Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Behavioral Med 1 > Substance Abuse > Flashcards

Substance Abuse Flashcards

1
Q

Substance abuse occurs in ___% of pts in the ambulatory setting

A

~ 20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Chemical dependence (non-tobacco) affects ____% of Americans

A

24.8%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

____% of hospital admits are assoc. w/ EtOH/drugs and accounts for 100,000 deaths/yr

A

40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Intoxication is associated w/ __% of all MVAs, __% of all DV cases and __% of all murders

A

50%, 50%, 50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

D/o are more common in (men/women), (younger/older) individuals (age of onset ____ y/o), and (low/high) income populations, but actual abuse is probably much greater than this

A

men; younger; 16-20 y/o; low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a substance that is commonly abused in the attempt to self-medicate for panic?

A

EtOH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a substance that is commonly abused in the attempt to self-medicate for anger?

A

opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a substance that is commonly abused in the attempt to self-medicate for depression?

A

amphetamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Is there a genetic component to substance abuse?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is conditioning (in reference to substance abuse)?

A

Behavior maintained by its consequences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What questionnaire should be used for substance abuse assessment? What does it stand for?

A

Cut down?
Annoyed by confrontation?
Guilt?
Eye opener?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If possible and allower for by the pt, who should you obtain a hx from on the patient’s substance abuse?

A

obtain hx from spouse, children, other family members and friends

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T/F “Addiction” is used as a dx term in DSM-5

A

False, it is not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Define substance abuse d/o

A

Any inappropriate use of a substance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In order to be dx w/ substance abuse d/o, a pt must have ___ out of ___ behaviors present, must occur in a ____ month period, and must lead to significant impairment or distress in _____ _____ and ______

A

2+ out of 11; 12 mo; social functioning and work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

________ is a reversible syndrome due to recent use of substance

A

Intoxication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

______ is characterized by the need to use an increased amount of a substance in order to achieve the desired effect, and/or a markedly diminished effect w/ continued use of the same amount of the substance

A

Tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

_______ occurs when nml fxn only becomes possible w/ active use of a substance and cessation of it causes adverse physiological consequences

A

Dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

_____ is a cluster of sx w/ an onset closely following the cessation (or reduction in dose) that is specific to a drug(s) –> sx can be both physiological and cognitive

A

Withdrawal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are opioids? Examples?

A

Natural and synthetic substances w/ morphine-like properties

Morphine, Heroin, Hydrocodone, Oxycodone, Codeine, Tramadol, Meperidine, Opium, Methadone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Opioid Rx users have a (very low/low/high/very high) chance of becoming addicted to their medications

A

very high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

_____x as many people abuse Rx pain meds than use heroin

A

> 5x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Opioid addicts have a higher chance of developing illness, such as ____, _____, and ____

A

Hep B, Hep C, and HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Opioid abuse is more common in (men/women), urban settings, African Americans; and addiction of pain meds is more common in (men/women)

A

men; women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Why is opioid addiction higher in medical professionals?
Access
26
Opioid addiction is extremely disabling and is assoc. w/ ↑ mortality rates due to ____, ____, and _____
suicide, OD, and accidental death
27
Describe what a pt may experience/present with while intoxicated, on opioids.
Sensation of euphoria, sense of well-being, pinpoint pupils, flushing, sedation, constipation, ↓ HR, hypoTN, ↓ RR, N/V
28
Is withdrawal from opioids life-threatening? Explain.
not life threatening unless severe medical illness but extremely uncomfortable.
29
Name some characteristics of opioid withdrawal
Dilated pupils, lacrimation, goosebumps, N/V/D, myalgias, arthralgias, dysphoria or agitation
30
Withdrawal in chronic users starts how long after last dose w/ short acting opioids?
~10 hours
31
What is recommended for tx of sx of opioid withdrawal?
Antiemetic, antacid, antidiarrheal, muscle relaxant (methocarbamol), NSAIDS, BZD
32
_____ is a long-acting opioid with a half-life of 22-56 hrs, used in the tx of opioid use d/o
Methadone
33
What is the initial dosage of methadone based on?
Extent of withdrawal sx
34
What is the titration of methadone dosage?
Increase until sx are controlled, then taper 20% per day for long-acting opioids, and 10% per day for short-acting opioids
35
How long is the typical course (length of time) of methadone? What does the course length depend on?
Will take 7 days to 3 weeks, depending on opioid
36
_____ is a long acting opioid antagonist administered at 50-100 mg/day that blocks the pleasurable effects of opioid drugs
Naltrexone
37
_____ is a mixed opioid agonist-antagonist usually used in combination w/ Naloxone
Buprenorphine
38
Buprenorphine is helpful for what type of pts?
highly motivated pts who do not need high doses
39
How should you assess a pt with alcoholism?
CAGE questionnaire
40
When assessing a pt with alcoholism, and you order a CBC, what might the results be?
alcohol-related bone marrow depression, anemia, MCV
41
When assessing a pt with alcoholism, and you order a CMP, what are you looking for?
LFTs (ALT, AST, TB and gamma-glutamyltransferase [ggt])
42
When assessing a pt with alcoholism, and you order a carbohydrate deficient transferrin, what might the results be? What can this lab test be used for distinguishing?
low after excessive consumption EtOH consumption > 50-80 g/d for x2-3 wks appears to ↑ serum concentrations of CDT, which tends to distinguish chronic heavy drinkers from light social drinkers
43
When assessing a pt with alcoholism, and you order a thiamine level, what are you evaluating the pt for?
Wernicke encephalopathy
44
When assessing a pt with alcoholism, and you order a folate level, what might the results be/sx the pt presents with?
anemia, HA, fatigue, glossitis
45
What is the direct test for alcohol in the body?
Blood Alcohol Level (BAL)
46
What is EtG? How long can it be detected? What is it an important biomarker of?
Ethyl glucuronide is a direct metabolite of EtOH After complete cessation of EtOH intake, EtG can be detected in urine for up to 5 days after heavy binge drinking Important biomarker of recent EtOH intake
47
``` BAL Effect 0-100 mg/dL ________ 100-150 mg/dL ________ 150-250 mg/dL ________ 250 mg/dL and up ________ 350 mg/dL and up ________ ```
BAL Effect 0-100 mg/dL Sense of well being, sedation 100-150 mg/dL Uncoordinated, irritable 150-250 mg/dL Slurred speech, ataxia 250 mg/dL and up Passing out/unconscious 350 mg/dL and up Coma and death *in a pt with no tolerance
48
Hazardous Use/At Risk (using “too much” but no significant negative consequences) is considered ____ drinks/week in men and _____ on one occasion. In women, _____ drinks/week and _____ drinks on one occasion. How many adults fit this criteria? (fraction)
Men: > 14 drinks/week, >4 drinks on one occasion Women: > 7 drinks/week, > 3 drinks on one occasion 3/10 adults fit this criteria
49
______ is alcohol use leading to impairment or distress, mild-mod substance use d/o ______ is alcohol use leading to impairment or distress, more pervasive and persistent than ___(above)___, +/- physical dependence and withdrawal sx
Abuse Dependence (abuse)
50
What are some early sx that a person might present with in chronic alcoholism? Late?
Early sx: Rosacea, Palmar erythema, Respiratory infxns, Palpable liver from fatty liver dz, Easy bruising Late sx: Caput medusae, Ascites, Jaundice, Esophageal varices/hemoptysis/hematochezia
51
How would you tx a pt with intoxication?
supportive measures, hydration, rest, mild OTC pain meds
52
In uncomplicated alcohol withdrawal, the “shakes” begin w/in _____ hrs after cessation, and are worst at ______ hrs, then subsides over ______ days w/o medical tx
12-18 hrs 24-48 hrs 5-7 days
53
How do you tx a pt with uncomplicated alcohol withdrawal?
BZD, hydration, nutrition, careful monitoring (family/friends)
54
If a markedly chronic EtOH abuser is going through EtOH withdrawal and is having sz, how many houra ago did they stop drinking? When will the sz peak? How many and what type of sz will they be having? (ranges)
begins w/in 7-38 hrs after cessation, peak 24-28 hrs, often a burst of 1-6 generalized sz
55
If a pt is going through EtOH withdrawal and is having sz, how should you tx this patient?
hospitalization, BZD, hydration, nutritional supplementation (banana bag, folate, thiamine, MVI), careful monitoring
56
When would alcoholic hallucinosis begin in a chronic alcoholic who has stopped drinking? How long does this last for?
begins w/in 48 hrs of cessation, sensorium is clear, auditory, visual or tactile hallucinations that are very unpleasant; lasts ~1 wk, can become chronic
57
If a pt is going through EtOH withdrawal and is experiencing alcoholic hallucinosis, how should you tx this patient?
hospitalize, BZD, hydrate, nutritional supplements, monitoring
58
What are the sx of EtOH withdrawal “Delirium Tremens”?
confusion, agitation, mild fever, N, irritability, tremor, autonomic hyperarousal
59
When do alcoholic DTs begin when going through withdrawal? Peak?
begins 2-3 days after cessation, peaks in 4-5 days | ~ 5% of hospitalized pts, ~ ⅓ of those w/ sz
60
How do you tx a pt with DTs?
Hospitalization, BZD, hydration, nutritional supplements, careful monitoring, possible restraints, haldol
61
What are medication tx options for patients with alcoholism? How do they work/what do they do?
Disulfiram (Antabuse): Inhibits EtOH dehydrogenase, accumulation of acetaldehyde, which causes N/V, HA, hypoTN Naltrexone: mu-opioid receptor partial antagonist, ↓ pleasurable effects of EtOH and the craving Acamprosate: glutamate receptor modulator, decrease craving
62
What medical condition can you NOT use Naltrexone?
Liver dz
63
What levels should be checked if a pt is taking Acamprosate?
renal function
64
__% of all alcoholic pts will relapse, and relapse is most common w/in ___ mo following initial tx; most require multiple detoxes/rehab sessions before maintaining sobriety
50%, 6 mo
65
All pts with alcoholism should be referred to ____
AA (alcoholics anonymous)
66
What are some examples of medications that are commonly abused in a pt with a sedative, hypnotic, or anxiolytic-related substance abuse d/o?
BZD (Libirum, valium, clorazepate, ativan, xanax), BZD-like meds Barbiturates (phenobarbital, barbital), Barbiturate-like meds Zolpidem (Ambien)
67
Are opioids or sedative/hypnotic/anxiolytic medications more addicting?
Opioids
68
Describe what sedative/hypnotic/anxiolytic intoxication would be like. (Similar to? Initially? Severe?)
Similar to alcohol but less cognitive/motor impairment Initially, lethargy, impaired cognition, poor memory, irritability, emotional disinhibition Severe intoxication can lead to slurred speech, ataxia, lack of coordination, and on to respiratory depression
69
A common detox mistake when it comes to sedative/hypnotic/anxiolytic medications is ______. Why?
tapering too fast | sx worse at end of taper
70
What are some examples of commonly abused stimulants?
Cocaine, Crack, Methylphenidate (Ritalin), Methamphetamine (Crank, Speed)
71
What are common sx of stimulant intoxication?
Autonomic hyperarousal, tachycardia, ↑ BP and HR, pupillary dilation (mydriasis)
72
Cocaine intoxication can induce what sx?
tactile hallucinations,sense of euphoria and disinhibition, sexual arousal, ↑ self-esteem, aggression, agitation, impaired judgment
73
What serious and life-threatening conditions can be caused by cocaine use?
myocardial infarction, rhabdomyolysis w/ compartment syndrome from hypermetabolic state, and psychosis associated w/ intoxication that resolves
74
What are the sx of stimulant withdrawal? When is the peak? Is it self limiting?
Fatigue, depression, nightmares, HA, sweating, muscle cramps, hunger Peak in 2-4 days from last dose Yes
75
What are the medications that can be used in the tx of stimulant withdrawal and sx?
No medications FDA-approved for tx If medication used, also need a psychosocial tx component Can use diazepam, lorazepam for agitation sxs Antipsychotics if psychotic sxs present
76
________ may arise 2 weeks after cessation of stimulant abuse. How would you tx this?
Depression | anti-depressants
77
What are some commonly abused hallucinogens?
LSD (lysergic acid diethylamide) Peyote, mescaline MDMA (3,4-methylenedioxymethamphetamine) PCP (phencyclidine)
78
Describe intoxication with hallucinogen abuse. how long will the sx last?
Hallucinations, perceptual disturbances, feelings of unreality, HTN, tachycardia, sweating, blurry vision, pupillary dilation, tremors 3-6 hr duration
79
What sx may a person on Ecstasy (MDMA) experience?
sense of connectedness, attachment, and high energy
80
T/F There are no concerning withdrawal sx of hallucinogen abuse
True
81
OD on hallucinogens can cause life threatening conditions, such as...
Hyperpyrexia, tachycardia, arrhythmias, stroke, death
82
Does tolerance develop slowly or quickly with hallucinogens? What does this mean for likelihood of hallucinogenic substance abuse?
Tolerance develops quickly and there are notable unpleasant side effects w/ continued use (teeth grinding on MDMA, etc) so dependence less likely
83
T/F There are no approved medications for tx of hallucinogenic substance abuse
True
84
What is the most commonly abused illicit drug in America?
THC (delta-9-tetrahydrocannabinol)
85
T/F THC is lipid soluble
true
86
THC levels reach peak ___-___ min
THC levels reach peak 10-30 min
87
What are some sx of THC intoxication?
increased appetite and thirst, colors/sounds/tastes are clearer, increased confidence, euphoria, libido Relaxation, slowed reaction time/ motor speed Transient depression, anxiety, paranoia Tachycardia, dry mouth, conjunctival injection Impaired cognition, Psychosis
88
What are sx of THC withdrawal?
Irritability, nervousness, poor appetite, restlessness, depressed mood, tremors, fevers, sweating, chills, headache
89
{She said we would not be tested on tobacco abuse, but if you want to know more go to google doc :) that's all folks! Freebie notecard! <3}
Aww, you flipped the card--adorable ;)

Behavioral Med 1 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions