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First Aid 2014 > PSYCH 513 - 516 > Flashcards

PSYCH 513 - 516 Flashcards

1
Q

What is the primary characteristic in narcolepsy?

A

Excessive daytime sleepiness

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2
Q

What psychiatric diagnosis involves disordered regulation of sleep-wake cycles?

A

Narcolepsy

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3
Q

What hormone change drives narcolepsy?

A

Decreased orexin production in lateral hypothalamus

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4
Q

What are some associations with narcolepsy?

A
  1. Hallucinations - either hypnagogic or hypnopompic
  2. Nocturnal and narcoleptic sleep episodes that start off with REM sleep
  3. Cataplexy - loss of all muscle tone following a strong emotional stimulus, such as laughter
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5
Q

Is there a genetic component in narcolepsy?

A

STRONG genetic component

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6
Q

How do we treat narcolepsy?

A

Daytime stimulants (e.g. amphetamines, modafinil) and nighttime sodium oxybate (GHB)

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7
Q

Substance use disorder is defined as the maladaptive pattern of substance use marked by 2 or more of what signs within a year?

A

Mnemonic: SUBSTANCE

Social or interpersonal conflicts
Unsuccessful attempts to cut down
Broke (significant energy spent obtaining, using, or recovering from substance)
Still using despite knowing its problems, still using despite physically dangerous situations
Tolerance - need more to achieve same effect
Addicted - withdrawal symptoms
Nothing else (important social, occupational, or recreational activities reduced because of substance use; unable to fulfill major obligations
)
Craving
Excessive amounts

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8
Q

What are the 6 stages of change in overcoming substance addiction?

A
  1. Precontemplation
  2. Contemplation
  3. Preparation/determination
  4. Action/willpower
  5. Maintenance
  6. Relapse
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9
Q

What is the difference between precontemplation vs. contemplation?

A

Precontemplation - not yet acknowledging there is a problem

Contemplation - acknowledging there is a problem but not yet ready or willing to make a change

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10
Q

What is getting ready to change behavior called?

A

Preparation/determination

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11
Q

What is the stage of changing behaviors in overcoming substance addiction?

A

Action/willpower

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12
Q

What is maintenance?

A

Maintaining the behavior change

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13
Q

What is relapse?

A

Returning to old behaviors and abandoning new changes

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14
Q

Give 4 examples of classes of depressant psychoactive drugs.

A
  1. Alcohol
  2. Opioids
  3. Barbiturates
  4. Benzodiazepines
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15
Q

What are the nonspecific symptoms of depressant intoxification?

A

Elevated: Mood
Depressed: Anxiety, behavioral inhibition, respiratory, agitation (depressants cause sedation)

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16
Q

What are the general withdrawal symptoms of depressants?

A

Anxiety, tremor, seizures, insomnia

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17
Q

What are the intoxification symptoms seen with alcohol?

A 
Mnemonic: ALCOholS
Ataxia
Lability (emotional)
Coma
Out (blackout)
HOL
Slurred speech
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18
Q

What can severe alcohol withdrawal cause?

A

Autonomic hyperactivity and delirium tremens

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19
Q

How do we treat delirium tremens?

A

Benzodiazepines

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20
Q

What are intoxification effects of opioids?

A
  1. Depression of respiratory and CNS
  2. Euphoria
  3. Decreased gag reflex
  4. Pupillary constriction
  5. Seizures
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21
Q

How do we treat an opioid overdose?

A

Naloxone, naltrexone

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22
Q

What are withdrawal symptoms for opioids?

A

3 HEENT:

  1. Dilated pupils
  2. Rhinorrhea
  3. Yawning

3 Systemic:

  1. Fever
  2. Sweating
  3. Piloerection (goosebumps)

3 Stomach:

  1. Cramps
  2. Nausea
  3. Diarrhea
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23
Q

What do we use to treat opioid withdrawal?

A

Long-term support, methadone, buprenorphine

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24
Q

Compare and contrast toxicity of benzodiazepine vs. barbiturate intoxification.

A

Barbiturates - respiratory depression

Benzos - minor respiratory depression, ataxia

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25
Q

What are withdrawal symptoms for barbiturates?

A

Delirium, life-threatening cardiovascular collapse

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26
Q

Do barbiturates or benzodiazepines have a greater safety margin?

A

Benzodiazepines

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27
Q

What are symptoms of benzodiazepine withdrawal?

A

Sleep disturbance, depression, rebound anxiety, seizure

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28
Q

Give 4 examples of stimulant psychoactive drugs.

A
  1. Amphetamines
  2. Cocaine
  3. Caffeine
  4. Nicotine
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29
Q

What are the nonspecific intoxification effects for stimulant drugs?

A

Elevated: Mood, psychomotor agitation, cardiac arrythmias, heart rate (tachycardia), anxiety
Depressed: Sleep (insomnia)

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30
Q

What are the nonspecific symptoms of stimulant withdrawal?

A

Post-use “crash” - depression, lethargy, weight gain, headache

31
Q

What are the intoxification symptoms for amphetamines?

A

Mnemonic - AMPHETAMINE

Attention increase
Magnified self view (grandiosity)
Pupillary dilation
Hypertension
Euphoria
Tachycardia
Awake (prolonged wakefulness)
MI (cardiac arrest)
Increased temperature (fever)
Nervous (paranoia)
Eating less (anorexia
32
Q

What are the withdrawal symptoms for amphetamines?

A

Anhedonia, increased appetite, hypersomnolence, existential crisis

33
Q

What are the intoxification symptoms for cocaine?

A

Mnemonic: COCAINE

Cardiac death (sudden)
treat with benzOs
Creating things that aren't there (hallucinations)
Angina
Impaired judgment
Nervous (paranoia)
Eyes - pupillary dilation
34
Q

What are the withdrawal symptoms for cocaine?

A

Hypersomnolence, malaise, severe psychological craving, depression/suicidality

35
Q

What are the intoxification effects for caffeine?

A

Restlessness, increased diuresis, muscle twitching

36
Q

Patient drinks 3 cups of coffee every day and suddenly stops one day. What is he or she likely to experience?

A

Lack of concentration, headache

37
Q

What is the number on intoxification effect of nicotine?

A

Restlessness

38
Q

What are some symptoms that people who quit cigarettes might experience?

A

Nicotine withdrawal - irritability, anxiety, craving

39
Q

What are some possible treatments for someone trying to quit cigarettes (deal with nicotine withdrawal)?

A

Nicotine patches, gum, or lozenges

Bupropion/varenicline

40
Q

Give three examples of hallucinogens.

A

PCP, LSD, marijuana

41
Q

Of the three hallucinogens, which one is not associated with withdrawal symptoms?

A

LSD

42
Q

What are the intoxification symptoms of PCP?

A

Mnemonic: ANGEL DUST

Agitation (psychomotor)
Nystagmus
analGesia
Elevated temperature (fever)
Loud (belligerent)

Delirium
Unstable (homicidality, psychosis, impulsiveness)
Seizures
Tachycardia

43
Q

What are the withdrawal symptoms of PCP?

A

Depression, anxiety, irritability, restlessness, anergia, disturbances of thought and sleep

44
Q

What are the intoxification symptoms for marijuana?

A

Mnemonic: MARIJUANA

Mouth dry
Appetite increased
Red eyes (conjunctival injection)
Intense feelings of joy (euphoria)
Judgment impaired
Unstable (paranoid delusions, hallucinations)
Anxiety
No hurry (perception of slowed time)
Alone (social withdrawal)
45
Q

What are the withdrawal symptoms of marijuana?

A

Irritability, depression, insomnia, nausea, anorexia

46
Q

What is the prescription form of marijuana?

A

Dronabinol (tetrahydrocannabinol isomer)

47
Q

How do you treat ADHD?

A

Methylphenidate

48
Q

How do you treat alcohol withdrawal?

A

Benzodiazepines

49
Q

How do you treat anxiety?

A

SSRI’s, SNRI’s, buspirone

50
Q

How do you treat bipolar disorder?

A

Mood stabilizers (lithium, valproic acid, carbamazepine), atypical antipsychotics

51
Q

How do you treat bulimia?

A

SSRI’s

52
Q

How do you treat depression?

A

SSRI’s, SNRI’s, TCA’s, bupropion, mirtazapine (especially with insomnia)

53
Q

How do you treat OCD?

A

SSRI’s, clomipramine

54
Q

How do you treat panic disorder?

A

SSRI’s, venlafaxine (think hyperVENtilation), benzodiazepines

55
Q

How do you treat PTSD?

A

SSRI’s

56
Q

How do you treat schizophrenia?

A

Antipsychotics

57
Q

How do you treat social phobias?

A

SSRI’s, beta blockers

58
Q

How do you treat Tourette syndrome?

A

Antipsychotics (e.g. haloperidol, risperidone)

59
Q

What is a sensitive indicator of alcohol intoxification?

A

Serum gamma-glutamyltransferase (GGT)

60
Q

What do AST/ALT values look like when someone is alcohol-intoxicated?

A

AST twice the ALT

61
Q

What are CNS stimulants used to treat?

A

ADHD, narcolepsy, appetite control

62
Q

What is the mechanism of CNS stimulants?

A

Increase catecholamines at the synaptic cleft, especially norepinephrine and dopamine

63
Q

How do you treat intoxification of PCP?

A

Benzodiazepines, rapid-acting antipsychotic

64
Q

How do you treat benzodiazepine intoxification?

A

Flumazenil

65
Q

How do you treat cocaine intoxification?

A

Benzodiazepine

66
Q

Name 2 uses of dronabinol.

A
  1. Antiemetic (chemotherapy)

2. Appetite stimulant (AIDS)

67
Q

When do most withdrawal symptoms for marijuana peak?

A

48 hours, but last for 5-7 days

68
Q

How can marijuana use be detected?

A

Urine - for 4 to 10 days

69
Q

What are heroin users at increased risk for?

A 
Hepatitis
Enflamed anus (hemorrhoids)
Right-sided endocarditis
Overdose
Immunocompromise (AIDS)
Neutrophil-filled abscess
70
Q

What is a life-threatening alcohol withdrawal syndrome and when does it occur?

A

Delirium tremens - peaks 2 to 5 days after last drink

71
Q

How do we treat delirium tremens?

A

Benzodiazepines

72
Q

What are the symptoms in order of appearance of delirium tremens?

A

Autonomic system hyperactivity (tachycardia, tremors, anxiety, seizures)
Psychotic symptoms (hallucinations, delusions)
Confusion

73
Q

What are 3 treatments for heroin addiction?

A
  1. Methadone
  2. Naloxone + buprenorphine
  3. Naltrexone
74
Q

What is methadone?

A

Long-acting oral opiate used for heroin detoxification or long-term maintenance

First Aid 2014 (24 decks)

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