Psychology #5

Question 1

What are symptoms of nicotine withdrawal?

Answer 1

-Restlessness, Anxiety, Increased appetite, headache, depression, weight gain

Question 2

How do you manage Nicotine dependence?

Answer 2

-Counseling, support therapy
-Nicotine tapering therapy: gum, patches, etc.
-Bupropion: dopamine and norepinephrine uptake inhibitor
-Varenicline: blocks nicotine receptors

Question 3

With varenicline, when should you start it and when should you discontinue it?

Answer 3

Start 1 week prior to quit date and continue 4 months after

Question 4

What are some side effects of Buproprion?

Start 1-2 weeks prior to quit date and continue 4-6 months after

Answer 4

Seizures (lowers threshold)
Weight loss, insomnia, hypertension, headache
Avoid abrupt withdrawal

Question 5

What are symptoms of opioid intoxication (Heroin, Codeine, Hydrocodone, Oxycodone)

Answer 5

-Euphoria and sedation
-Pupillary constriction, AMS
-Respiratory depression
-Biot’s Breathing: quick shallow –> apnea
-Bradycardia
-Hypotension

Question 6

Symptoms of opioid withdrawal

Answer 6

-Lacrimation
-Mydriasis
-Rhinorrhea
-Flu Like Symptoms
-Piloerections

Question 7

Management for opioid intoxication

Answer 7

-Naloxone

Question 8

Management for opioid withdrawal

Answer 8

-Clonidine
-Benzos for symptom control

Question 9

Methadone is used for opioid _______

Answer 9

dependence/long-term use

Question 10

Symptoms of LSD intoxication

Answer 10

-Visual hallucinations, synesthesias (seeing sound as color), pupillary dilation, delusions

Question 11

What are symptoms of stimulants/cocaine/amphetamine intoxication? (Ecstasy, Meth, Adderall, MDMA)

Answer 11

-Euphoric Mood, Pressured Speech, Aggression, Agitation

Question 12

Intoxication with Benzo’s has symptoms such as

Treatment?

Answer 12

-Depression, aggression, erratic behavior, ataxia

Flumenazil

Question 13

Marijuana binds to _____ and ___________.

Symptoms of intoxication include…

Answer 13

-CB1 and CB2 cannabinoid receptors

Euphoria, dry mouth, increased appetite, motor impairment
Conjunctivitis, tachycardia, hypotension

Question 14

What are some withdrawal symptoms of marijuana?

Answer 14

-Insomnia, irritability, depression, diarrhea

Question 15

Explain how cocaine works

What are symptoms of intoxication?

Answer 15

Stimulant effect via inhibition of reuptake of dopamine, norepinephrine, and epinephrine

Elevated/euphoric mood, pressured speech, n/v, seizures, increased motor activity, tremor, mydriasis, MI, stroke

Question 16

Treatment for cocaine intoxication

Answer 16

-Benzos for mild
-Severe or Psychosis: Antipsychotics
–No restraints–> rhabdomyolysis

Question 17

Symptoms of cocaine withdrawal

Answer 17

-Hypersomnia, anhedonia, depression, increased appetite, miosis (constriction), suicidal ideation

Question 18

PCP has a short onset (1-4 hours) and symptoms of intoxication include

Answer 18

-Impulsiveness, rage, hallucinations, multidirectional nystagmus, ataxia, dry skin

Question 19

What screening should be used for alcohol dependence? What’s considered positive?

Answer 19

CAGE
-Cutdown: ever felt the need to
-Annoyed: people told you they are
-Guilt: feel guilty
-Eye Opener

2 or more is positive

Question 20

Treatment for alcohol dependence

Answer 20

-Support groups
-Antabuse (Disulfiram)
-Naltrexone

Question 21

Explain how Antabuse (Disulfiram) works

Answer 21

-Inhibits aldehyde dehydrogenase (enzyme needed to metabolize alcohol) –> leads to hypotension, palpitations, headache, n/v when alcohol is ingested

Question 22

At what time frame do seizures start happening in alcohol withdrawal?

Answer 22

6-48 hours

Tonic Clonic, single brief episode

Question 23

Hallucinosis occurs how many hours after the last drink in alcohol withdrawal?

Answer 23

12-48 hours

Visual, auditory, and tactile
Clean sensorium and vital signs

Question 24

Delirium Tremens, occurs 2-5 days after the last drink, is…

Answer 24

Delirium, Abnormal vital signs, and hallucinations

“Something crawling on my skin”

Question 25

There are two other complications of alcohol withdrawal that can occur. Explain them.

-Wernicke Encephalopathy
-Korsakoff Syndrome

Answer 25

-Wernicke: ataxia + confusion + oculomotor palsy (due to B1 deficiency)

-Korsakoff: amnesia, hepatosplenomegaly, etc.

Question 26

Uncomplicated alcohol withdrawal can occur 6-36 hours after the last drink. What are some symptoms?

Answer 26

Increased CNS activity, tremors, anxiety, GI, HTN, palpitations

Question 27

Treatment for delirium tremens

Answer 27

Hospitalization (can be fatal)
IV Benzos
IVF, IV Thiamine (B1), Mg, B12, Folate, electrolytes