PMHNP Certificate Study Addiction Flashcards
Addiction is believed to be the result of an entrenched neuronal system of chemical rewards caused by the release of
dopamine into the ventral tegmental area (VTA)
Persistent and increased use of a substance or behavior that, when discontinued, causes distress and an urge to resume use despite related adverse consequences; sometimes known as psychological dependence
Addiction
Repeated use of a substance for physical needs leading to increased tolerance, and, when discontinued, results in physical withdrawal symptoms.
Dependence
The use of any substance that deviates from approved social or medical practice.
Abuse
The learned behavior pattern characterized by enabling maladaptive coping motivated by fear of losing the relationship. Usually seen in the family members of an identified patient.
Codependence
The physiological process caused by a physical change in the body due to repeated exposure to a substance.
Neuroadaptation
The process by which one drug can be substituted for another drug producing the same physiological and psychological effect (e.g., benzodiazepine and phenobarbital).
Cross Tolerance
A substance-specific cluster of signs and symptoms that occurs when reducing or stopping the consistent use of the substance.
Withdrawal
The condition in which repeated administration of a dosage causes a decreased effect despite increasingly larger doses, which are required to obtain the effect observed of the original dosage.
Tolerance
The co-occurrence of a substance use disorder with a primary mood disorder.
Dual Diagnosis
Substance use disorder requires how many DSM V symptoms over how much time?
2 or more over 12 months
How is substance abuse positively reinforced?
dopamine mediated in the ventral tegmental area and nucleus accumbens in the brain.
How is substance abuse negatively reinforced
When they stop using it; GABA mediated response triggers symptoms of dysphoria and anxiety
Agitation, restlessness, irritability, grandiosity, elatedness, euphoria, aggression, lability may indicate use of
stimulants
Dysphoria, impaired attention, impaired memory, disinhibition, psychomotor retardation, paranoia may indicate use of
Depressants
Mood swings, panic, aggression, paranoia, flashbacks, tremors, impaired cognition may indicate use of
Hallocinagens
Paranoia, confusion, disorientation to time may indicate use of
Cannabis
Irritability, delirium, confusion, stupor may indicate use of
inhalants
Pinpoint pupils and or nystagmus indicate
Opioid use
What labs will likely be elevated with alcohol abuse?
AST, ALT, GGT, PT, Potassium, Cholesterol, Triglycerides, Amylase, Homocysteine
Would lab will likely be decreased with alcohol abuse?
sodium
What is legal intoxication of blood alcohol level?
0.08%
What is considered an impaired blood alcohol level?
0.08-0.4%
At what blood alcohol level is there a risk of death?
> 0.4%
Which type of withdrawals can be fatal?
Benzodiazepines and alcohol
should not be used until the patient has been alcohol free for at least 12 hours. The client should avoid any alcohol-containing products (mouthwash, cough medicine, vinegar, extracts) for up to 14 days after the last dose.
Disulfiram (Anatabuse)
Which medication Reverses opioid sedation?
Naloxone
Which medication is longer acting, reduces cravings, enhances abstinence efforts by blocking reward associated with substance?
Naltrexone
Which medication reduces opioid cravings, facilitates opioid detox, preferred for long-acting formulations
Buprenorphine
Which medication reduces cravings, facilitates opioid detox, preferred for short acting formulations
Buprenorphine/ naloxone
Which medication is long-acting opioid suppresses withdrawal, requires a government approved program
methadone
Which medication reduces alcohol cravings and promotes abstinence-reducing tolerance effects
Acamprosate
Which medication is aversive therapy when alcohol is consumed: vomiting, nausea, headache, flushing
Disulfiram
Which two antidepressants can be prescribed for substance use disorder?
citalopram and bupropion
Which Selective serotonin (5-HT3) antagonist can be prescribed to reduce cravings?
Ondansetron
The patient’s reaction to a lapse, if attributed to self-failure; negative emotions may follow. Alternatively, if the lapse is viewed as a learning opportunity relapse is less likely to occur and the likelihood of future relapse is reduced.
Abstinence violation effect
When is the most common time for drug and alcohol debut?
Adolesence
In the older adult with substance use disorder you may opt for what treatment over detox?
harm reduction strategy rather than total abstinence given the physiological strain of detox; requires
