Substance Abuse II Flashcards
What are the criteria for caffeine use disorder?
No such thing
What is considered “high dose” caffeine?
250 mg
What are the criteria for caffeine intoxication? (non -obvious)? How many are needed?
-Flushed face
5
What are the criteria for caffeine withdrawal? How many within a 24 hours timeframe are needed to diganose?
At least 3 within 24 hours:
- HA
- Fatigue
- Dysphoric
- Flu-like s/sx
- Difficulty concentring
What is the major issue with Li and Caffeine use?
Diuretic aspect of caffeine may alter [Li]
What is the most widely used illicit substance?
Marijunana
What is the age range that has the highest marijuana use?
18-29 years
True or false: regular users of marijuana had concurrent metal disorders
True
True or false: most individuals who use cannabis report that they use it solely for pleasure
False–cope with mood, sleep, pain etc
What are the four criteria for marijuana intoxication? How many are needed? Within what time frame?
2 within 2 hours:
- Conjunctival injection
- Increased appetite
- Dry mouth
- Tachycardia
What is “K2?
Synthetic cannabinoid–sprayed onto herbal/plant matter
What are the major effects of synthetic cannabinoid?
- Anxious
- Irritable
- Cognitive impairment
- Psychosis
How reliable are tox screens for K2?
Not very
What are the physical effects of K2?
Conjunctival injection
What are the s/sx of cannabis withdrawal?
- Sleep difficulty
- Anxiety
- Decreased appetite
What are the major phencyclidines?
- PCP
- Ketamine
What are the s/sx of phencyclidine (PCP) use? (5)
- Dissociative symptoms
- Nystagmus
- HTN
- Violent behavior
- Analgesia
What are the complications that can result from phencyclidine use?
- Cognitive deficits
- Szs
- Intracranial hemorrhage
What is MDMA?
Ecstasy
What are the eye findings with phencyclidine use?
- Pupillary dilation
- Nystagmus
What are the muscle findings of phencyclidine?
- Rigidity
- Ataxia
- Dysarthria
What are the CV effects of Phencyclidine intoxication?
- Tachycardia
- HTN
How mayn diagnostic criteria are needed, and in what timeframe, for phencyclidine intoxication?
Within 1 hour, at least 2
What are the ocular s/sx of hallucinogenic intoxication?
Dilation
Blurred vision
True or false: there is no withdrawal with inhalant use
True
What are the general features of inhalant intoxication?
- Belligerence
- lethargy
- Impaired judgement
What are the the ocular findings of inhalant use?
- Nystagmus
- Blurred vision
- Diplopia
What are the motor findings of inhalant intoxication? (4)
- Incoordination
- Psychomotor retardation
- Tremor
- Generalized weakness
What is the common cause of death with inhalant use?
Cardiac arrhythmias
What is the general MOA of opioids?
Mu-opioid receptor agonist
What happens after the euphoric-Perceptual motor phase with opioid use?
Apathy and dysphoria
What happens to motor function with opioid intoxication?
Agitation or retardation
What are the diagnostic criteria for opioid intoxication? (4)
Pupillary constriction + 1 or more of:
- Slurred speech
- Drowsiness
- Impairment in attention or memory
How many criteria are needed to diagnose opioid withdrawal? In what timeframe?
3 or more within minutes to days
What are the ocular findings with opioid withdrawal?
Pupillary dilation
What are the general s/sx of opioid withdrawal?
- Dysphoria
- N/v
- myalgias
What are the ANS findings of opioid withdrawal? (3)
- Lacrimation / rhinorrhea
- Piloerection
- Diaphoresis
What are the GI findings of opioid withdrawal?
Diarrhea
What is the name of the diagnostic algorithm used to diagnose opioid withdrawal?
COWS
What are the three major medication used in opioid withdrawal?
- Methadone
- Buprenorphine
- Naltrexone
What is the MOA of methadone?
Long acting synthetic opioid agonist
What s the MOA of buprenorphine?
Synthetic partial agonist of opioid receptors
What is the MOA of naltrexone?
opioid antagonist
Why give buprenorphine and naloxone as a combination?
Naloxone is not enterically absorbed, so if used PO, then the buprenorphine will give only a small high. If injected, then naloxone will cause withdrawal symptoms
True or false: craving is not typical with Sedatives / hypnotics / Anxiolytic use
False
Sedatives / hypnotics / Anxiolytic use appears very similar to what other substance?
EtOH
True or false: if you experience withdrawal from prescribed use of Sedatives / hypnotics / Anxiolytic, then you are diagnosed with use disorder
False
What are the s/sx of Sedatives / hypnotics / Anxiolytic intoxication?
- Impaired judgement
- Mood lability
- Inappropriate or sexual behavior
What are the motor findings of Sedatives / hypnotics / Anxiolytic use?
- Slurred speech
- Incoordination
- Unsteady gait
What are the ocular findings of Sedatives / hypnotics / Anxiolytic intoxication?
Nystagmus
How many diagnostic criteria are needed for Sedatives / hypnotics / Anxiolytic intoxication?
1 or more
What are the cognitive effects of Sedatives / hypnotics / Anxiolytic intoxication?
- Impairment
- Stupor/coma
What is the reversal agent for benzos? MOA?
- Flumazenil
- GABA antagonist
How many diagnostic criteria are needed to diagnose anxiolytic/sedative withdrawal? In what timeframe?
2 or more within hour to days
What are the nervous system withdrawal symptoms of anxiolytic withdrawal?
- ANS hyperactivity
- Psychomotor agitation
- Hallucinations
- Seizures
True or false: reality testing is intact with withdrawal from anxiolytic use
True
What are the results of long term use of stimulants? (4)
- Chaotic behavior
- Social isolation
- Sexual dysfunction
- Aggressive behavior
What are the non-obvious s/sx of stimulant use intoxication?
- Stereotyped and repetitive behavior
- Tension and anxiety
What are the pupillary findings of stimulant use?
Dilation
What are the CV criteria for stimulant intoxication?
- Tachycardia or bradycardia
- HTN or hypotension
- Cardiac arrhythmias
What are the psychomotor criteria for stimulant intoxication?
Retardation or agitation
What are the GI criteria for stimulant intoxication?
- n/v
- Weight loss
NDMA is structurally similar to what other illicit drug?
Methamphetamine
What are the CNS complications from cocaine use?
- SAH
- HA
- CVA
- Szs
What is the major muscular complication from cocaine use?
Rhabdomyolysis
What are the GI complications from cocaine use?
Intestinal ischemia
-gangrene
What are the OB complications from cocaine use?
- Abruptio placenta
- Spontaneous abortion
- Premature labor
- Perinatal mortality
True or false: cocaine can cause DKA
True
What are the diagnostic criteria for stimulant withdrawal (1 + 5)
Dysphoric mood +
- Fatigue
- Vivid dreams
- Sleep changes
- Increased appetite
- Psychomotor retardation
True or false: there is NO tobacco intoxication
True
What are the criteria for tobacco use disorder?
Daily use
What are some of the intranasal complications from cocaine use?
- Anosmia
- Necrosis and perforation of the nasal septum
What is the timeframe and symptoms amount needed to diagnose tobacco withdrawal?
Within 24 hours
4 or more
What happens to appetite with tobacco withdrawal?
INcreased
What happens to mood with tobacco withdrawal?
Depression / dysphoria
What is the first step in the treatment of withdrawal? What are the limitations of this?
Detox
-Does not address social/psych concerns
What is the hopsital model for short term residential rehab?
- 3-6 week hospital inpt tratment
- outpatient care
- self help group
What is the long term residental model for rehab?
- 6-12 months
- Resocialization
- Struturalization
What are the focuses of outpatient rehab programs?
- group counseling
- Intensive day treatment
What are the focuses of individual rehab counseling?
- Areas of impaired functioning
- Short term behavioral goals
What is the cost for alcoholics anonymous?
Free
What are the three keys to alcoholics anonymous?
- Acceptance
- Surrender-
- 12 step program
What is the role of Gas chromatography and mass spec in drug testing?
Confirmatory
