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*Pharm III > Substance Abuse > Flashcards

Substance Abuse Flashcards

1
Q

A chronic disorder characterized by the compulsive use of substance resulting in physical, psychological, or social harm to be user and continued use despite the harm.

A

Addiction

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2
Q

Physiological adaptation to the effect of drugs so as to diminish effects with constant dosages or to maintain the intensity and duration of effects through increased dosage.

A

Tolerance

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3
Q

Reversible substance-specific syndrome

Due to recent ingestion or exposure to a substance

A

substance intoxication

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4
Q

what is the reward pathway in the brain

A

DA in mesocorticolimbic system

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5
Q

Increased response following repeated intermittent administration of a drug, in contrast to tolerance to drug effects that occur secondary to continuous exposure to a drug

A

Sensitization

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6
Q

CNS depressant
Works in a dose dependent fashion
Sedative, sleep, unconsciousness, coma, respiratory depression and CV collapse

A

alcohol

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7
Q

five or more drinks on the same occasion at least once in the past 30 days

A

Binge use

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8
Q

five or more drinks on the same occasion on at least 5 different days in the past 30 days.

A

heavy use

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9
Q

Major excitatory system in CNS

A

glutamate

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10
Q

what happens to NMDA pathway with alcohol intoxication

A

decrease glutamate activity

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11
Q

what GABA receptor is affected by alcohol

A

GABA A

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12
Q

what happens with chronic ethanol intoxication and GABA

A

down-regulation of GABA A which means they need more alcohol for the same effect

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13
Q

what causes the positive reinforcement and pleasurable effects of ethanol

A

dopamine (DA)

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14
Q

with alcohol If consciousness is impaired then ___________ should be given IV or IM for at least 3 days

A

thiamine

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15
Q

When a person’s maladaptive pattern of alcohol use lease to clinically important distress or impairment, as shown in a single 1-month period

A

Alcohol dependence

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16
Q

Acetaldehyde dehydrogenase (ALDH) inhibitor (irreversible)

A

Disulfiram

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17
Q

What happens if someone has alcohol while on sifulfiram

A

N/V, HA

SOB, sweating, etc

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18
Q

how long must patient have had to be abstinent from ETOH before starting disulfiram

A

12 hours

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19
Q 
Competitive mu (µ) opioid receptor antagonist
 blocks ß- endorphin which stimulates dopamine release
blocks ethanol-induced DA release in NAC
A

naltrexone

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20
Q

what is naltrexone used for

A

narcotic abuse

alcohol dependence

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21
Q

Approved to maintain abstinence after detoxification, works to restore balance between glutamate and GABA

A

acamprosate

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22
Q

main ADR w/ acamprosate

A

transient diarrhea

23
Q

S/S of alcohol withdrawal

A 
Tremor
GI (nausea/vomiting)
Mild diaphoresis
Vital signs increase (mild)
Sleep disturbance
Hallucinations
Seizures (7%)
24
Q

what is the time course for major withdrawal symptoms

A

120-168 hours

25
scale to assess withdrawal from alcohol in patients
CIWA scale (t need additional meds)
26
drug to treat seizures from alcohol withdrawal
lorazepam
27
what 3 meds can be given if CIWA >8
Chlordiazepoxide 50-100 mg Diazepam 10-20 mg Lorazepam 2-4 mg
28
what type benzos is preferred therapy for benzos
long acting chlordiazepoxide diazepam
29
what benzo is best to use in patients w/ liver dz
short acting lorazepam oxazepam
30
what drugs may people in seizures/ DT needs to correct electorlyte imbalances
IV magnesium | IV thaimine
31
when is haloperidol given for DTs
only for severe agitation unresponsive to benzos
32
what is given for DTs
IV benzos | IV thiamine
33
simple taper for benzos
25% dose reduction per week until 50% reached | then decrease by 1/8 every 4-7 days
34
if benzo therapy is >8 weeks how long of a taper is recommended
2-3 weeks
35
if therapy if >6 month with benzo how long of a taper
4-8 week
36
what symptoms can occur w/ benzo withdrawal
Rebound anxiety Recurrence or relapse of symptoms Withdrawal symptoms
37
common bdz withdrawal symptoms
``` anxiety insomnia restlessness muscle tension irritability ```
38
signs of stimulant intoxication
Hyperthermia, Hypertension, Cardiac arrhythmias, Stroke
39
with stimulant withdrawal when are most of the symptoms
first 24 hours give benzos or antipsychotics
40
``` with intoxication patients presents with Euphoria Dysphoria Apathy Motor retardation Sedation Attention impairment Miosis ```
opioid
41
how can you reverse opioid intoxication
naloxone
42
what happens when chronic opiate users d/c using them
Leads to cyclic AMP in the adrenergic neurons becomes overactive
43
is opioid withdrawal fatal?
no, usually just discomfort
44
Alpha adrenergic autoreceptors that helps with opioid withdrawal help taper off heroin or methadone
clonidine
45
µ and ō opioid withdrawal agonist Suppresses opioid withdrawal symptoms Blocks effect of other opioids
methadone
46
ADRs of methadone
Constipation, sweating, urinary retention | Respiratory depression in intolerant individuals
47
µ receptor partial agonist and weak K receptor antagonist Similar effects as methadone Opioid antagonist at higher doses safer than heroin
buprenoprhine
48
naltrexoine shouldn't be initiated until patient is opioid free for how long?
7-10 days
49
what test assess nicotine dependence
fagerstrom test (>4 indicates dependence)
50
what are smoking cessation drugs
Buproprion Varenicline Clonidine TCA’s
51
New name for sustained release buproprion approved by FDA for treatment of tobacco dependence block NA and NE
Zyban
52
antagonizes and blocks nicotinic acetylcholine receptors | BBW for neuropsychiatric symptoms nad suicidality
Varenicline (Chantix)
53
can you combine multiple therapies for nicotine addiction
yes as long as risk/benefit ration is favorable | ex- cardiac dz and pregnancy
54
what TCA has been used as 2nd line for smoking cessation
nortriptyline (inhibit reuptake NE and 5-HT) | disadvantages= ACH burden, cardiac ADRs

*Pharm III (8 decks)

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