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Psychiatry pro +1700 > Substance Abuse > Flashcards

Substance Abuse Flashcards

1
Q

What is considered risky drinking for men and women under 65 yo? Those over 65?

A

Men = more than 14 drinks / week

Women, and those over 65 = More than 7 drinks/day

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2
Q

What, generally, is meant by the term risky use?

A

Health consequences may arise from using

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3
Q

What is the definition of physical dependence?

A

A state of adaptation that is manifested by withdrawl syndrome produced by an abrupt cessation

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4
Q

What is unhealthy use?

A

Spectrum from risky use to addiction

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5
Q

What is meant by the term abuse in terms of drug use?

A

Any use or amount that deviates from social norms

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6
Q

What is misuse in the context of drugs?

A

Prescription drugs that are taken in an amount greater than prescribed

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7
Q

What is cross-tolerance in the context of drug use?

A

The ability of one drug to be substituted for another to produce the same effects

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8
Q

How, generally, do drugs work?

A

Activation of the reward system based on:

  • Reinforcement of behaviors
  • Changes to Memory production
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9
Q

True or false: the pathway of reward is difference for each drug, but the mechanism is the same

A

False-mechanism different, but the pathway is the same

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10
Q

What is the pathway of reward activation?

A

Prefrontal cortex to ventral tegmental area nucleus accumbens, to ventral tegmental area

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11
Q

What is the role of the nucleus accumbens?

A

Motivation and goal-directed behavior

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12
Q

What is the area of the brain that produces dopamine?

A

Ventral tegmental area

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13
Q

What is the major neurotransmitter involved in the reward pathway?

A

Dopamine

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14
Q

What are the four major functions of serotonin?

A
  • mood
  • Memory processing
  • Sleep
  • Cognition
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15
Q

What are the major functions of dopamine (5)

A
  • Reward
  • Pleasure
  • Motor function
  • Compulsion
  • Perseveration
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16
Q

What is the MOA of cocaine?

A

Ester–blocks dopamine reuptake

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17
Q

What BP drugs should never be combined with cocaine?

A

Beta blockers

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18
Q

How long must drug use continued for to be called a disorder?

A

12 months

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19
Q

What are the mild, moderate, and severe drug use disorder?

A 
Mild = 2-3
Moderate = 4-5
Severe = 6+
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20
Q

What are the “impaired control” diagnostic criteria for abuse disorder (4)?

A
  • Taking substance over longer period, or in larger amounts
  • Desire to cut down or unsuccessful efforts
  • Spend too much time
  • Craving
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21
Q

What are the “social impairment” diagnostic criteria for abuse disorder (3)?

A
  • Failure to fulfill role
  • Social problems
  • Social concerns giving up for use
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22
Q

What are the “Risky use” diagnostic criteria for abuse disorder (2)?

A
  • Using when physically hazardous

- Using despite negative health consequences

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23
Q

What are the “Pharmacological” diagnostic criteria for abuse disorder (2)?

A
  • tolerance

- Withdrawal

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24
Q

True or false: either tolerance or withdrawal are needed for a diagnosis of substance abuse disorder

A

False

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25
Q

What are the major ocular changes with: EtOH?

A

Nystagmus

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26
Q

What are the major ocular changes with: sedatives, hypnotics, anxiolytics

A

Nystagmus

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27
Q

What are the major ocular changes with: inhalents

A

Nystagmus

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28
Q

What are the major ocular changes with: hallucinogens

A

Dilated pupils

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29
Q

What are the major ocular changes with: PCP

A

Nystagmus

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30
Q

What are the major ocular changes with: stimulants

A

Dilated pupils

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31
Q

What are the major ocular changes with: Cannabis

A

Conjunctival reddening

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32
Q

What are the major ocular changes with: opioids

A

Constricted pupils

33
Q

What are the criteria for withdrawal?

A
  • Syndrome caused by cessation
  • Clinically significant or impairment
  • Cannot be attributed to anything else
34
Q

A short acting substance affects what part of withdrawal?

A

Intensity

35
Q

A long acting substance affects what part of withdrawal?

A

Duration

36
Q

What are the following for stimulant use:

  • BP changes
  • HR changes
  • Temp
  • Ocular findings
  • DTRs
  • Ataxia
  • Hallucinations
  • Delusions
A
  • BP changes = increased
  • HR changes = increased
  • Temp = increased
  • Ocular findings = dilated
  • DTRs = increased
  • Ataxia = none
  • Hallucinations =yes
  • Delusions = yes
37
Q

What are the following for PCP use:

  • BP changes
  • HR changes
  • Temp
  • Ocular findings
  • DTRs
  • Ataxia
  • Hallucinations
  • Delusions
A
  • BP changes = increased
  • HR changes = Increased
  • Temp = increased
  • Ocular findings = nystagmus
  • DTRs = increased
  • Ataxia = yes
  • Hallucinations = yes
  • Delusions = yes
38
Q

What are the following for opioid overdose:

  • BP changes
  • HR changes
  • Temp
  • Ocular findings
  • DTRs
  • Ataxia
  • Hallucinations
  • Delusions
A
  • BP changes = none
  • HR changes = none
  • Temp = none
  • Ocular findings = pinpoint
  • DTRs = no changes
  • Ataxia = none
  • Hallucinations = none
  • Delusions = none
39
Q

What are the following for opioid withdrawl:

  • BP changes
  • HR changes
  • Temp
  • Ocular findings
  • DTRs
  • Ataxia
  • Hallucinations
  • Delusions
A
  • BP changes =no change
  • HR changes = no change
  • Temp = increased
  • Ocular findings = dilated
  • DTRs = normal
  • Ataxia = none
  • Hallucinations = none
  • Delusions = none
40
Q

What are the following for sedative intoxication:

  • BP changes
  • HR changes
  • Temp
  • Ocular findings
  • DTRs
  • Ataxia
  • Hallucinations
  • Delusions
A
  • BP changes = decreased
  • HR changes = no changes
  • Temp = decreased
  • Ocular findings = nystagmus
  • DTRs = no changes
  • Ataxia = none
  • Hallucinations = none
  • Delusions = none
41
Q

What are the following for sedative withdrawal:

  • BP changes
  • HR changes
  • Temp
  • Ocular findings
  • DTRs
  • Ataxia
  • Hallucinations
  • Delusions
A
  • BP changes = variable
  • HR changes = increased
  • Temp = increased
  • Ocular findings = none
  • DTRs = normal
  • Ataxia = none
  • Hallucinations = none
  • Delusions = none
42
Q

What are the following for LSD, ecstasy, shrooms:

  • BP changes
  • HR changes
  • Temp
  • Ocular findings
  • DTRs
  • Ataxia
  • Hallucinations
  • Delusions
A
  • BP changes = increased
  • HR changes = no changes
  • Temp = increased
  • Ocular findings = dilated pupils
  • DTRs = increased
  • Ataxia = none
  • Hallucinations = none
  • Delusions = Yes
43
Q

What are the following for THC use:

  • BP changes
  • HR changes
  • Temp
  • Ocular findings
  • DTRs
  • Ataxia
  • Hallucinations
  • Delusions
A
  • BP changes = none
  • HR changes = none
  • Temp= decreased
  • Ocular findings = red
  • DTRs = none
  • Ataxia = none
  • Hallucinations= yes
  • Delusions - yes
44
Q

What are the following for inhalant use:

  • BP changes
  • HR changes
  • Temp
  • Ocular findings
  • DTRs
  • Ataxia
  • Hallucinations
  • Delusions
A
  • BP changes = none
  • HR changes = none
  • Temp = none
  • Ocular findings = nystagmus
  • DTRs = decreased
  • Ataxia = yes
  • Hallucinations = none
  • Delusions = none
45
Q

What are the criteria of substance induced psychosis?

A

appearance of mental disorder within one month of intoxication or withdrawal of a substance that is capable of producing psychosis

46
Q

What are the drink equivalents in terms of beer, wine and hard liquor?

A

12 oz
5 oz
1.5 oz

47
Q

True or false: males have higher rates of substance use disorders and intoxication relative to females

A

Partly false–higher rates yes, but females more likely to be intoxicated

48
Q

Where does EtOH fall in terms of preventable causes of death in the US?

A

Third

49
Q

What is the positive affect regulation theory of alcohol use?

A

Feels good, so do it

50
Q

What is the negative affect regulation theory of alcohol use?

A

Takes away the bad

51
Q

What is the pharmacological vulnerability theory of alcohol use?

A

Some are more prone to use disorders than others

52
Q

What are some skin changes associated with alcoholism?

A

Red palms

Caput medusae

53
Q

What type of hematological problems can EtOH cause? (2)

A

Macrocytosis

Anemia

54
Q

What are the two, non obvious cancers that smoking increases the risk for?

A

Cervical

Pancreatic

55
Q

What are the characteristics and causes of Mallory Weiss tears? How do these present?

A

Linear streaks 2/2 chronic vomiting.

Painful hematemesis

56
Q

How can you differentiate between mallory weiss tears and esophageal varices?

A

Mallory weiss tears = painful hematemesis

Esophageal varices - painless hematemesis

57
Q

What type of seizures are had with EtOH withdrawal? When do they usually occur?

A
  • Tonic clonic

- 6-48 hours from last drink

58
Q

What is the classic triad of Wernicke-Korsakoff syndrome?

A
  • Confusion
  • Ataxia
  • Ophthalmoplegia
59
Q

What is the classic symptom of Wernicke-Korsakoff syndrome?

A

Confabulation

60
Q

What is the level of BAC for the Buzzed feeling?

A

30-50 mg/dL

61
Q

What is the level of BAC for the euphoric feeling?

A

50 mg/dl

62
Q

What is the level of ataxia/slurred speech for the Buzzed feeling?

A

100 mg/dL

63
Q

What is the level of BAC for the drowsy/confused?

A

200 mg/dL

64
Q

What is the level of BAC for stupor?

A

300 mg/dL

65
Q

What is the level of BAC for progression to coma/death?

A

more than 400 mg/dL

66
Q

When does alcohol withdrawal usually present following the last drink?

A

4-72 hours

67
Q

What are the s/sx of alcohol withdrawal?

A
  • Insomnia
  • Palpitations
  • Diaphoresis
  • Anxiety
  • HAs
  • Tremors
  • Hallucinations
  • Szs
68
Q

What type of hallucinations are more common with substance use: visual or auditory?

A

Visual

69
Q

When do DTs usually present? How long do they last for?

A
  • begin with 72 hours

- can persist for 7 days

70
Q

What are the lab changes that can occur with DTs? (3)

A
  • Elevated cardiac markers
  • Respiratory alkalosis
  • Lyte abnormalities
71
Q

What are the risk factors for DTs? (besides obvious)

A
  • presence of concurrent illness
  • age over 30
  • Withdrawal effects seen while still intoxicated, but at a lower level
72
Q

What is the CIWA scoring system, and what score indicates that you’re all good?

A

Predictor for the development of withdrawal

Less than 10 = no withdrawal

73
Q

What is the treatment for DTs?

A

Ativan (lorazepam)

74
Q

What is the difference between the MOA of barbiturates and benzos?

A

Barbiturate = prolong GABA channel opening

Benzos = increase frequency of GABA opening

75
Q

What is the MOA of naltrexone, and what is it used for?

A

Opioid antagonist

reduced reward from drinking

76
Q

What is the MOA of disulfiram?

A

Inhibition of acetaldehyde dehydrogenase

77
Q

What are the three components of maintenance therapy for alcohol use disorder?

A
  • Naltrexone
  • Acamprosate
  • Disulfiram
78
Q

What are the 7 components of CIWA?

A
  • Paroxysmal sweats
  • HA
  • Agitation
  • N/v
  • Tremors
  • Anxiety
  • Tactile hallucination
  • Sensorium
  • Auditory hallucinations

Psychiatry pro +1700 (28 decks)

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