, resp insufficiency due to spasms of chest muscles
- require immediate treatment as MDA-associated deaths or near-death is common

158
Q

MDMA is derived from

A

oil of sassafras & oil of nutmeg to suppress appetite

159
Q

MDMA effects

A

releases of serotonin, decreases activity in the amygdala, increases activity in prefrontal cortex

160
Q

chronic use of MDMA

A
  • teeth grinding
  • dehydration
  • anxiety
  • insomnia
  • fever
  • uncontrolled seizures
  • high BP
  • depression caused by sudden drop in serotonin levels
161
Q

phencyclidine

A

PCP
- produces hallucinogenic by blocking a specific neurochemical receptor site = pain perception, learning, memory, and emotion
- high doses = seizures, coma, resp depression

162
Q

ketamine

A

low doses produce delusions and mental confusion that progress into hallucinations and degrees of dissociation bordering on schizo-like state

163
Q

cannabis

A
  • low doses = altered perception
  • high dose = hallucinations
  • THC binds to THC receptors
164
Q

main psychoactive agent for cannabis

A

tetrahydrocannabinol

165
Q

key risk factors for developing cannabis disorder

A
  • younger age
  • male sex
  • deprived socioeconomic status
  • early onset of cannabis use
  • other substance use concerns
  • family history of substance use disorder
  • mental health disorders
166
Q

immediate physiological effects of MJ

A

tachycardia
- other effects:
(hypertension, bronchial relaxation, dry mouth, conjunctival injection, hunger)

167
Q

neurological & immune sx of MJ

A
  • reduction is size of hippocampus, brain volume
  • MJ triggered flashback
  • memory issues
  • suppresses REM & immune system
    (faster onset of sx in HIV pts)
168
Q

cancer, reproduction, circulation effects MJ

A
  • risk cancer mouth, tongue, throat, lungs (smoking)
  • higher risk of testicular cancer
  • reduced sperm count, low testosterone
  • cardiac arrythmias
  • MI risk
169
Q

cannabis hyperemesis syndrome

A

severe cyclic nausea and vomiting
- relief of sx with hot showers

170
Q

half life of infrequent use of MJ

A

1.3 days

171
Q

half life of frequent use of MJ

A

5-13 days due to absorption of THC in fat

172
Q

screening tool for cannabis disorder

A

CUDIT-R questionnaire (self-screening tool)

173
Q

amotivational syndrome

A

psychiatric disorder characterized by a variety of changes in personality, emotions and cognitive functions such as lack of activity, inward-turning, avolition, apathy, incoherence, blunted affect, inability to concentrate and memory disturbance.

174
Q

harm reduction for cannabis

A
  • delay starting cannabis
  • limit daily use
  • avoid smoking
  • limit the use of higher-potency products
  • don’t drive after consuming
  • some groups shouldn’t use (prego, heart disease, hx psychosis)
175
Q

stimulants produce

A

general increase in activity of cerebral cortex creating mood elevation, increased vigilance

176
Q

some stimulants are used as

A

appetite suppressants, decongestants, treat ADHD & produce changes through dopamine

177
Q

higher doses of stimulants produce

A

irritability, violent behaviour, spasms, convulsions

178
Q

all stimulants primarily act on

A

dopamine system & norepinephrine

179
Q

half life of cocaine

A

0.5-2.0 hrs

180
Q

half life ofmeth

A

10 hours = more efficient due to less frequent dosing requirements (ppl report transitioning from cocaine to meth)

181
Q

free basing

A

similar to crack, made with ether & ammonia rather than baking soda to convert cocaine into base

182
Q

cocaine and meth during urine drug testing

A
  • cocaine metabolized quickly = detectable for 3-5 days (this is highly specific = almost no false +)
  • meth = urine 3-5 days
183
Q

cocaine withdrawal

A
  • sx starting 90 mins after last dose
  • sx last for 7-10days
184
Q

withdrawal sx of cocaine

A

fatigue, depression, lethargy, irritability, cramps, dehydration

185
Q

ritalin works in … to improve …

A

RAS to improve concentration & focus

186
Q

atomoexetine

A

CNS stimulant for ADHD

187
Q

medical uses of amphetamines

A
  • improves action of smooth muscles
  • anorexic side effects
  • weight loss
  • treatment resistant depression
  • narcolepsy
  • ADHD
  • HIV disease
188
Q

withdrawal sx of amphetamines

A

fatigue, disrupted REM, irritability, strong hunger, abdominal & muscle cramps, apathy, violent behvaiours, depression

189
Q

nicotine in the brain

A

stimulants the release of dopamine in nucleus accumbens

190
Q

nicotine effects

A
  • increased HR BP
  • depresses spinal reflex
  • reduces msucle tone
  • decreases skin temp
  • increases acid in stomach
  • reduces urine formation
  • loss of appetite
  • increases adrenaline
191
Q

medical complications of nicotine

A
  • cancers
  • stroke
  • emphysema
  • bronchitis
  • heart disease
  • ulcers
  • wrinkles
192
Q

second hand smoke

A

composed of mainstream smoke that has been exhalaed and side stream smoke emitted from the tip of cig

193
Q

third hand smoke

A

tobacco smoke pollutants found in second hand smoke that have settled on surfaces of indoor space (clothes, walls)

194
Q

5 a’s for tobacco

A
  • ask about use
  • advise every user to quit
  • assess readiness to quit
  • assist pharmatherapy, counselling, help resources
  • arrange follow up or referral
195
Q

nicotine withdrawal sx

A

Having urges or cravings to smoke. …
Feeling irritated, grouchy, or upset. …
Feeling jumpy and restless. …
Having a hard time concentrating. …
Having trouble sleeping. …
Feeling hungrier or gaining weight. …
Feeling anxious, sad, or depressed.

196
Q

what are some common NRT

A

patch, gum, inhaler, nasal spray, lozenge

197
Q

nictone gum

A
  • absorb slowly from buccal
  • 24mg/day
  • give hourly - 2 hours
198
Q

side effects of NRT

A
  • skin reactions from patches
  • sleep disturbances = stimulant
  • heart palpitations
  • nausea & vomiting
  • GI complaints
  • mouth & throat pain
  • mouth ulcers
199
Q

zyban

A
  • blocks dopamine re-uptake
  • decreases nicotine
  • half life 14 hrs
  • contradindications (hx seizures, eating disorders, MAOI drug use)
200
Q

champix

A
  • blocks nicotine receptors
  • decreases physiological cravings for nicotine
201
Q

side effects champix

A
  • nausea
  • insomnia
  • constipation
  • GI problems
  • abnormal dreams

addictions (4 decks)

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