Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NMSP Exam 1 > Substance Abuse Disorders > Flashcards

Substance Abuse Disorders Flashcards

1
Q

What explains the development of tolerance and physical dependence?

A

These are normal physical adaptations of the body in the presence of an opioid

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

How is addiction different from physical dependence?

A

Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry; dysfunction in these circuits leads to biological, psychological and behavioral dysfunction

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

What is the criteria for a diagnosis of substance use disorder?

A
  1. Using larger amounts or longer time than intended
  2. Persistent desire or unsuccessful attempts to cut down/control use
  3. Craving
  4. Fail to fulfill major roles
  5. Persistent social or interpersonal problems caused by substance use
  6. Important social, occupational, recreational activities have been given up on or reduced
  7. Use in physically hazardous situation
  8. Use despite physical or psychological problems caused by use
  9. Tolerance
  10. Withdrawal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

of symptoms that classify substance use disorder as mild

A

2-3 symptoms

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

of symptoms that classify substance use disorder as moderate

A

4-5 symptoms

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

of symptoms that classify substance use disorder as severe

A

6 or more symptoms

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

Criteria for early remission from substance use disorder

A

No criteria for > 3 months but < 12 months

(except craving)

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

Criteria for sustained remission from substance use disorder

A

No criteria for > 12 months (except craving)

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

What differentiates a substance-induced mental disorder from a regularly classified mental disorder?

A

The disorder developed within 1 month of substance intoxication or withdrawal or taking a medication

and

The involved substance/medication is capable of producing a mental disorder

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

With which substances is withdrawal not seen?

A

PCP, certain hallucinogens (MDMA), inhalants

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

Define neuroadaptation

A

Underlying CNS changes that occur following repeated substance use such that persons develop tolerance and/or withdrawal

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

Define tolerance

A

The need to use an increased amount of a substance in order to achieve the desired effect

or

Markedly diminished effect with continued use of the same amount of the substance

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

Symptoms associated with alcohol intoxication include?

A

Mood lability

Impaired judgment,

Poor coordination

Neurologic impairment (dysarthria, amnesia, ataxia, obtundation)

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

Early signs of alcohol withdrawal
(first 8-24 hours)

A

Anxiety
Irritability
Tremor
HA
Insomnia
Nausea
Tachycardia
HTN
Hyperthermia
Hyperactive reflexes

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

What is typically seen 24-48 hours into alcohol withdrawal?

A

Seizures
(tend to be grand mal)

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

What condition develops 48-72 hours into alcohol withdrawal?

A 
Delirium tremons
(characterized by AMS, hallucinations, autonomic instability)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the hallmark of delirium tremens?

A

Profound global confusion

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

What is the typical treatment for alcohol withdrawal?

A

Benzodiazepines

Anticonvulsants, including Valproic acid or Carbamazepine

Thiamine supplementation to prevent wernicke/korsakoff

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

It is important to check LFTs to assess hepatotoxicity when a patient is taking what medication to treat alcohol use disorder?

A

Naltrexone

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

What is the treatment for alcohol use disorder?

A

Alcoholics anonymous!!!

Naltrexone

Acamprosate

???Disulfiram

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

Intoxication by what substance is similar to alcohol intoxication but with less cognitive/motor impairment?

A

Benzos & barbiturates

22
Q

Symptoms associated with benzodiazepine withdrawal include?

A

Anxiety
Irritability
Insomnia
Fatigue and HA
Tremor
Sweating
Poor concentration

**time frame depends on half-life**

23
Q

What common detox mistake often precipitates significant benzodiazepine withdrawal symptoms?

A

Tapering too fast

(symptoms worse at end of taper)

24
Q

What pharmacologic therapies are helpful in treating benzodiazepine withdrawal?

A

Carbamazepine

Valproic acid

Gabapentin + Tizanidine

25
Q

What benzodiazepines are metabolized only through glucuronidation in the liver and thus are not affected by age/hepatic insufficiency

A

Oxazepam

Temazepam

Lorazepam

26
Q

Symptoms associated with opioid intoxication include?

A

Pinpoint pupils
Sedation
Constipation
HoTN
Decreased RR

27
Q

Symptoms associated with opioid withdrawal include?

A

Dilated pupils
Lacrimation
Goosebumps
N/V/D
Myalgias and arthralgias
Dysphoria
Agitation

“Anxious, hot and moist”

28
Q

What medications are used to treat opioid use disorder?

A

Naltrexone (antagonist)

Methadone (full agonist)

Buprenorphine (partial agonist)

29
Q

Why is Methadone a high risk medication?

A

It can be deadly when used with a benzodiazepine

Frequently causes QTc prolongation which may lead to torsades depointe arrhythmia (fatal)

Dangers increase when used with other CYP3A4 substrates

30
Q

Is methadone maintenance used to treat pain?

A

NO

31
Q

Of the opioids, which is not a CYP3A4 substrate?

A

Morphine

32
Q

Symptoms associated with acute stimulant intoxication include

A

Euphoria
gregariousness
hyperactivity
restlessness
anxiety, tensionl, anger
tachycardia, HTN, sweating
N/V
seizures, coma, hyperthermia

33
Q

Symptoms associated with chronic stimulant intoxication include

A

Affective blunting
Fatigue
Sadness
Social withdrawal
HoTN and bradycardia
Muscle weakness

34
Q

What is the main association with stimulant withdrawal?

A

Suicidal depression

35
Q

Cocaine prevents the reuptake of what NT?

A

Dopamine

36
Q

There is an increased risk of CVA and MI with what stimulant?

A

Cocaine

37
Q

What two conditions are associated with cocaine use?

A

Rhabdomyolysis with compartment syndrome

Psychosis

38
Q

What is the preferred treatment for stimulant use disorder?

A

Narcotics anonymous

Support, education, skills

39
Q

Amphetamines can be fatal at lower doses in the setting of what syndrome?

A

Brugada syndrome

40
Q

Amphetamines inhibit the reuptake of what NTs?

Greatest effect on which one?

A

DA, NE, and 5HT

Greatest effect on DA

41
Q

Tobacco induces what cytochrome P450 enzyme?

What drugs are metabolized with this enzyme and thus should be monitored for interactions in smokers?

A

CYP1A2

Olanzapine, Ramelteon

42
Q

Nicotine ACh receptors on DA neurons in the VTA release DA onto what area of the brain?

A

Nucleus accumbens

43
Q

Symptoms associated with nicotine withdrawal include?

A

Dysphoria
Irritability
Anxiety
Decreased concentration
Insomnia
Increased appetite

44
Q

Treatment options for Tobacco use disorder

A

CBT

Nicotine gum, patches, nasal spray

Bupropion

Varenicline (Chantix)

45
Q

Commonly abused hallucinogens include

A

Mescaline

Psilocybin (shrooms)

LSD

DMT

STP

MDMA

46
Q

Symptoms associated with MDMA intoxication include

*note MDMA = ecstasy/molly*

A

Illusions
Hyperacusis
Sensitivity to touch, taste, and smell
Euphoria
Panic/paranoia
Impaired judgment

47
Q

What is a classic symptom that points to MDMA intoxication?

A

extremely high fever!!!

(38.5 to 43ºC)

48
Q

MDMA affects 5-HT, DA and NE receptors, but what specific 5-HT?

A

5-HT2

49
Q

What gender of adolescents who regularly use cannabis have a 7-fold increased risk of psychosis?

A

Males

50
Q

Symptoms of PCP intoxication include?

A

Severe dissociative rxns (paranoid delusions, hallucinations, agitated/violent)

Nystagmus!!! (Vertical and horizontal)

Hyperthermia, rhabdomyolysis, seizures, coma and death with severe OD

51
Q

Treatment for PCP intoxication includes

A

Antipsychotic drugs (SGAs are first line)

NMSP Exam 1 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions