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4th year psych > Psychoactive substances > Flashcards

Psychoactive substances Flashcards

1
Q

Amphetamines class

A

B

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2
Q

amphetamines mechanism

A

Stimulant, increases dopamine and noradrenaline

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3
Q

how amphetamines make you feel

A

Alert

Chatty and confident

Focused

Decreased appetite

Not sleepy

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4
Q

How do you take amphetamines

A

Sniff, smoke, swallow, inject

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5
Q

Injected drugs can be class B true or false?

A

False, injected class B drugs become class A

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6
Q

amphetamines effect on HR, BP, RR, temp, pupil size

A

all up

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7
Q

amphetamines come down

A

lethargy, exhaustion, anxiety, restlessness

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8
Q

amphetamines are similar to which prescribed drugs?

A

ADHD drugs (methylphenidate and modafinil)

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9
Q

SEs amphetamines

A

panic attacks

Depression

Agression

Paranoia

Psychosis incl hallucinations

Chronic sleep deprivation

Wt loss

Tremors

Seizures

Immune suppression

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10
Q

amphetamines physical or psychological dependence?

A

physical

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11
Q

Two drugs similar/related to amphetamines?

A

Meth and MDMA

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12
Q

How is meth different in its effects to amphetamines?

A

Reaches brain more easily and lasts longer- massive dopamine hit.

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13
Q

Meth side effects/risks

A

MI risk and damages cognition

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14
Q

MDMA has what additional effect on users?

A

Feeling of closeness to others (empathogen)

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15
Q

Risk of MDMA?

A

Dehydration/hyponatraemia

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16
Q

Cocaine class?

A

A

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17
Q

Cocaine mechanism

A

Reuptake inhibitor of dopamine, serotonin and noradrenaline

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18
Q

Cocaine effects?

A

Feeling of well being

Alert and confident

Increased energy

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19
Q

cocaine route

A

snort

ingest

smoke

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20
Q

cocaine SEs

A

Dry mouth

sweating

decreased appetite

Anxious

Panicky

hallucinations

vasoconstriction

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21
Q

cocaine effect on HR, BP, RR, pupils

A

All up

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22
Q

Risks of cocaine

A

Stroke, MI, cardiac arrest, bowel gangrene, ENT

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23
Q

Daily use of cocaine can lead to what effects?

A

restless

Insomnia and weight loss can ==> run down

‘wired’/paranoid

nausea

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24
Q

Cocaine withdrawal

A

Tired, panicky, exhausted, insomnia, extreme emotional and physical distress, anorexia, sweating

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25
Q

Opioids class

A

A/B

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26
Q

Are opiates legal?

A

Not unless prescribed

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27
Q

Opiates and driving?

A

Must inform DVLA

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28
Q

Opiate route

A

tab/syrup/smoke/snort/inject

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29
Q

Opiates effect on HR, RR, temp, pupils

A

All decrease

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30
Q

Opiate effect

A

feel happy, relaxed, euphoric, sleepy

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31
Q

SEs opiates

A

Constipation, nausea

Itching

lethargy

dizziness

Toxicity

If injecting- gangrene and clots

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32
Q

Signs of opiate toxicity

A

Resp. depression

Coma

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33
Q

Symptoms of opiate withdrawal in first 24-48hr

A

Craving, flu like sx, sweating, yawning

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34
Q

Symptoms of opiate withdrawal in first 7-10 days

A

Mydriasis, abdo cramps, diarrhoea, agitation, restlessness, piloerection, tachycardia

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35
Q

How long does an opiate detox take?

A

4-12w

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36
Q

First line drug for opiate detoxification?

A

Methadone or buprenorphine

37
Q

Methadone and buprenorphine for opiate detox are kinds of _____ therapy

A

Replacement

38
Q

How does replacement therapy work?

A

Allow patient to stabilise, decrease crime etc. Then move to withdrawal and then abstinence

39
Q

What is an alternative drug for opiate detox if it is a short detox or if abuse is mild or uncertain?

A

Lofexidine

40
Q

How does lofexidine help in opiate detox?

A

Relieves withdrawal sx

41
Q

What is the mechanism of methadone and buprenorphine

A

Opiate agonists

42
Q

Lofexidine can be used in combo with what?

A

Naltrexone- blocks euphoric effects but little effect on cravings

43
Q

Treatment for opiate overdose?

44
Q

Benzodiazepine class

45
Q

Benzo routes

A

tabs, inject, suppositories, melting down tabs to inject

46
Q

Why is melting down benzo tabs to inject dangerous

A

collapsed veins

Infection and abscess

47
Q

Benzos mechanism of action

A

increases GABA

48
Q

Benzo feeling

A

Calm, relaxed, sleepy

49
Q

Benzos are dangerous in combination with___ and ___

A

Alcohol

Other depressants

50
Q

Withdrawal Sx benzos

A

Decreased conc

Tremors

N&V

Headaches

Anxiety

Panic attacks

Depression

Seizures

51
Q

After only ___ weeks you can become addicted to benzos

52
Q

How do you detox from benzos?

A

Use a longer acting one e.g. diazepam

53
Q

Drug for diazepam OD?

A

Flumazenil

54
Q

Cannabis class

55
Q

cannabis effects

A

Euphoria, relaxation, hallucinations, increased appetite

56
Q

SEs cannabis

A

Conj irritation, low sperm, lung disease, flashbacks, transient psychosis, schizo, D&A, apathy, nausea

57
Q

Cannabis dependence- psychological or physical?

A

Psychological

58
Q

Ketamine class

59
Q

Ketamine mechanism

A

Unclear but antagonises NMDA receptors

60
Q

Ket routes

A

snort, inject, tablet, ‘bomb’

61
Q

Ket effects

A

Dream like, detached

Chill

Confused

Nausea

Dissociative

Analgesic

62
Q

What is a K hole

A

Mind and body separated out of control

63
Q

Why does ket present a risk of harm to the pts or others

A

Dissociative and analgesic

64
Q

SEs Ket

A

agitation

Panic attacks

memory damage short and long term

depression (if freq)

Bladder problems

65
Q

Alcohol withdrawal occurs after how many days abstinence

66
Q

1 unit of alcohol is equivalent to how much wine and beer

A

small glass wine, half pint beer

67
Q

alcohol withdrawal sx

A

anxiety, restless, insomnia

tremor

sweating

tachycardia

ataxia

pyrexia

hallucinations/illusions (usually visual)

Seizures

68
Q

What does delirium tremens signify

A

Severe withdrawal

69
Q

Alcohol withdrawal can lead to what? (pathway)

A

Thiamine deficiency –> mamillary body damage –> Wernicke’s enceph —>recover OR Korsakoff’s

70
Q

Sx wernickes

A

ataxia

nystagmus

ophthalmoplegia

acute confusion

71
Q

Sx korsakoffs

A

ST memory loss

Confabulation

72
Q

Repeated heavy drinking leads to what 4 things

A

40% risk temporary depressive episodes

Suicidal ideas and attempt

Severe anxiety

Insomnia

73
Q

Management of alcohol abuse

A

Aim for abstinence

Detox in hosp if risk of delirium tremens or withdrawal seizures

Often need initially high but rapidly tailing sedation- a benzo such as chlordiazepoxide to control symptoms and prevent seizures

Delirium tremens is treated with lorazepam or APs

Pabrinex for B vits and vit C injection

Psychosocial- AA, motivational interviews, psych therapies

74
Q

What meds can be used to maintain alcohol abstinence

A

Disulfiram- blocks alcohol metabolism –> flushing, headaches, anxiety, nausea

Acamprosate (acts on GABA) or naltrexone- opioid receptor antagonists which reduce cravings

75
Q

Possession of drugs can result in unlimited fine and what maximum prison sentence for each class?

A

A- 7

B-5

C-2

76
Q

Supply of drugs can result in unlimited fine and what maximum prison sentence for each class?

A

A- life

B- 14

C- 14

77
Q

What is an NPS

A

New psychoactive substance- similar to illegal drugs

78
Q

Are NPS illegal?

A

Supply, production etc is illegal since 2016, possession is not unless in an institution

79
Q

Which psychoactive substances are exempt?

A

Nicotine, alcohol, caffeine

80
Q

Drug dependence is having 3+ of what symptoms for at least 12m?

A
  1. Tolerance
  2. Withdrawal
  3. Using more/for longer than was intended
  4. Unsuccessful attempts to reduce use
  5. Large amounts of time spent seeking, using and recovering from use
  6. Drug taking is priority over social, work, recreational activities
  7. Persistent use despite harm
81
Q

Sections of an alcohol history

A
  1. CAGE
  2. details of intake
  3. impact on life incl crime
  4. thanks for sharing!
  5. PMH incl drink related e.g. pancreatitis, liver, ulcer
  6. DH incl rec drugs
  7. FH and any dependents at home
  8. Psych assessment- depression, self harm and harm to others screen
82
Q

Neurotransmitter in alcohol (or any depressive substance)

A

GABA agonist

83
Q

GHB/GBL mechanism

A

GABA agonist

84
Q

GHB/GBL effects

A

reduced inhibitions

euphoria

drowsiness

85
Q

Does ket have withdrawal sx?

86
Q

LSD mechanism

A

Dopamine agonist

87
Q

Mephedrone mechanism

A

Monoamine agonist/antagonist

88
Q

Psilocybin mushrooms mechanism

A

5HT partial agonist

89
Q

Mephedrone slang name?

4th year psych (15 decks)

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