Substance Abuse

Question 1

___ is the most common drug of abuse

Answer 1

alcohol

Question 2

Alcohol

Answer 2

1. CNS depressant
2. teratogen (fetal alcohol syndrome)
3. affects judgement, concentration, coordination
4. 25% of auto accidents

Question 3

Dental Aspects - Alcohol

Answer 3

1. impaired informed consent
2. erratic appointments
3. aggressive behavior
4. anemia/thrombocytopenia
5. drug interactions
6. altered drug metabolism (especially drugs that are metabolized by the liver)
7. avoid general anesthesia

Question 4

Aspirin and NSAIDs should be avoided for patients with __

Answer 4

alcohol dependency

Question 5

Poor wound healing, sialosis, leukoplakia, and squamous cell cacinoma are characteristic of ___

Answer 5

alcohol dependency

Question 6

Amphetamines

Answer 6

1. euphoriant
2. counters fatigue
3. weight loss

Question 7

Elevated BP, hyperpyrexia, insomnia, anorexia, hallucinations/paranoia, hyposalivation, rampant caries, and bruxism are characteristic of patients with __

Answer 7

amphetamine dependency

Question 8

Barbiturates

Answer 8

1. sedative-hypnotics
2. treaty anxiety and insomnia (not commonly used today)
3. cause respiratory depression, bradycardia, impaired cognition
4. narrow therapeutic index
5. often mixed with other recreational drug (heroin)

Question 9

Therapeutic Index

Answer 9

How much of the drug is required to get the desired affect from the drug?

Question 10

Benzodiazopenes

Answer 10

1. anxiolytics
2. psychological effects (relatively) less severe
3. rapid physical dependence
4. insomnia, paradoxical anxiety (makes you more anxious instead of less), anorexia, occasional psychotic episodes

Question 11

Cocaine

Answer 11

1. common drug of abuse
2. profound, immediate CNS effects
   * *hyperstimulation
   * *diminished fatigue
   * *diminished appetite
   * *feeling of well-being

Question 12

Cocaine mimics __

Answer 12

adrenaline

1 dilated pupils

2. peripheral constriction
3. hyperpyrexia
4. tachycardia
5. hypertension

Question 13

Paranoia, visual hallucinations, formication (itchy sensation), cardiovascular effects, respiratory depression, ischemic necrosis (perforated septum and hard palate) is characteristic of __

Answer 13

cocaine

Question 14

What are the withdrawl symptoms of cocaine?

Answer 14

1. depression
2. sleep craving
3. fatigue
4. recurrence of craving

Question 15

Cocaine - Dental Aspects

Answer 15

1. blood-borne infections
2. xerostomia
3. bruxism
4. dental erosion
5. NO EPI for 2 hours after last use
6. best to treat 6 hours after last use

Question 16

__ is the second most commonly abused substance

Answer 16

marijuana

Question 17

Marijuana

Answer 17

1. influence pleasure, memory, thought, concentration, sensory/time perception
2. impaired attention, memory, learning
3. 50-70% more carcinogens that tobacco**
   4 impaired immune function, increased risk of MI, respiratory infection, fetal neurological maldevelopment
4. xerostomia, increased appetite, oral leukoplakia

Question 18

Opioid analgesics

Answer 18

1. morphine

2. heroin

Question 19

Synthetic opioids

Answer 19

1. methadone

2. codeine

Question 20

Clinical Aspects - Opiates and Opioids

Answer 20

1. analgesia
2. respiratory depression
3. nausea
4. decreased GI motility**
5. sedation
6. addiction
7. CNS depression/sleepiness
8. euphoria
9. constricted pupils
10. impaired mental function

Question 21

Weight loss, self-neglect, needle marks, drug tolerance is characteristic of __

Answer 21

analgesic and opioid addicts

Question 22

Dental Aspects - Opiates and Opioids

Answer 22

1. significant dental neglect
2. cariogenic diet
3. pain control is difficult

Question 23

Ischemic necrosis (hole in septum and hard palate)

Answer 23

cocaine

Question 24

altered drug metabolism (especially drugs that are metabolized by liver)

Answer 24

alcohol

Question 25

Elevated BP

Answer 25

amphetamine

Question 26

Hyperpyrexia

Answer 26

amphetamine

Question 27

Insomnia

Answer 27

amphetamine, Benzodiazopenes

Question 28

Anorexia

Answer 28

amphetamine

Question 29

Hallucinations/paranoia

Answer 29

amphetamine

Question 30

Hyposalivation

Answer 30

amphetamine

Question 31

Rampant caries

Answer 31

amphetamine

Question 32

Bruxism

Answer 32

amphetamine

Question 33

Sedative-hynotics

Answer 33

Barbiturates

Question 34

treats anxiety and insomnia

Answer 34

Barbiturates

Question 35

respiratory depression, bradycardia, impaired cognition

Answer 35

Barbiturates

Question 36

narrow therapeutic index

Answer 36

Barbiturates

Question 37

often mixed with heroin

Answer 37

Barbiturates

Question 38

Anxiolytics

Answer 38

Benzodiazopenes

Question 39

psychological effects LESS severe

Answer 39

Benzodiazopenes

Question 40

paradoxical anxiety

Answer 40

Benzodiazopenes

Question 41

anorexia

Answer 41

Benzodiazopenes

Question 42

psychotic episodes

Answer 42

Benzodiazopenes

Question 43

Paranoia/visual hallucination

Answer 43

cocaine

Question 44

itchy sensation

Answer 44

cocaine

Question 45

cardiovascular effects

Answer 45

cocaine

Question 46

respiratory depression

Answer 46

cocaine

Question 47

influences pleasure, memory, thought, concentration, sensory/time perception

Answer 47

marijuana

Question 48

50-70% more carcinogens than tobacco

Answer 48

marijuana

Question 49

impaired immune funtion

Answer 49

marijuana

Question 50

increased risk of MI

Answer 50

mairjuana

Question 51

respiratory infection

Answer 51

marijuana

Question 52

fetal neurological mal-development

Answer 52

marijuana

Question 53

decreased GI motility

Answer 53

opiates and opioids

Question 54

significant dental neglect

Answer 54

opiates and opioids

Question 55

cariogenic diet

Answer 55

opiates and opioids