Mood Substance Abuse Flashcards by Marissa Robertson

Addiction

overwhelming compulsion/repetitive drug-taking behavior despite consequences (health/social)

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Substance Dependence

physical and psychological dependence

can’t stop taking a drug

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increased levels of dopamine

^feelings of well/being, exhilaration/pleasure

dependence

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body held in depressive state

(alcohol)
decreased GABA release
withdrawal/tolerance

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NT Intoxication

^ GABA (sedation/loss of balance/no inhibitions)
^ Epinephrine (hypertension)
decreased L glutamic acid (memory disruption)
^ serotonin (sedation/euphoria)
^ dopamine (mood elevation)

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NT Withdrawal

D GABA (anxiety/insomnia/seizures)
^ Epinephrine (htn, tachycardia)
^ glutamic acid (delirium/seizures)
D Serotonin (insomnia, mood disorder)
D Dopamine (dysphoria)

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Addiction Agent/Drug Factors

cost
availability
dose
mode of administration 
length of drug use

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Impossible to predict

if a person will develop substance abuse

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Alcohol withdrawal

onset manifestation 24- 72 hours after drinking cessation

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Effects of alcohol

enhances GABA
decreases Glutamate
increases dopamine
interrupts sleep
liver failure
hypoglycemia

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Mild alcohol withdrawal

insomnia, irritability ha nausea

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moderate alcohol withdrawal

tremors

ansiety insomnia nausea confusion sweating

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severe alcohol withdrawal

uncontrollable shaking
agitaiton
vomiting
sweating
hallucinations
seizures
death

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Alcohol Heavy use

chronic malnutrition
cancer
hormonal changes
brain tissue loss from alc0hol toxicity

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organic brain syndrome

wernicke-korsakoff syndrome

chronic alocholism = thiamine deficiency = brain tissue ischemia/death

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wernicke’s syndrome

acute confusion
ataxia
opthalmoplegia (weakness of eye muscles)

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korsakoff’s syndrome

amnesia
psychosis
confabulation (misinterpreted memories)

delirium tremens

long term alcohol use
hallucinations confusion disoreintation
medical emergency
peaks 24-48 hours

tx alcohol withdrawal

benzodiazepines (diazepam/lorazepam)

anti seizure meds

Disulfiram

aldehyde hydrogenase inhibitor

creates sickness if drinking alcohol

disulfiram se/bbw/contra/interx/preg

hepatitis, liver failure, optic neuritis, DISULFIRAM RXN: severe n/v, hypotension, palpitations, vertigo
never admin while intoxicated/without full knowledge
contra: metronidazole, psychoses, severe MI, coronary occlusion
interx: metronidazole, omeprazole (confusion), phenytoin (ataxia, hyperreflexia, nystagmus, tremors)
B

Nicotine Effects

activation specific areas of brain (visual attention/arousal/motor activation)
stimulation AND sedation
impaired reproductive health (miscarriage, bad for mom/baby)
tachycardia, htn, increased respiration
hoarse voice, stained nails/teeth

Nicotine withdrawal

irritability frustration anger
anxiety
difficulty concentrating
ha
increased appetite
restlessness
increased hr/bp
depressed mood
insomnia

tobacco cessation meds

buporpion

varenicline

smoking cessation agent | prevents nicotine from binding/acts as agonist

varenicline se/contra/interx

constipation, farting, nausea/vom, dream disorder, ha, insomnia serious se: angina, mi, cva, sleepwalking, vision changes, depression, hostile behavior, mood disorder, suicide ideation contra: history of hypersensitivty interx: amantadine, cimetidine, cisplatin, lamivudine, metformin, rantidine

cannabis withdrawal

cessation of frequent/prolonged cannabis usage >3 s/s over 1 week irritability restlessness, insomnia, tremors, chills, weight loss

cardiovascular consequences of cocaine

sns effects effect on cardiomyocytes vasculature effects

stimulant withdrawal

mental depression/anxiety | extreme fatigue/hunger

hallucinogens

all schedule 1 drugs (cannot be prescribed) rarely observed withdrawal psychological dependence but no physical though can develop tolerance

stimulant moa

cross blood brain barrier | rapid onset of effects

opioid withdrawal symptoms

``` serious bu tno life-threatening diaphoresis restlessness pinpoint pupils agitation goose pumps violent yawning orthostatic hypotension muscle spasms weight loss ```

naloxone/naltrexone

opioid antagonist | tx overdose of opiate

naloxone/naltrexone se/contra/interactions/preg

``` dizziness, irritated injection site, ha serious: cardiac arrest, htn, hypotension, tachycardia, v-fib, v-tach, coma, encephalopathy, seizure, pulmonary edema, abrupt opioid withdrawal contra: hypersensitivity to naloxone interx: w/ clonidine: htn caution with cardiotoxic drugs c ```

metadone

opioid maintenance therapy

metadonese/bbw/contra/interx/preg

hypotension, diaphoresis, constipation, n/v severe: prolonged qt, torsades, adrenal insufficiency, hypoglycemia, anaphylaxis, respiratory acidosis, respiratory arrest, drug dependence, serotonin syndrome bbw: serious arrhythmia, neonatal opioid withdrawal syndrome contra: acute bronchial asthma, paralytic ilius, GI obstruction, respiratory depression intx: QT prolonging meds c

Buprenorphine

tx opioid dependence | pain

Buprenorphine se/bbw/contra/interx

sweating, ab pain, constipation, n/v, ha, sedation, somnolence, vertigo, miosis severe: hypotension, mi, prolonged qt, adrenal insufficiency, hepatits, anaphylaxis, seizure, resp depression bbw: abuse/misuse can cause death/overdose contra: gi obstruction/resp depres/bronchial asthma interx: litium, amphetamines: serotonin syndrome meds w/ prolong qt interval

buprenorphine w/ naloxone

balances each other out reduces addiction hopefully initiates withdrawal if injected

buprenorphine w/ naloxone se/contra/interx

``` hyperhidrosis (diaphoresis) abdominal pain constipation ha insomnia drug withdrawal serious: hepatits, anaphylaxis, serotonin syndrome, cns depression contra: hypersensitivity to buprenorphine/naloxone inter: meds that prolong qt interval ```