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addictions > midterm from quizlet > Flashcards

midterm from quizlet Flashcards

1
Q

substance dependence

A

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

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2
Q

Pharmodynamics tolerance

A

Body’s ability to develop some degree of insensitivity to the drug’s effect so the body may continue to function normally

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3
Q

Withdrawl syndrome

A

symptoms that result when a patient discontinues taking a substance on which he or she was dependent

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4
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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5
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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6
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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7
Q

cross dependence

A

dependence on a drug can be relieved by other similar drugs

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8
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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9
Q

paradoxical effect

A

the opposite of the intended drug response

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10
Q

rebound effect

A

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

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11
Q

Alchohol Amnesic Disorder

A

Blackouts after a drinking episode Associated with higher risk of alcohol dependence
Amnesia for period before the drinking (can last hours to days)

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12
Q

teratogenic effect

A

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

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13
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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14
Q

prime effects

A

what the drug is intended for

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15
Q

side effects

A

reactions to medicine other than the one intended

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16
Q

enteral route

A

movement of drugs from the outside of the body to the inside using the gastrointestinal tract

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17
Q

Bioavailability

A

the rate at and the extent to which a nutrient is absorbed and used
Distribution-how chemical molecules are transported within the body

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18
Q

DSM-5 addiction

A

4 Categories
1) Craving
2)Activities are centred around substance
3)have tried to quit previously
4)Impaired control substance use

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19
Q

4 C’s of addiction

A

cravings, compulsion, control (loss), consequences

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20
Q

What state is a SUD?

A

Primary

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21
Q

ABCDE

A

Abstain (can’t), Behavioural (impairment), Craving, Diminished (ability to see problems), Emotional (loosing touch)

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22
Q

social use

A

the recreational use stage

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23
Q

dependence

A

the condition that results when the brain develops a chemical need for a drug and cannot function normally without it

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24
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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25
Q

Epigenetics

A

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

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26
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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27
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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28
Q

Neurobiological model

A

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

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29
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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30
Q

components of the VTA

A

Mesolimbic, hippocampus, amygdala

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31
Q

Biological differences theory

A

Way people metabolize drugs predisposes them, high alcohol dehydrogenase rapidly break down alcohol=increased alcohol use

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32
Q

Pharmacokinetics

A

what the body does to the drug

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33
Q

Pharmacodynamics

A

what the drug does to the body

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34
Q

cumulative effect

A

condition that occurs when the body cannot metabolize a drug before additional doses are administered

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35
Q

Post Acute Withdrawal Syndrome

A

PAW occurs because chronic drinkers body adapts over time to the effects of alcohol so that drinking ends up having normalizing effect on body. Can last up to three months after cessation of drinking and primarily affects higher level cognitive processes, resulting in impaired abstract thinking, concentration, memory, increased emotionality, overreaction to stress

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36
Q

Secondary effects

A

side effects; unwanted bodily responses

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37
Q

Biotransformation

A

the process in which enzymes convert a drug into a metabolite that is itself active, possibly in ways that are substantially different from the actions of the original substance *usually takes place in the liver

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38
Q

Therapeutic half-life

A

time necessary for plasma concentration to be reduced halfway from peak value to minimum effective concentration

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39
Q

drug agonist

A

a drug that will bind to a receptor on a cell and trigger a response by the cell, generally mimicking the response or action of a naturally occurring substance

Morphine!

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40
Q

Drug antagonist , ex?

A

drug that will cause a reaction not to occur or block a reaction from occurring
Narcan!

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41
Q

Partial agonist

A

Weak response in comparison to agonist when binding to receptor sites
Suboxone

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42
Q

metabolic tolerance

A

the form of drug tolerance that arises when repeated exposure to the drug causes the metabolic machinery of the body to become more efficient at clearing the drug

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43
Q

SAVE ME

A

Stimulate Airway Ventilate Evaluate Medication Evalute

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44
Q

Harm reduction

A

efforts to minimize the harmful effects caused by drug use

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45
Q

Carfentanyl

A

Opioid Agonist
100x more potent than Fentanyl
Can be put in aerosol
Dangers are it causes puking and respiratory depression

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46
Q

CIWA

A

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

(0-7 for each) = alcohol

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47
Q

Alchohol is considered ___ because it affects each and every organ

A

Dirty

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48
Q

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

A

Dehydrogenase

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49
Q

Alchohol _______ REM cycles

A

Decreases

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50
Q

MAOIs

A

antidepressants, happy pills (Cause lots of reactions)

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51
Q

How much alchohol is metabolized per hour?

A

15 cc’s

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52
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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53
Q

Alchohol dehydrogenase are located in the ________

A

stomach

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54
Q

Acetaldehyde is then turned into

A

Aldehyde dehydrogenase

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55
Q

Avitaminosis

A

A disease condition, described as a deficiency syndrome, resulting from lack of a vitamin.

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56
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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57
Q

PAWSS

A

Withdrawal severity scale - do they need to go into unit for coming off of alchohol? More than 4 is serious

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58
Q

Coming off of alchohol increases _______ neurotransmitter
This causes : nightmares, diaphoresis, headaches

A

Glutimate

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59
Q

Dt’s are most common in the first _______ hours

A

48-96

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60
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
Ataxia
Mental state changes
Nystagmus:is a vision condition in which the eyes make repetitive, uncontrolled movements.
Acute confusion
Fatigue
Thiamine deficiency rapid within 7 to 8 weeks of heavy drinking.
What is the difference between Wernikes and Korsakoff syndrome

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61
Q

Korsikoff’s Syndrome

A

Thiamine deficiency from alchohol use- not reversible

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62
Q

Alchohol withdrawal syndrome occurs how long after cessation of alchohol?

A

6-24 hours

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63
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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64
Q

Side effects of benzodiazepines

A

Sedation, tolerance, dependence, respiratory depression

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65
Q

Benzodiazepines

A

Gold standard for treating withdrawal symptoms of alchohol dependency

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66
Q

Flumenazil

A

Benzodiazepine antagonist

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67
Q

Disulfiram

A

Used in tx of alcohol cessation.

Inhibits acetaldehyde dehydrogenase–>increased acetaldehyde when drinking (toxic)–>N/V–>incentive not to drink
Antibuse!

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68
Q

Naltrexone

A

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

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69
Q

Acamprosate

A

Campral
Alcohol abstinence
GABA agonist and glutamate antagonist

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70
Q

Clonidine

A

Suppresses - anxiety, tachycardia, and hypertension associated with alchohol withdrawal
DOES NOT PREVENT DT’S

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71
Q

Barbiturates have greatest effect on

A

RAS & Medulla

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72
Q

Barbiturates have a ________ of causing overdose

A

High risk

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73
Q

Benzo’s have a __________ of causing overdose

A

Low risk

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74
Q

Barbiturates

A

drugs that depress central nervous system activity, reducing anxiety - amytal, luminal

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75
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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76
Q

Benzodiazepines addiction components

A

Duration of use
Dose used
Half-life of BZ used
Individual expectations

77
Q

Rohypnol (roofies)

A

date rape drug

78
Q

Clinical Opiate Withdrawal Scale (COWS)

A

Clinically reliable tool for Opioid withdrawal DONE every 4 hours

79
Q

What is an example of a Long acting opioid

A

Methadone

80
Q

Short acting opioid

A

Heroin

81
Q

SOWS

A

Self-administered tool used by patients to determine degree of opioid withdrawal for potential inductions of buprenorphine/naloxone outside of a medical setting, such as at an individual’s home.
(Subjective)

82
Q

Suboxone

A

buprenorphine/naloxone

83
Q

When will start to feel the withdrawal of long acting opioids

A

36-72 hours

84
Q

Will start to feel the withdrawal of short acting opioids?

A

12-24 hours

85
Q

protracted withdrawal

A

recurrence of withdrawal symptoms after a person has already detoxified, often causing craving for a drug which results in relapse

86
Q

Methadone

A

Synthetic opioid drug
Blocks opioid receptors in the brain
Decreases euphoria from opioid use
Does not block effect or cravings for other drugs such as cocaine or stimulants

87
Q

Suboxone should be administered ______?

A

Sublingually

88
Q

Alchohol in moderation has anticoagulation properties T/F

A

T

89
Q

Alcohol decreases good cholesterol in moderation​ T/F

A

F

90
Q

Alcohol will decrease BP by action on angiotensin T/F

A

False. Increases blood pressure

91
Q

Person who starts drinking before age 14 or 15 has higher risk of AUD later in life T/F

A

T

92
Q

Alcohol has a mild analgesic effect T/F

A

T

93
Q

Alcohol does not cross the blood, brain barrier T/F

A

F

94
Q

Pancreas is the major organ for alcohol biotransformation

A

False, it breaks down in liver

95
Q

Mixing alcohol with food decreases absorption rate

A

T

96
Q

What are barbiturates?

A

Old drugs with narrow therapeutic windows. Very addictive, very lethal

97
Q

What are some medical uses for barbiturates

A

Detoxification, anticonvulsant

98
Q

What are some subjective effects of barbituate drugs at normal levels

A

Decreases anxiety, induces sleep, groggy, dangerous w/65+ year olds. Blood pressure drop, dizziness, falls in older patients

99
Q

What is the relationship of drug half-life and withdrawal syndrome

A

Depends on the drug

100
Q

What are some dangers of barbiturate drugs

A

Suicide risk. Very lethal in OD. Suppresses breathing

101
Q

What are benzodiazepines?

A

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

102
Q

What do Benzodiazepines act on

A

Acts on the GABA neurotransmitter

103
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.

104
Q

Benzos have a narrow therapeutic window

A

F

105
Q

Common side effects of benzos

A

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

106
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.

107
Q

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

A

ODing mostly

108
Q

T/F Barbiturate drugs speed up metabolism of antibiotics, oral contraceptives and anticoagulants.​
What are some medical uses of barbiturate drugs?​

A

T

109
Q

T/F Barbiturates can worsen symptoms of ADHD.​

A

T

110
Q

T/F Barbiturates can only be administered orally.​

A

F

111
Q

T/F Barbiturate effect is similar to alcohol.​

A

T

112
Q

T/F Barbituates have a very high therapeutic window

A

F

113
Q

T/F Barbiturates can be lethal in overdose.

A

T

114
Q

T/F Barbiturate withdrawal is similar to alcohol withdrawal.​

A

T

115
Q

T/F Barbiturate drugs do not produce hangover effect.​

A

F

116
Q

T/F Benzodiazepines can cause death in overdose.​

A

F

117
Q

T/F There is no antidote for benzodiazepine drug overdose.​

A

F

118
Q

T/F Alcohol has a cross tolerance to benzodiazepines

A

T

119
Q

T/F Benzodiazepines can induce sexual dysfunction in men and women.​

A

T

120
Q

T/F Benzodiazepines can increase REM sleep cycle.​

A

T

121
Q

T/F Benzodiazepines can cause hangover and blackouts similar to alcohol.​

A

T

122
Q

T/F Benzodiazepines can lead to cognitive impairment in older adults.​

A

T

123
Q

T/F Benzodiazepines with shorter half life have higher abuse potential​

A

T

124
Q

What is a concurrent disorder

A

Wherein an individual has both a mental disorder and a substance use disorder

125
Q

How are concurrent disorders treated?

A

Through a integrated approach where both disorders are treated simultaneously

126
Q

Can Benzos be mixed with heroin?

A

NO

127
Q

Are methadone and alcohol synergistic?

A

NO

128
Q

When one is overdosing on cocaine, what should be one of the first assessments done

A

Vital signs, particularly temperature as hyperthermia may cause seizures

129
Q

Do drugs taken orally have a slower effect than those injected?

A

YES

130
Q

CNS stimulant overdose signs

A
  1. Agitation
  2. Increased body temp
  3. Hallucinations
  4. Convulsions
131
Q

opioid overdose

A

constricted pupils, clammy skin, nausea, drowsiness, resp depression

132
Q

Signs of Marijuana Us

A

-mild euphoria
-relaxation
-decreased concentration
-lack of motivation
-sensation of time passing slowly
-short term memory impairment
-inhibitions lessen
-audio/visual sensations may be enhanced

133
Q

Models of Addiction

A

1 moral model

2 Disease model
Persistent, chronic illness

3 Psychological and behavioural model
Reinforcement and reward systems.

4 Epigenetics model

134
Q

Champix

A

(Varenicline) Smoking Cessation Aid

135
Q

CNS stimulant complications

A

insomnia , restlessness
weight loss related to reduced appetite, growth suppression
dysrhythmias, chest pain, high BP
developed hallucinations and paranoia

136
Q

Opioid withdrawal symptoms

A

agitation, insomnia, flu-like symptoms, yawning, sweating, diarrhea

137
Q

CNS depressant withdrawal

A

treatment includes: benzos, thiamine

138
Q

What are symptoms of caffeine intoxication

A

Intoxication restlessness, nervousness, excitement, insomnia, flushed face, diuresis, and GI complaints.

139
Q

What are symptoms for caffeine withdrawa

A

headache, insomnia, abnormal dreams, drowsiness, fatigue, impaired psychomotor performance, difficulty concentrating, craving, yawning, and nausea.

140
Q

What are some acute cannabis intoxication symptoms

A

motor impairment, loss of coordination and balance, and slowing of reaction time.

141
Q

Cannabis withdrawal symptoms

A

Irritability, anger, aggression, anxiety, depression, insomnia, unusual dreams, restlessness, sweating, nausea, tachycardia, decreased appetite, weight loss.

142
Q

What are some acute symptoms of hallucinogenic drugs

A

induce visual, auditory, gustatory, tactile, and olfactory hallucinations in addition to euphoria/dysphoria, altered body image, distorted sensory perceptions, confusion, incoordination, and impaired judgment and memor

143
Q

What are some acute short term and long-term effects of inhalant drugs

A

euphoria, sedation, emotional lability, and/or impaired judgment.

hearing loss, damage to the liver, kidney, lungs, heart, as well as bone marrow suppression.

144
Q

What are the short term effects of opioid drug use

A

CNS depression, sleep/stupor, euphoria; analgesic properties can trigger addiction.

145
Q

What are the long term effects of opioid drug use

A

dose-dependent sedation, fatigue, confusion, cognitive impairment, respiratory depression, as well as reproductive and endocrine effects.

146
Q

What are some acute Opioid drug withdrawal symptoms?

A

Severe cravings, anxiety, dysphoria, nausea, vomiting, muscle aches, lacrimation/rhinorrhoea, papillary dilation, piloerection, sweating, diarrhoea, yawning, fever, and insomnia.

147
Q

What are some acute intoxication symptoms of CNS stimulants

A

tachycardia, hypertension, dilated pupils and rise in body temperature.

148
Q

What are some long-term effects of CNS stimulant drugs?

A

seizures, myocardial infarcts, and cerebrovascular accidents.

149
Q

What are some CNS stimulant withdrawal symptoms

A

sleep disturbances with rebound REM, anergia, decreased libido, depression w/ suicidal tendencies, anhedonia, poor concentration, and cravings.

150
Q

What are tobacco use disorders

A

The urge to smoke within minutes of waking, smoking at regular intervals throughout the day, and continuing to smoke despite wanting to quit

151
Q

What are some tobacco withdrawal symptoms

A

cravings, irritability, restlessness, difficulty concentrating, depression, frustration, anxiety, insomnia, fatigue, and increased appetite.

152
Q

What is considered binge drinking for men

A

When a man consumes 5 or more standard drinks, glasses of wine, or standard servings of beer ina 2 hr-period

153
Q

What is considered binge drinking for women

A

When a woman consumes 4 or more standard drinks, glasses of wine, or standard servings of beerin a 2 hr-period

154
Q

t/f Alcohol molecule is a simple molecule, soluble in lipids and water

A

T

155
Q

T/F Majority of alcohol is absorbed through the small intestine

A

T

156
Q

t/f Smokers are likely to die from heart disease than from lung disease

A

T

157
Q

T/F Nicotine is absorbed more quickly from smoking tobacco than from chewing tobacco

A

T

158
Q

T/F Cigar smoke is safer than cigarettes as it contains lower amount of ammonia.​Female smokers on BCP are at lower risk of MI and strokes

A

F

159
Q

T/F Clozapine levels are increased in smokers

A

F

160
Q

T/F Nicotine stimulates the release of acetylcholine in the brain.

A

T

161
Q

T/F Methadone dose increases tend to increase the craving for nicotine use in smokers

A

T

162
Q

/F Tolerance to nicotine is lost overnight.

A

T

163
Q

T/F Ritalin works in the RAS of the brain to improve concentration and focus

A

T

164
Q

T/F Formication is sensation of bugs crawling on skin

A

T

165
Q

T/F Ice is colorless, odorless concentrated form of methamphetamine

A

T

166
Q

T/F Amphetamines are safe to use with MAOI drugs

A

F

167
Q

T/F Amphetamines have an anorexic effect

A

T

168
Q

What are some medical uses of cocaine in medical practice today?

A

Cocaine is used for its freezing and vasoconstricting properties

169
Q

Why would someone use alcohol when also using coke?

A

Alcohol enhances the euphoric effect of cocaine & extends high

170
Q

What are some complications of coke abuse on the CNS?

A

Gait and hypomania

171
Q

What are some complications of the digestive system in chronic coke abusers?

A

Assess for constipation, diarrhea, nausea. Ulcer can also be a complication

172
Q

T/F THC is not stored in body for long duration

A

False. Infrequent users have THC in their urine for 72-96 hours after last use, but chronic usershave THC for about 30 days in their urine.

173
Q

T/F MJ use can increase lithium levels in the user.

A

T

174
Q

T/F Marijuana has mild analgesic property.

A

T

175
Q

T/F Tolerance to MJ develops rapidly

A

TT

176
Q

What will you be assessing for in a chronic MJ user?

A

Check airway patency if there are any obstructions or any secretions present in all lobes. For chronic users, assess for any abnormal consistency, colour, volume of their expectorates.

177
Q

What are reproductive system complications of MJ abuse?

A

Reduced sperm count, low testosterone levels, small testicular size for males. Females on theother hand have menstrual abnormalities and failure to ovulate. Women who wish to conceive areasked to abstain from marijuana

178
Q

What are some common cardiovascular complications of chronic MJ use and abuse?

A

Cardiac arrhythmias, MI risk, 30-50% cardiac rate, decrease in strength of cardiac muscle contraction

179
Q

What are some subjective factors that determine the effect of Opioids on a person?

A

The route of administration
the interval between doses
the actual dose of the medication being used
the half-life of the medication being used
the individual’s anxiety level
their expectations for the medication
the length of time that s/he has been used a given narcotic analgesic
the individual’s expectations for the medication’s effects
the individual’s biochemistry.

180
Q

T/F Opioids can be used for severe constipation.

A

False. Opioids cause constipation

181
Q

T/F Opioid dependence can occur within few days of using the drug.

A

T

182
Q

T/F People who take Opioid drugs without being in pain can become depressed.

A

F

183
Q

T/F Opioids can be used to suppress cough

A

True, codeine is used to treat coughs

184
Q

T/F Methadone OD can be fatal

A

T

185
Q

T/F Long term methadone use has shown higher success rate in users

A

T

186
Q

Is detox considered treatment?

A

no

187
Q

Opioid history includes

A

Type, quantity, past overdoses, tolerance, signs and symptoms of withdrawal, last usage of opioid

188
Q

Complications of Opioid use

A

General vulnerability - Strongly dependent on genetics and environment

Pupillary constriction - Occurs even in the dark

Respiratory depression - Makes brain-stem less responsive to present Co2

Nausea / vomitting

Increase in blood pressure

addictions (4 decks)

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