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NBB 2 > Substance Abuse > Flashcards

Substance Abuse Flashcards

1
Q

The most widely used substances

A

Alcohol and tobacco

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2
Q

1 cause of death in the US

A

Tobacco

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3
Q

Cigarette smoke has more than 7000 compounds. What are 4?

A

Acetone, cyanide, carbon monoxide, and formaldehyde

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4
Q

What is the criteria for the following degrees of substance use disorders?

  1. ) Mild
  2. ) Moderate
  3. ) Severe
A
  1. ) 2-3 symptoms
  2. ) 4-5 symptoms
  3. ) 6 or more symptoms
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5
Q

Schedule I controlled substances are high potential for abuse with no medical use. What are 5 examples?

A

MDMA, Heroin, GHB, Marijuana, and LSD

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6
Q

Have high potential for abuse and medical use

A

Schedule II controlled substances

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7
Q

What do we consider at risk drinking for men?

A

More than 4 drinks/day or 14 per week

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8
Q

What do we consider at risk drinking for women?

A

More than 3 drinks/day or 7 per week

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9
Q

What is the CAGE questionnaire screening test?

A

Cut down, Annoyed, Guilty, Eye opener

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10
Q

In the CAGE assessment test, what do we consider a positive test?

A

2 positive responses (1 is at risk)

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11
Q

One drink contains about

A

14 grams of pure alcohol

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12
Q

Has a male:female ration of 3:1 and typical onset is 16-30 years old

A

Alcohol use disorder

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13
Q

Almost all heavy drinkers have

  • Usually asymptomatic
  • Reversible
A

Fatty Liver

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14
Q

Alcoholic cirrhosis can lead to

A

Portal Hypertension, decreased androgens, spider angioma

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15
Q

Has the classic findings of hepatosplenomegaly, caput medusae, esophageal varices, and hemorrhoids

A

Portal Hypertension

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16
Q

Alcoholic cirrhosis can decrease albumin levels which can lead to

A

Ascites (abdominal edema)

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17
Q

Alcoholic cirrhosis can decrease coagulation factors, making you more susceptible to bruising. This is called

A

Ecchymoses

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18
Q

The liver functions to store

A

Thiamine, folate, and B6

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19
Q

Lack of folate from chronic alcohol use causes

A

Macrocytic anemia

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20
Q

B6 deficiency from chronic alcoholism causes

A

Pallor (anemia)

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21
Q

A test we can order if we are suspicious of heavy alcohol use is

A

Carbohydrate deficient Transferrin

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22
Q

What level of Carbohydrate Deficient Transferrin (CDT) indicates heavy drinking?

A

CDT > 20g/L

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23
Q

The legal BAC limit is

A

0-100 mg/dL

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24
Q

A good marker for heavy drinking is

-Normalizes after about ~5 weeks of abstinence

A

GGT (>35)

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25
Q

An AST:ALT ratio of what is suggestive of alcohol?

-Less sensitive than GGT

A

AST:ALT > 2:1

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26
Q

Caused by an acute drop in thiamine

  • Reversible
  • Results in confusion, ataxia, and opthalmoplegia (eye muscle paralysis)
A

Wernicke Encephalopathy

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27
Q

Cause by a chronic decrease in thiamine

-non-reversible

A

Korsakoff’s syndrome

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28
Q

Results in impaired memory, confabulation, and retrograde/anterograde memory loss

A

Korsakoff’s syndrome

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29
Q

Wernicke-Korskoff syndrome shows bilateral degradation of

A

Mammillary Bodies

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30
Q

Decreases the GABA receptor sensitivity

A

Alcohol

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31
Q

Also serves as an NMDA receptor antagonist

32
Q

Thus, alcohol withdrawal causes an

A

Excitation due to decreased GABA function and increased glutamate function

33
Q

The peak severity is at 36 hours and is where 90% of alcohol withdrawal seizures occur

A

Stage I withdrawal

34
Q

Occurs during stage III of alcohol withdrawal (72-105 hours)

A

Delirium Tremens

35
Q

Classified as a medical emergency with 20% mortality if untreated

A

Delerium Tremens

36
Q

Characterized by autonomic instability, perceptual disturbances, and hyperactivity to lethargy

A

Delerium Tremens

37
Q

Delerium Tremens is preceded by a

38
Q

Used to treat alcohol withdrawal by increasing GABA function and decreasing seizures

A

Benzodiazepines

39
Q

Characterized by seizure, delirium, hallucinations, and delirium tremens

A

Complicated Withdrawal

40
Q

Long-acting oxycodone with delayed absorption

-“abuse-resistant”

41
Q

Marketed heavily for non-cancer prescriptions

42
Q

A schedule II synthetic opioid that is 0-100 times stronger than morphine

43
Q

Is being illicitly made and mixed with or sold as heroin

-Can cause fatal OD

44
Q

What are two major forms of heroin associated morbidity?

A

Endocarditis and syphilis

45
Q

If you crush it, sniff it, or inject it, it causes a massive euphoria that lasts for more than 8 hours

46
Q

Fatalities appear to be heroin ODs

-Can only be correctly identified post-mortem

47
Q

Characterized as non responsive with pinpoint pupils, no respiration, hypotension, and bradycardia

A

Opioid overdose

48
Q

The cause of death from opioid overdose is

A

Respiratory depression

49
Q

The two most important risk factors for opioid overdose are

A
  1. ) Higher dose

2. ) Combination with sedatives (alcohol/benzodiazepines)

50
Q

Used as a marker for fatal overdose of opiates

A

Morphine Milligram Equivalence (MME)

51
Q

An MME of 50-99 mg/day had an increase in OD risk of

52
Q

An MME of greater than 100 mg/day had an increase in OD risk of

53
Q

Which opioids are full mu agonists

A

Morphine and oxycodone

54
Q

Which opioids are partial mu agonists?

A

Buprenorphine

55
Q

Which two opioids are mu antagonists

A

Naloxone and naltrexone

56
Q

Bind to receptors but only activate them to a limited extent

A

Partial agonists

57
Q

Prevents opiate withdrawal and blocks full agonists

-No respiratory depression

A

Partial agonist

58
Q

Causes full opiate activity with respiratory depression and analgesia

A

Full agonist

59
Q

Shows no opiate activity

-Used for OD reversal

A

Antagonist

60
Q

FDA approved for alcohol dependence and opiate dependence

A

Naltrexone

61
Q

Why is Naloxone added in combination with oral opiate antagonists if it is not affective orally?

A

Prevent people from diverting by crushing and snorting or shooting up

62
Q

Bupenorphine with Naloxone that is given as a sublingual tablet

63
Q

Have the effects of changes in thoughts, perceptions, and mood

-Minimal sedation

A

Hallucinogens

64
Q

Cause no change in memory or intellectual function

-5-HT2 receptor action

A

Hallucinogens

65
Q

PCP, angel dust, LSD, and ketamine are examples of

A

Hallucinogens

66
Q

Are not associated with abstinence syndrome and do not need detoxification

A

Hallucinogens

67
Q

Lethal overdose is rare, but are often accompanied by psychological dependence and compulsive use

A

Hallucinogens

68
Q

Users can develop symptoms that look just like schizophrenia

69
Q

A dissociative anesthetic that causes psychosis resembling schizophrenia, but is characterized by marked neurological signs like vertical nystagmus and ataxia

70
Q

Characterized by hyperalertneess, restlessness/pacing, talkative/pressured speech, and aggression or elation

A

Cocaine intoxication

71
Q

Characterized by agitation and restless behavior, depressed mood, fatigue, and generalized malaise

A

Cocaine Withdrawal

72
Q

Cocaine withdrawal also causes vivid and unpleasant

73
Q

A schedule II stimulant used for narcolepsy and ADHD

A

D-Methamphetamine

74
Q

Releases high levels of dopamine

-causes increased wakefulness, physical activity, respiration, and HR

A

Methamphetamine

75
Q

Chronic abusers have severe structural and functional changes in areas of the brain associated with emotion and memory

A

Methamphetamine

NBB 2 (21 decks)

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