Substance Abuse Disorders

Question 1

CAGE

Answer 1

Cut down on drinking?
Annoyed by criticism of your dirnking?
Guilty feelings about your drinking?
Ever had an Eye opener?

Question 2

Moderate drinking

Answer 2

2 or less drinks/day men

1 or less for women

Question 3

Heavy drinking

Answer 3

> 14 drinks/wk for men

>7 drinks for women

Question 4

Binge drinking

Answer 4

More than 5 drinks in a row for men and 4 for women

Question 5

ADH

Answer 5

Alcohol dehydrogenase

Converts alcohol to acetaldehyde.

Question 6

ALDH

Answer 6

Aldehyde Dehydrogenase.

Converts acetaldehyde to acetate

Question 7

Wernicke’s Encephalopathy

Answer 7

Acute sx reversible with high dose thiamine.

Ataxia, vestinular dysfxn, confusion, ocular abnormalities.

Question 8

Korsakoff’s Syndrome

Answer 8

Chronic condition where 20% of pts recover.

Impaired recent memory and anterograde amnesia.

Question 9

Cocaine

Answer 9

Serotonin, norepenephrine, dopamine reuptake inhibitor.

Adrenergic stimulation.

Question 10

Methamphetamine

Answer 10

2nd to cannabis as most abused substance.

Question 11

Meth intoxication tx

Answer 11

Sedation
Protect airway
Control temp and BP
Watch for cardiovascular collapse.

Question 12

Is cannabis dependence inherited?

Answer 12

Yes. 60%

Question 13

LSD

Answer 13

Lysergic acid diethylamide
Capsule, pill or liquid
Neuropsych sx, but alert and aware of situation

Question 14

Dextromethorphan (DXM)

Answer 14

Codeine analog

OTC in cold and cough prep.

Question 15

Mescaline

Answer 15

Active ingredient of cactus.
“bromo”
Gentler than LSD

Question 16

PCP

Answer 16

Phencyclidine

Similar to ketamine

Question 17

Varenicline

Answer 17

Chantix
Agonist of nicotinic acth receptors
1st line smoking cessation
Watch for neuropsych!

Question 18

Drinking withdrawls

Answer 18

Begin within 6 hrs

Start to resolve within 24-48 hrs

Question 19

Withdrawl seizures

Answer 19

Occur within 48 hrs after last drink

Treat w/ benzos

Question 20

Alcoholic hallucinosis

Answer 20

Develop within 12-24 hrs from last drink, resolve within 24-48 hrs.
Usually visual

Question 21

Delirium Tremens (DT’s)

Answer 21

5% of pts in withdrawl
Hallucinations, disorientation, tachycardia
HTN
Agitation
Can be fatal

Question 22

When do DT’s begin?

Answer 22

48 - 96 hrs after last drink.
Last 1-5 days
Mortality rate of 5%

Question 23

What should be given during moderare to severe withdrawals?

Answer 23

Benzos, thiamine

Question 24

What should not be used to treat withdrawal?

Answer 24

Antipsychotics (lower seizure threshold)

Question 25

Naltrexon

Answer 25

Mu-opioid receptor antagonist
Blunts pleasurable effects of etoh
Follow LFT’s
Also used in opioid abuse.

Question 26

Acamprosate

Answer 26

Used for etoh relapse prevention.

Not as effective as naltrexon

Question 27

Disulfiram (antabuse)

Answer 27

Causes hypersensitivity to etoh.
Unpleasant effect
Inhibits ALDH

Question 28

Methadone

Answer 28

Method of long term tx
Schedule II
Single daily dose, controlled setting

Question 29

Clonidine

Answer 29

Alpha II Adrenergic receptor agonist.

May decrease W/D sx