substance abuse part 2 Flashcards

1
Q

What s GHB

A

gamma hydroxyburyrate is a CNS depressant that causes memory loss, resp distress, and coma. common date rape drug. considered a sedative/hypnotic`

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2
Q

How is benzodiazepam overdose treated?

A

flumazenil- short acting BZD antagonist. be careful- may cause seizure

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3
Q

How is barbiturate OD treated?

A

alkalinize urine with sodium bicarb

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4
Q

Which opiate causes mydriasis?

A

meperidine Can cause serotonin syndrome if taken with MAO-I

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5
Q

What is the tx for opiate withdrawal

A

clonidine for autonomic problems, NSAIDs, dicyclomine for abd cramps

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6
Q

What is the role of cannabinoid receptors in the brain? What are some benefits of THC?

A

inhibit adenylate cyclase. benefits: incr appetite in AIDS, decreae intraocular pressure

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7
Q

How does caffeine work?

A

adenosine antagoist to incr. cAMP. stimulant via dopaminergic system

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8
Q

What post-mortem findings are best correlated with severity of disease in Alzhemier’s patients?

A

-neuritic plaques, but NOT neurofibrillary tangles

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9
Q

what are the cholinesterase inhibitors used to treat dementia?

A

tacrine (cognex), donepazil, rivastigmine, galantamine

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10
Q

What is the tx for REM sleep behavior disorder?

A

clonazepam.

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11
Q

What are the key characteristics of frontotemporal dementia in terms of age of onset, genetics, and duration of illness?

A
  • usually begin between 45 and 65
  • 1/3 are familial and associated with mutations in the progranulin or MAPT gene
  • duration of illness typically 4-6 yrs
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12
Q

What are the key features of frontotemporal dementia?

A
  • personality changes
  • inhibited social behaviors
  • echolalia, overeating, and oral fixation
  • lack of empathy
  • deficits in isnight, planning, abstraction, and problem solving, with initially normal memory, language, and spatial function
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13
Q

What are the pathologic features of frontotemporal dementia?

A

neuronal loss, microvacuolization, astrocytic gliosis in cortical layer 2

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14
Q

Prominent features of creutzfeldt-jakob disease

A
  • rapidly progressive dementia and periodic generalized sharp waves on EEG plus 2 clinical features:
  • myoclonus
  • cortical blindness
  • ataxia or pyramidal signs
  • atrophy
  • mutism
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15
Q

What are changes seen in NORMAL aging?

A

decr brain weight, decr brain bass and incr. fat, impaired vision and hearing, and minor forgetfulness

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16
Q

What is the best TCA to use in an elderly person and why?

A

nortriptyline- fewest anticholinergic side effects

17
Q

What is complicated grief?

A

grief lasting >6 mo and including 4/8 sx:

  1. difficulty moving on
  2. numbness/detachment
  3. bitterness
  4. feeling empty
  5. trouble accepting the loss
  6. feeling that the future holds no meaning
  7. agitation
  8. difficulty trusting others
18
Q

When should you tread for MDD in a pt who has had a loss?

A

treat if 2 consecutive weeks of depressive sx 6-8 wks AFTER the loss occurs

19
Q

What are the safest sedative hypnotics in the elderly?

A

hydroxyzine or trazodone