substance abuse disorders

Question 1

what is psychological dependence

Answer 1

overwhelming desire to repeat the use of a particular drug to produce pleasure or avoid discomfort

Question 2

what is intoxication

Answer 2

development of a reverible substance-specific syndroe caused by recent ingestion of or exposure to a substance

Question 3

what is physical dependence

Answer 3

cluster of cognitive, behavioral, and physiologic symptoms, indicating a person continues to use a substance of abuse despite significant substance related probs

Question 4

describe the pathophysiology of abuse

Answer 4

• drugs stimulate or inhibit neurotransmitters in the brain to produce pleasure and euphoria or to decrease unpleasant feelings such as anxiety
• noradrenergic neurotransmission system uses norepi as its neurotransmitter often involved as well as the dopaminergic system

Question 5

whats a clinical manifestation of acute intoxication

Answer 5

behavioral changes

Question 6

whats a clinical manifestation of chronic abuse

Answer 6

• serious organ damage
• impaired ability to function

Question 7

what is the drug oh choice for treating withdrawal from alcohol and other CNS depressants

Answer 7

benzos

(chlordiazepoxide)

Question 8

what does chlordiazepoxide do for withdrawal

Answer 8

• provides adequate sedation
• has significant anticonvulsant effect
• allows for patient to participate in rehab program
• allows for gradual reduction and discontinuation of abused substance

Question 9

describe the pharmacokinetics of benzos for alcohol withdrawal

Answer 9

• PO/IV/IM
• metabolized in the liver
• excreted in urine

Question 10

describe the action of benzos for alcohol withdrawal

Answer 10

• acts at subcortical level of CNS
• main site of action may be limbic system and reticular formation

Question 11

what are some adverse effects of benzos for alcohol withdrawal

Answer 11

• CNS effects
• other effects
• black box warning for habit forming stuff and dependence

Question 12

what are some contraindications of benzos for alcohol withdrawal

Answer 12

• known sensitivity to the drug
• psychosis
• acute-narrow-angle glaucoma

Question 13

describe methadone

Answer 13

• opioid sub used to prevent withdrawal symptoms for opioid abuse tx
• full opioid agonist
• given in methadone clinic

Question 14

describe naltrexone

Answer 14

opioid antagonist that binds and blocks opioid receptors and reduces opioid cravings

Question 15

describe buprenorphine

Answer 15

opioid partial agonist at the mu receptor, partially activates opiate receptors

for tx of opioid abuse

Question 16

name some CNS stimulants you can abuse

Answer 16

• amphetamines
• amphetamine-related drugs
• caffeine
• cocaine
• nicotine

Question 17

describe drug therapy for CNS stimulant abuse and dependence

Answer 17

few proven pharmacologic treatments are effective in the treatment of CNS stimulant abuse and dependence

Question 18

name some psychoctive drugs and how do you treat its abuse and dependence

Answer 18

• good ole mary jane
• hallucinogens like club drugs, date rape drugs, and inhalants

no proven FDA drugs for it