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Pathopharm: NAT > substance abuse > Flashcards

substance abuse Flashcards

1
Q

what are factors that contrite to drug abuse

A

reinforcing properties: some drugs work on pleasure receptors, physical + psychologic dependence, availability

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2
Q

what is the neurobiology of addiction

A

molecular changes in the brain lead to addiction, main NT is dopamine

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3
Q

when using therapy what percent of people can reduce drug use

A

40-60%

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4
Q

what is difficult for opioid, cigarettes and alcohol abuse

A

sustained moderation

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5
Q

what is the ideal goal of treatment fir drug use

A

complete cessation

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6
Q

what is the most used and abused psychoactive agent in the US

A

alcohol

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7
Q

what happens when people use moderate consumption of alcohol

A

prolongs life, reduces dementia risk and cardiovascular disorders

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8
Q

what happens when people use excessive consumption of alcohol

A

diminishes quality and quantity of life

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9
Q

what happens to the CNS because of alcohol

A

depression of function

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10
Q

what are the two chronic effects of alcohol

A

wernickes encephalopathy and Korsakoff’s psychosis

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11
Q

what is wernickes encephalopathy

A

confusion, nystagmus, abnormal ocular movements

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12
Q

is wernickes encephalopathy reversible

A

yes, with thiamin

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13
Q

what is Korsakoff’s psychosis

A

neuropathic, can’t convert short term memories to long term, fills memories with fabricated things

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14
Q

is Korsakoff’s psychosis reversible

A

NO, neuropathy and confusion

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15
Q

what effect does alcohol have on the cardiovascular system

A

direct damage to myocardium

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16
Q

what effect does alcohol have on respirations

A

respiratory depression

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17
Q

what effect does alcohol have on liver

A

non viral hepatitis–> precursor to cirrhosis

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18
Q

what effect does alcohol have on stomach

A

erosive gastritis–> stomach ulcer

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19
Q

what effect does alcohol have on kidneys

A

alcohol is a diuretic

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20
Q

what effect does alcohol have on pancreas

A

pancreatitis

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21
Q

what effect does alcohol have on pregnancy and lactation

A

fetal alcohol syndrome

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22
Q

what is the blood levels for intoxication

A

US: 0.08%
earliest effects: 0.05%

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23
Q

at what percent does risk for respiratory depression, peripheral collapse and death occur at

A

0.4%

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24
Q

what are some of the drug interactions with alcohol

A

CNS depressants, NSAID’s, acetaminophen, disulfiram, antihypertensive drugs

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25
Q

what happens with hypotension in acute overdose with alcohol

A

can’t be corrected with vasoconstrictors (i.e. epinephrine) and can lead to renal failure and cardiovascular shock

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26
Q

what do you treat alcohol related hypotension with

A

fluids

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27
Q

what are some drugs that are used to facilitate alcohol withdrawal

A

benzodiazepines: CNS depressant, decreases anxiety
adjuncts to benzodiazepines

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28
Q

what are examples of the benzodiazepines that help facilitate withdrawal

A

chlordiazepoxide and lorazepam

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29
Q

what are examples of the adjuncts to benzodiazepines that help facilitate withdrawal

A

clonidine

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30
Q

what drugs are used to maintain abstinence

A

disulfiram and naltrexone

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31
Q

what is disulfiram

A

Antabuse effect, refrain from drinking, pts. must before careful chosen

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32
Q

what is important to educate your patient on when they take disulfiram

A

AVOID ALL FORMS OF ALCOHOL (sauces, cough syrups, alcohol applied to skin

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33
Q

what is naltrexone

A

opioid antagonist, decreases cravings for alcohol

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34
Q

what is something pts can use for nutritional support

A

b vitamins: thiamin, folic acid, cyancobalamin

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35
Q

what is the greatest single cause of preventable illness and premature death

A

cigarette smoking

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36
Q

what effects does nicotine have on the body

A

cardiovascular, gastrointestinal, CNS

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37
Q

during pregnancy what nicotine is safer than tobacco smoke

A

pharmaceutical nicotine

38
Q

what are some examples of nicotine replacement therapy

A

gum, lozenges, patches, nasal spray, inhaler

39
Q

what are some non-nicotine drug treatments for smoking cessation

A

bupropion and varenicline

40
Q

what are the 5 A’s for treating tobacco use and dependence

A

Ask, advise, assess, assist, arrange

41
Q

what are some of the therapies that double smoking cessation rate

A

gum, NicoDerm CQ and Nicotrol (transdermal), inhaler, nasal spray,

42
Q

what is important to know about nicotine gum

A

chew slowly and intermittently for about 30 minutes, avoid eating+ drinking 15 minutes before

43
Q

what is important to know about the transdermal patches (NicoDerm CQ and Nicotrol)

A

change application daily and not reused for at least one week

44
Q

what pt should you not use the nicotine inhaler on

A

asthma pts.

45
Q

what is important to know about the nicotine nasal spray

A

nicotine levels rise rapidly

46
Q

what is bupropion SR in smoking cessation

A

atypical antidepressant, reduces urge to smoke

47
Q

what are the adverse effects of bupropion SR

A

dry mouth and insomnia

48
Q

what is the most effective aid for smoking cessation

A

varenicline

49
Q

what is varenicline

A

agonist for nicotinic receptors, attaches to receptors and gives slight feeling of smoking

50
Q

what are some neuropsychiatric effects of varenicline

A

seizure, anxiety/depression, hostility, SI

51
Q

can cardiovascular events occur with varenicline

A

yes

52
Q

what is a product that is not recommended for smoking cessation

A

E-cigarettes

53
Q

who is heroin used by

A

all segments of society, cheaper than prescribe opioids

54
Q

what happens to the behavior of a person after they use herion

A

pleasure, relaxation, warmth, thirst, euphoria

55
Q

what is the intention of oxycodone and how is it abused

A

controlled-release drug, crushed and snorted

56
Q

what drug is most often abused by nurses and healthcare providers and why

A

meperidine and it is highly effective orally and leaves no sign

57
Q

why do you want to have a careful titration with naloxone

A

to avoid withdrawal

58
Q

why is clonidine-assisted withdrawal used for opioid detoxification

A

provides modest relief and most effective against symptoms like N+V and diarrhea

59
Q

what causes ultra rapid withdrawl

A

naloxone or naltrexone

60
Q

which opioid is used to prevent symptoms of withdrawal

A

methadone substitution, long acting oral

61
Q

can methadone be used for long term opioid addiction management

A

yes, maintenance and therapy supression

62
Q

what is naltrexone used for with long term opioid addiction management

A

takes away cravings, discourages renewed abuse

63
Q

are barbiturates dose dependent?

A

yes

64
Q

is there an antidote for barbiturates

A

NO

65
Q

what do you do for acute toxicity with barbiturates

A

maintain respiration and remove drug

66
Q

what is better about benzodiazepines compared to barbiturates

A

safer, has an antidote

67
Q

what risk is increases with benzodiazepines

A

overdose when used with IV or other depressants

68
Q

what is the antidote for benzodiazepines

A

flumazenil (romazicon)

69
Q

what are some psychostimulants

A

methamphetamines and cocaine

70
Q

what is bad about meth and cocaine

A

puts a lot of work on the heart: stimulates heart, blood vessels

71
Q

what is cociane

A

similar CNS effects of amphetamines, produce local anesthesia, vasoconstriction, and cardiac stimulation

72
Q

what is the treatment of cocaine overdose

A

IV diazepam or lorazepam, nitroprusside, hypertonic sodium bicarbonate, aspirin, external cooling

73
Q

what are some signs of severe overdose with cocaine

A

hyperpyrexia (very hot)

74
Q

what are some things that occur with chronic toxicity of cocaine intranasally

A

atrophy of nasal mucosa and loss of sense of smell

75
Q

what are some ways you can treat cocaine addiction

A

anticocaine vaccine, disulfiram

76
Q

what does the anticocaine vaccine do

A

keeps drug from entering CNS from bloodstream

77
Q

what are the adverse effects of methamphetamines

A

HTN, angina pectoris (chest pain), dysrhythmias, system vasculitis (inflammation of blood vessels

78
Q

how do you treat methamphetamine addiction

A

cognitive behavioral therapy

79
Q

In the oral route of Marijauna, what happens

A

most THC is inactivated through first pass effect

80
Q

what behaviors are correlated with marijuana

A

euphoria, sedation, hallucinations

81
Q

what are the therapeutic uses of marijuana

A

antiemetic, appetite stimulant, neuropathic pain

82
Q

what can happen to respirations with marijuana

A

acute: bronchodilator
chronic: airway constriction

83
Q

does marijuana affect reproduction

A

yes with males and females

84
Q

what does LSD act on

A

brains serotonin receptors

85
Q

what is the original use for phencyclidine (PCP) and ketamine

A

surgical anesthetics

86
Q

out of PCP and ketamine which has shorter duration of effects

A

ketamine

87
Q

which drug is highly abused by adolescents and teens in developing countries

A

dextromethorphan

88
Q

what is dextromethorphan

A

OTC cough suppressant

89
Q

what is ecstasy (MDMA)

A

stimulant and psychedelic properties

90
Q

what are the adverse effects of MDMA/ecstasy

A

dangerously high body temp, seizures, spasmodic jerking, jaw clenching, teeth grinding, paranoia

91
Q

what are androgens

A

anabolic steroids

92
Q

why are androgens us

A

enhance athletic performance, increase muscle mass and strength

Pathopharm: NAT (12 decks)

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