Psychology #5 Flashcards
What are symptoms of nicotine withdrawal?
-Restlessness, Anxiety, Increased appetite, headache, depression, weight gain
How do you manage Nicotine dependence?
-Counseling, support therapy
-Nicotine tapering therapy: gum, patches, etc.
-Bupropion: dopamine and norepinephrine uptake inhibitor
-Varenicline: blocks nicotine receptors
With varenicline, when should you start it and when should you discontinue it?
Start 1 week prior to quit date and continue 4 months after
What are some side effects of Buproprion?
Start 1-2 weeks prior to quit date and continue 4-6 months after
Seizures (lowers threshold)
Weight loss, insomnia, hypertension, headache
Avoid abrupt withdrawal
What are symptoms of opioid intoxication (Heroin, Codeine, Hydrocodone, Oxycodone)
-Euphoria and sedation
-Pupillary constriction, AMS
-Respiratory depression
-Biot’s Breathing: quick shallow –> apnea
-Bradycardia
-Hypotension
Symptoms of opioid withdrawal
-Lacrimation
-Mydriasis
-Rhinorrhea
-Flu Like Symptoms
-Piloerections
Management for opioid intoxication
-Naloxone
Management for opioid withdrawal
-Clonidine
-Benzos for symptom control
Methadone is used for opioid _______
dependence/long-term use
Symptoms of LSD intoxication
-Visual hallucinations, synesthesias (seeing sound as color), pupillary dilation, delusions
What are symptoms of stimulants/cocaine/amphetamine intoxication? (Ecstasy, Meth, Adderall, MDMA)
-Euphoric Mood, Pressured Speech, Aggression, Agitation
Intoxication with Benzo’s has symptoms such as
Treatment?
-Depression, aggression, erratic behavior, ataxia
Flumenazil
Marijuana binds to _____ and ___________.
Symptoms of intoxication include…
-CB1 and CB2 cannabinoid receptors
Euphoria, dry mouth, increased appetite, motor impairment
Conjunctivitis, tachycardia, hypotension
What are some withdrawal symptoms of marijuana?
-Insomnia, irritability, depression, diarrhea
Explain how cocaine works
What are symptoms of intoxication?
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
Treatment for cocaine intoxication
-Benzos for mild
-Severe or Psychosis: Antipsychotics
–No restraints–> rhabdomyolysis
Symptoms of cocaine withdrawal
-Hypersomnia, anhedonia, depression, increased appetite, miosis (constriction), suicidal ideation
PCP has a short onset (1-4 hours) and symptoms of intoxication include
-Impulsiveness, rage, hallucinations, multidirectional nystagmus, ataxia, dry skin
What screening should be used for alcohol dependence? What’s considered positive?
CAGE
-Cutdown: ever felt the need to
-Annoyed: people told you they are
-Guilt: feel guilty
-Eye Opener
2 or more is positive
Treatment for alcohol dependence
-Support groups
-Antabuse (Disulfiram)
-Naltrexone
Explain how Antabuse (Disulfiram) works
-Inhibits aldehyde dehydrogenase (enzyme needed to metabolize alcohol) –> leads to hypotension, palpitations, headache, n/v when alcohol is ingested
At what time frame do seizures start happening in alcohol withdrawal?
6-48 hours
Tonic Clonic, single brief episode
Hallucinosis occurs how many hours after the last drink in alcohol withdrawal?
12-48 hours
Visual, auditory, and tactile
Clean sensorium and vital signs
Delirium Tremens, occurs 2-5 days after the last drink, is…
Delirium, Abnormal vital signs, and hallucinations
“Something crawling on my skin”
There are two other complications of alcohol withdrawal that can occur. Explain them.
-Wernicke Encephalopathy
-Korsakoff Syndrome
-Wernicke: ataxia + confusion + oculomotor palsy (due to B1 deficiency)
-Korsakoff: amnesia, hepatosplenomegaly, etc.
Uncomplicated alcohol withdrawal can occur 6-36 hours after the last drink. What are some symptoms?
Increased CNS activity, tremors, anxiety, GI, HTN, palpitations
Treatment for delirium tremens
Hospitalization (can be fatal)
IV Benzos
IVF, IV Thiamine (B1), Mg, B12, Folate, electrolytes
