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Year 4k: Psych > Substance Abuse (not alcohol) > Flashcards

Substance Abuse (not alcohol) Flashcards

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1
Q

What is the aetiology of substance misuse?

A
  • Genetics
  • Peer pressure
  • Parental drug use
  • Life stressors
  • Personal vulnerability e.g lack of resources to cope with stresses
  • Cultural acceptability
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2
Q

What are the routes that opiates are taken through?

A
  • Morphine (PO, IV)
  • Diamorphine/Heroin (IN, IV, Smoked)
  • Codeine (PO)
  • Methadone (PO)
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3
Q

What are psychological effects of Opiates?

A
  • Apathy
  • Disinhibition
  • Psychomotor retardation
  • Impaired judgement
  • Inattention
  • Drowsiness
  • Slurred speech
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4
Q

What are physical effects of opiate use?

A
  • Respiratory depression
  • Hypoxia
  • Reduced BP
  • Hypothermia
  • Coma
  • Pupillary constriction
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5
Q

What are symptoms and signs shown in withdrawal state for Opiates?

A
  • Craving
  • Rhinorrhoea
  • Lacrimation
  • Myalgia
  • Abdominal cramps
  • Nausea and vomiting
  • Diarrhoea
  • Pupillary dilatation
  • Piloerection
  • Increase heart rate or blood pressure
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6
Q

What are examples of routes for Cannabinoids?

A
  • Cannabis (PO, IV)
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7
Q

What are psychological effects of Cannabinoids?

A
  • Euphoria
  • Disinhibition
  • Agitation
  • Paranoid ideation
  • Temporal slowing
  • Impaired judgement/attention/reactions time
  • Illusions
  • Hallucinations
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8
Q

What are physical effects of Cannabinoids?

A
  • Increased appetite
  • Dry mouth
  • Conjunctival injection
  • Increased heart rate
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9
Q

What are symptoms and signs of the withdrawal state upon taking Cannabinoids?

A
  • Anxiety
  • Irritability
  • Tremor of outstretched hands
  • Sweating
  • Myalgia
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10
Q

What are symptoms and signs of the withdrawal state upon taking Sedatives-Hypnotics?

A
  • Tremor of hands/tongue/eyelids
  • Nausea and vomiting
  • Increased heart rate
  • Postural hypotension
  • Headache, agitation
  • Malaise
  • Transient illusions/hallucinations
  • Paranoid ideation
  • Grand mal convulsions
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11
Q

What are psychological effects of taking Sedatives-Hypnotics?

A
  • Euphoria
  • Disinhibition
  • Apathy
  • Aggression
  • Anterograde amnesia
  • Labile mood
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12
Q

What are physical effects of taking Sedatives-Hypnotics?

A
  • Unsteady gait
  • Difficult standing
  • Slurred speech
  • Nystagmus
  • Erythematous skin lesions
  • Reduced blood pressure
  • Hypothermia
  • Depression of gag reflex
  • Coma
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13
Q

What are examples of Sedative-Hyponotics?

A
  • Benzodiazepines (PO, IV)
  • Barbiturates (PO, IV)
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14
Q

What are examples of Stimulants?

A
  • Cocaine, crack cocaine - IV, IN, Smoked
  • Ecstasy - PO
  • Amphetamine - PO, IV, IN, smoked
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15
Q

What are psychological effects of Stimulants?

A
  • Euphoria
  • Increased energy
  • Grandiose beliefs
  • Aggression
  • Argumentative
  • Illusions
  • Hallucinations (intact orientation)
  • Paranoid ideation
  • Labile mood
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16
Q

What are physical effects of Stimulants?

A
  • Increase HR
  • Increased BP
  • Arrythmias
  • Sweating
  • Nausea and vomiting
  • Pupillary dilatation
  • Psychomotor, agitation
  • Muscular weakness
  • Chest pain
  • Convulsions
17
Q

What are signs and symtpoms of withdrawal states upon taking Stimulants?

A
  • Dysphoric mood
  • Lethargy
  • Psychomotor agitation
  • Cravings
  • Increase appetite
  • Insomnia
  • Bizarre/unpleasant dreams
18
Q

What are examples of Hallucinogens?

A

Per Oral

  • LSD
  • Magic
  • Mushrooms
19
Q

What are psychological effectis of Hallucinogens?

A
  • Anxiety
  • Illusions
  • Hallucinations
  • Depersonalisation
  • Derealization
  • Paranoia
  • Ideas of reference
  • Hyperactivity
  • Impulsivity
  • Inattention
20
Q

What are physical effects of Hallucinogens?

A
  • Increased HR
  • Palpitation
  • Sweating
  • Tremor
  • Blurred vision
  • Pupillary dilation
  • Incoordination
21
Q

What are examples of Volatile Solvents?

A

Inhaled

  • Aerosols
  • Paint
  • Glue
  • Petrol
22
Q

What are the psychological effects of Volatile Solvents?

A
  • Apathy
  • Lethargy
  • Aggression
  • Impaired attention and judgement
  • Psychomotor retardation
23
Q

What are the physical effects of Volatile Solvents?

A
  • Unsteady gait
  • Diplopia
  • Nystagmus
  • Decreased consciousness
  • Muscle weakness
24
Q

What are examples of anabolic steroids?

A

Per oral and Intramuscular

  • Testosterone
  • Androstenedione
  • Danazol
25
Q

What are psychological effects of Anabolic Steroids?

A
  • Euphoria
  • Depression
  • Aggression
  • Hyperactivity
  • Mood swings
  • Hallucinations
  • Delusions
26
Q

What are physical effects of Anabolic Steroids?

A
  • Increased muscle mass
  • Reduced fat
  • Acne
  • Male pattern baldness
  • Reduced sperm count
  • Infertility
  • Stunted growth
27
Q

What is substance dependance?

A

Substance dependence describes a syndrome including behavioural, physiological and psychological elements. Patients are physiologically dependent if they show tolerance or withdrawal.

  • ≥ 3 of the following manifestations must have occurred over 1 month:
    • (1) Strong Desire (compulsion) to consume substance
    • (2) Preoccupation with substance use
    • (3) Withdrawal state when substance ingestion is reduced or stopped
    • (4) Impaired ability to control substance-taking behaviour (e.g. onset, termination or level of use)
    • (5) Tolerance to substance. More consumption for desired effect.
    • (6) Persisting with use, despite clear evidence of the Harmful effects
28
Q

What are investigations for Substance abuse?

A
  • Bloods: HIV screen, HEP B, HEP C, Tuberculosis testing, U&Es to check renal function, LFTs and clotting for hepatic function or Drug levels
  • Urinalysis: drug metabolites detected in urine
  • ECG for arrhythmia
  • Echo if endocarditis
29
Q

What are steps taken to manage patient generally in substance abuse?

A
  • Hep B immunization for those at risk
  • Motivational interviewing to help with controlling substance misuse and CBT may be offered. Contingency management which focuses on changing specified behaviours for positive behaviours
  • Supportive help can be in housing, finance and employment. Help with co-exiting alcohol misuse and smoking cessation. Self-help groups useful. Consider issue of driving as well.
  • Detoxification is a process which effects of drug are eliminated in a safe manner such that withdrawal symptoms are avoided in an attempt to attain abstinences. In maintenance therapy, abstinence is not priority rather the aim is minimisation of harm
30
Q

How is Opoid dependance managed?

A
  • Methadone or buprenorphine for detoxification
  • Naltrexone is recommended for those who were former opioid dependant but have now stopped and are motivated to continue abstinence
  • Intravenous naloxone used for antidote to opioid overdose
31
Q

What are some complications of substance misuse?

A
  • Physical: death, infections (HIV, HEP B, HEP A, HEP C, staph aureus, group A strep, clostridium difficile, TB), endocarditis, superficial thrombosis, DVT, PE
  • Psychological: craving, anxiety, cognitive disturbance, drug-induced psychosis
  • Social: crime, prison, homelessness, prostitution, relationship problems

Year 4k: Psych (14 decks)

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