midterm from quizlet Flashcards
1
Q
substance dependence
A
Chronic requirement for substance Cognitive and physical symptoms Evidence of tolerance Evidence of withdrawal syndrome
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
3
Q
Withdrawl syndrome
A
symptoms that result when a patient discontinues taking a substance on which he or she was dependent
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
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)
6
Q
cross tolerance
A
tolerance for a substance one has not taken before as a result of using another substance similar to it
7
Q
cross dependence
A
dependence on a drug can be relieved by other similar drugs
8
Q
synergistic effect
A
interaction of two or more medicines that results in a greater effect than when the medicines are taken alone
9
Q
paradoxical effect
A
the opposite of the intended drug response
10
Q
rebound effect
A
form of withdrawal; paradoxical effects that occur when a drug has been eliminated from the body
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)
12
Q
teratogenic effect
A
Effect of a drug administered to the mother that results in abnormalities in the fetus.
13
Q
REM rebound
A
the tendency for REM sleep to increase following REM sleep deprivation (created by repeated awakenings during REM sleep)
14
Q
prime effects
A
what the drug is intended for
15
Q
side effects
A
reactions to medicine other than the one intended
16
Q
enteral route
A
movement of drugs from the outside of the body to the inside using the gastrointestinal tract
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
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
19
Q
4 C’s of addiction
A
cravings, compulsion, control (loss), consequences
20
Q
What state is a SUD?
A
Primary
21
Q
ABCDE
A
Abstain (can’t), Behavioural (impairment), Craving, Diminished (ability to see problems), Emotional (loosing touch)
22
Q
social use
A
the recreational use stage
23
Q
dependence
A
the condition that results when the brain develops a chemical need for a drug and cannot function normally without it
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
25
Epigenetics
the study of environmental influences on gene expression that occur without a DNA change
26
Behaviour/psychological model
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
27
Stress-Diathesis Model
Internal genetic predisposition and environmental factors play a role in risk for person to become addicted to a substance
28
Neurobiological model
Substances disrupt various parts of the mesolimbic dopamine system in the brain
29
ventral tegmental area
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
30
components of the VTA
Mesolimbic, hippocampus, amygdala
31
Biological differences theory
Way people metabolize drugs predisposes them, high alcohol dehydrogenase rapidly break down alcohol=increased alcohol use
32
Pharmacokinetics
what the body does to the drug
33
Pharmacodynamics
what the drug does to the body
34
cumulative effect
condition that occurs when the body cannot metabolize a drug before additional doses are administered
35
Post Acute Withdrawal Syndrome
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
36
Secondary effects
side effects; unwanted bodily responses
37
Biotransformation
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
38
Therapeutic half-life
time necessary for plasma concentration to be reduced halfway from peak value to minimum effective concentration
39
drug agonist
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!
40
Drug antagonist , ex?
drug that will cause a reaction not to occur or block a reaction from occurring
Narcan!
41
Partial agonist
Weak response in comparison to agonist when binding to receptor sites
Suboxone
42
metabolic tolerance
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
43
SAVE ME
Stimulate Airway Ventilate Evaluate Medication Evalute
44
Harm reduction
efforts to minimize the harmful effects caused by drug use
45
Carfentanyl
Opioid Agonist
100x more potent than Fentanyl
Can be put in aerosol
Dangers are it causes puking and respiratory depression
46
CIWA
Nausea, tremors, anxiety, agitation, sweats, headache, tactile visual or auditory hallucinations
EXAM
(0-7 for each) = alcohol
47
Alchohol is considered ___ because it affects each and every organ
Dirty
48
With the use of alchohol ________ the substance turns alchohol to ACETALDEYDE (this substance causes organ issues
Dehydrogenase
49
Alchohol _______ REM cycles
Decreases
50
MAOIs
antidepressants, happy pills (Cause lots of reactions)
51
How much alchohol is metabolized per hour?
15 cc's
52
ALCOHOL USE DISORDER
(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.
53
Alchohol dehydrogenase are located in the ________
stomach
54
Acetaldehyde is then turned into
Aldehyde dehydrogenase
55
Avitaminosis
A disease condition, described as a deficiency syndrome, resulting from lack of a vitamin.
56
Signs and symptoms of Alchohol Withdrawal
Tremors, increased bp, insomnia, nausea, vomitting, psychomotor aggitation, seizure (tonic clonic)-DT concern & diaphoresis
57
PAWSS
Withdrawal severity scale - do they need to go into unit for coming off of alchohol? More than 4 is serious
58
Coming off of alchohol increases _______ neurotransmitter
This causes : nightmares, diaphoresis, headaches
Glutimate
59
Dt's are most common in the first _______ hours
48-96
60
Wernicke's syndrome
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
61
Korsikoff's Syndrome
Thiamine deficiency from alchohol use- not reversible
62
Alchohol withdrawal syndrome occurs how long after cessation of alchohol?
6-24 hours
63
Phenobarbital (Luminal)
Antiseizure med. Precautions/interactions: contraindicated in history of substance use disorder. Side effects: drowsiness, hypotension, respiratory depression.
64
Side effects of benzodiazepines
Sedation, tolerance, dependence, respiratory depression
65
Benzodiazepines
Gold standard for treating withdrawal symptoms of alchohol dependency
66
Flumenazil
Benzodiazepine antagonist
67
Disulfiram
Used in tx of alcohol cessation.
Inhibits acetaldehyde dehydrogenase-->increased acetaldehyde when drinking (toxic)-->N/V-->incentive not to drink
Antibuse!
68
Naltrexone
opioid antagonist-*is recommended for patients who have a goal of a reduction of alcohol consumption or abstinence.
69
Acamprosate
Campral
Alcohol abstinence
GABA agonist and glutamate antagonist
70
Clonidine
Suppresses - anxiety, tachycardia, and hypertension associated with alchohol withdrawal
DOES NOT PREVENT DT'S
71
Barbiturates have greatest effect on
RAS & Medulla
72
Barbiturates have a ________ of causing overdose
High risk
73
Benzo's have a __________ of causing overdose
Low risk
74
Barbiturates
drugs that depress central nervous system activity, reducing anxiety - amytal, luminal
75
Level of intoxication in barbiturates
Mild- Sedation, Moderate-Coma, Severe-Deep coma with absent gag reflex (shock or resp arrest)
76
Benzodiazepines addiction components
Duration of use
Dose used
Half-life of BZ used
Individual expectations
77
Rohypnol (roofies)
date rape drug
78
Clinical Opiate Withdrawal Scale (COWS)
Clinically reliable tool for Opioid withdrawal DONE every 4 hours
79
What is an example of a Long acting opioid
Methadone
80
Short acting opioid
Heroin
81
SOWS
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
Suboxone
buprenorphine/naloxone
83
When will start to feel the withdrawal of long acting opioids
36-72 hours
84
Will start to feel the withdrawal of short acting opioids?
12-24 hours
85
protracted withdrawal
recurrence of withdrawal symptoms after a person has already detoxified, often causing craving for a drug which results in relapse
86
Methadone
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
Suboxone should be administered ______?
Sublingually
88
Alchohol in moderation has anticoagulation properties T/F
T
89
Alcohol decreases good cholesterol in moderation T/F
F
90
Alcohol will decrease BP by action on angiotensin T/F
False. Increases blood pressure
91
Person who starts drinking before age 14 or 15 has higher risk of AUD later in life T/F
T
92
Alcohol has a mild analgesic effect T/F
T
93
Alcohol does not cross the blood, brain barrier T/F
F
94
Pancreas is the major organ for alcohol biotransformation
False, it breaks down in liver
95
Mixing alcohol with food decreases absorption rate
T
96
What are barbiturates?
Old drugs with narrow therapeutic windows. Very addictive, very lethal
97
What are some medical uses for barbiturates
Detoxification, anticonvulsant
98
What are some subjective effects of barbituate drugs at normal levels
Decreases anxiety, induces sleep, groggy, dangerous w/65+ year olds. Blood pressure drop, dizziness, falls in older patients
99
What is the relationship of drug half-life and withdrawal syndrome
Depends on the drug
100
What are some dangers of barbiturate drugs
Suicide risk. Very lethal in OD. Suppresses breathing
101
What are benzodiazepines?
anti-anxiety medications used to treat depression, anxiety, and schizophrenia
102
What do Benzodiazepines act on
Acts on the GABA neurotransmitter
103
What are some current medical uses of benzodiazepine drugs?
Used in short term bases. Mixed with haldol to calm someone that is agitated.
104
Benzos have a narrow therapeutic window
F
105
Common side effects of benzos
Decrease in anxiety, speech slurring, decrease in blood pressure, dizziness, insomnia, decrease in REM sleep
106
What are some neurocognitive impairment risks and symptoms of benzodiazepine drugs?
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
What are some dangers of mixing CNS depressants with alcohol?
ODing mostly
108
T/F Barbiturate drugs speed up metabolism of antibiotics, oral contraceptives and anticoagulants.
What are some medical uses of barbiturate drugs?
T
109
T/F Barbiturates can worsen symptoms of ADHD.
T
110
T/F Barbiturates can only be administered orally.
F
111
T/F Barbiturate effect is similar to alcohol.
T
112
T/F Barbituates have a very high therapeutic window
F
113
T/F Barbiturates can be lethal in overdose.
T
114
T/F Barbiturate withdrawal is similar to alcohol withdrawal.
T
115
T/F Barbiturate drugs do not produce hangover effect.
F
116
T/F Benzodiazepines can cause death in overdose.
F
117
T/F There is no antidote for benzodiazepine drug overdose.
F
118
T/F Alcohol has a cross tolerance to benzodiazepines
T
119
T/F Benzodiazepines can induce sexual dysfunction in men and women.
T
120
T/F Benzodiazepines can increase REM sleep cycle.
T
121
T/F Benzodiazepines can cause hangover and blackouts similar to alcohol.
T
122
T/F Benzodiazepines can lead to cognitive impairment in older adults.
T
123
T/F Benzodiazepines with shorter half life have higher abuse potential
T
124
What is a concurrent disorder
Wherein an individual has both a mental disorder and a substance use disorder
125
How are concurrent disorders treated?
Through a integrated approach where both disorders are treated simultaneously
126
Can Benzos be mixed with heroin?
NO
127
Are methadone and alcohol synergistic?
NO
128
When one is overdosing on cocaine, what should be one of the first assessments done
Vital signs, particularly temperature as hyperthermia may cause seizures
129
Do drugs taken orally have a slower effect than those injected?
YES
130
CNS stimulant overdose signs
1. Agitation
2. Increased body temp
3. Hallucinations
4. Convulsions
131
opioid overdose
constricted pupils, clammy skin, nausea, drowsiness, resp depression
132
Signs of Marijuana Us
-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
Models of Addiction
1 moral model
2 Disease model
Persistent, chronic illness
3 Psychological and behavioural model
Reinforcement and reward systems.
4 Epigenetics model
134
Champix
(Varenicline) Smoking Cessation Aid
135
CNS stimulant complications
insomnia , restlessness
weight loss related to reduced appetite, growth suppression
dysrhythmias, chest pain, high BP
developed hallucinations and paranoia
136
Opioid withdrawal symptoms
agitation, insomnia, flu-like symptoms, yawning, sweating, diarrhea
137
CNS depressant withdrawal
treatment includes: benzos, thiamine
138
What are symptoms of caffeine intoxication
Intoxication restlessness, nervousness, excitement, insomnia, flushed face, diuresis, and GI complaints.
139
What are symptoms for caffeine withdrawa
headache, insomnia, abnormal dreams, drowsiness, fatigue, impaired psychomotor performance, difficulty concentrating, craving, yawning, and nausea.
140
What are some acute cannabis intoxication symptoms
motor impairment, loss of coordination and balance, and slowing of reaction time.
141
Cannabis withdrawal symptoms
Irritability, anger, aggression, anxiety, depression, insomnia, unusual dreams, restlessness, sweating, nausea, tachycardia, decreased appetite, weight loss.
142
What are some acute symptoms of hallucinogenic drugs
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
What are some acute short term and long-term effects of inhalant drugs
euphoria, sedation, emotional lability, and/or impaired judgment.
hearing loss, damage to the liver, kidney, lungs, heart, as well as bone marrow suppression.
144
What are the short term effects of opioid drug use
CNS depression, sleep/stupor, euphoria; analgesic properties can trigger addiction.
145
What are the long term effects of opioid drug use
dose-dependent sedation, fatigue, confusion, cognitive impairment, respiratory depression, as well as reproductive and endocrine effects.
146
What are some acute Opioid drug withdrawal symptoms?
Severe cravings, anxiety, dysphoria, nausea, vomiting, muscle aches, lacrimation/rhinorrhoea, papillary dilation, piloerection, sweating, diarrhoea, yawning, fever, and insomnia.
147
What are some acute intoxication symptoms of CNS stimulants
tachycardia, hypertension, dilated pupils and rise in body temperature.
148
What are some long-term effects of CNS stimulant drugs?
seizures, myocardial infarcts, and cerebrovascular accidents.
149
What are some CNS stimulant withdrawal symptoms
sleep disturbances with rebound REM, anergia, decreased libido, depression w/ suicidal tendencies, anhedonia, poor concentration, and cravings.
150
What are tobacco use disorders
The urge to smoke within minutes of waking, smoking at regular intervals throughout the day, and continuing to smoke despite wanting to quit
151
What are some tobacco withdrawal symptoms
cravings, irritability, restlessness, difficulty concentrating, depression, frustration, anxiety, insomnia, fatigue, and increased appetite.
152
What is considered binge drinking for men
When a man consumes 5 or more standard drinks, glasses of wine, or standard servings of beer ina 2 hr-period
153
What is considered binge drinking for women
When a woman consumes 4 or more standard drinks, glasses of wine, or standard servings of beerin a 2 hr-period
154
t/f Alcohol molecule is a simple molecule, soluble in lipids and water
T
155
T/F Majority of alcohol is absorbed through the small intestine
T
156
t/f Smokers are likely to die from heart disease than from lung disease
T
157
T/F Nicotine is absorbed more quickly from smoking tobacco than from chewing tobacco
T
158
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
F
159
T/F Clozapine levels are increased in smokers
F
160
T/F Nicotine stimulates the release of acetylcholine in the brain.
T
161
T/F Methadone dose increases tend to increase the craving for nicotine use in smokers
T
162
/F Tolerance to nicotine is lost overnight.
T
163
T/F Ritalin works in the RAS of the brain to improve concentration and focus
T
164
T/F Formication is sensation of bugs crawling on skin
T
165
T/F Ice is colorless, odorless concentrated form of methamphetamine
T
166
T/F Amphetamines are safe to use with MAOI drugs
F
167
T/F Amphetamines have an anorexic effect
T
168
What are some medical uses of cocaine in medical practice today?
Cocaine is used for its freezing and vasoconstricting properties
169
Why would someone use alcohol when also using coke?
Alcohol enhances the euphoric effect of cocaine & extends high
170
What are some complications of coke abuse on the CNS?
Gait and hypomania
171
What are some complications of the digestive system in chronic coke abusers?
Assess for constipation, diarrhea, nausea. Ulcer can also be a complication
172
T/F THC is not stored in body for long duration
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
T/F MJ use can increase lithium levels in the user.
T
174
T/F Marijuana has mild analgesic property.
T
175
T/F Tolerance to MJ develops rapidly
TT
176
What will you be assessing for in a chronic MJ user?
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
What are reproductive system complications of MJ abuse?
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
What are some common cardiovascular complications of chronic MJ use and abuse?
Cardiac arrhythmias, MI risk, 30-50% cardiac rate, decrease in strength of cardiac muscle contraction
179
What are some subjective factors that determine the effect of Opioids on a person?
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
T/F Opioids can be used for severe constipation.
False. Opioids cause constipation
181
T/F Opioid dependence can occur within few days of using the drug.
T
182
T/F People who take Opioid drugs without being in pain can become depressed.
F
183
T/F Opioids can be used to suppress cough
True, codeine is used to treat coughs
184
T/F Methadone OD can be fatal
T
185
T/F Long term methadone use has shown higher success rate in users
T
186
Is detox considered treatment?
no
187
Opioid history includes
Type, quantity, past overdoses, tolerance, signs and symptoms of withdrawal, last usage of opioid
188
Complications of Opioid use
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
