Mood Substance Abuse Flashcards
Addiction
overwhelming compulsion/repetitive drug-taking behavior despite consequences (health/social)
Substance Dependence
physical and psychological dependence
can’t stop taking a drug
increased levels of dopamine
^feelings of well/being, exhilaration/pleasure
dependence
body held in depressive state
(alcohol)
decreased GABA release
withdrawal/tolerance
NT Intoxication
^ GABA (sedation/loss of balance/no inhibitions)
^ Epinephrine (hypertension)
decreased L glutamic acid (memory disruption)
^ serotonin (sedation/euphoria)
^ dopamine (mood elevation)
NT Withdrawal
D GABA (anxiety/insomnia/seizures) ^ Epinephrine (htn, tachycardia) ^ glutamic acid (delirium/seizures) D Serotonin (insomnia, mood disorder) D Dopamine (dysphoria)
Addiction Agent/Drug Factors
cost availability dose mode of administration length of drug use
Impossible to predict
if a person will develop substance abuse
Alcohol withdrawal
onset manifestation 24- 72 hours after drinking cessation
Effects of alcohol
enhances GABA decreases Glutamate increases dopamine interrupts sleep liver failure hypoglycemia
Mild alcohol withdrawal
insomnia, irritability ha nausea
moderate alcohol withdrawal
tremors
ansiety insomnia nausea confusion sweating
severe alcohol withdrawal
uncontrollable shaking agitaiton vomiting sweating hallucinations seizures death
Alcohol Heavy use
chronic malnutrition
cancer
hormonal changes
brain tissue loss from alc0hol toxicity
organic brain syndrome
wernicke-korsakoff syndrome
chronic alocholism = thiamine deficiency = brain tissue ischemia/death
wernicke’s syndrome
acute confusion
ataxia
opthalmoplegia (weakness of eye muscles)
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
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
