substance abuse part 2 Flashcards
What s GHB
gamma hydroxyburyrate is a CNS depressant that causes memory loss, resp distress, and coma. common date rape drug. considered a sedative/hypnotic`
How is benzodiazepam overdose treated?
flumazenil- short acting BZD antagonist. be careful- may cause seizure
How is barbiturate OD treated?
alkalinize urine with sodium bicarb
Which opiate causes mydriasis?
meperidine Can cause serotonin syndrome if taken with MAO-I
What is the tx for opiate withdrawal
clonidine for autonomic problems, NSAIDs, dicyclomine for abd cramps
What is the role of cannabinoid receptors in the brain? What are some benefits of THC?
inhibit adenylate cyclase. benefits: incr appetite in AIDS, decreae intraocular pressure
How does caffeine work?
adenosine antagoist to incr. cAMP. stimulant via dopaminergic system
What post-mortem findings are best correlated with severity of disease in Alzhemier’s patients?
-neuritic plaques, but NOT neurofibrillary tangles
what are the cholinesterase inhibitors used to treat dementia?
tacrine (cognex), donepazil, rivastigmine, galantamine
What is the tx for REM sleep behavior disorder?
clonazepam.
What are the key characteristics of frontotemporal dementia in terms of age of onset, genetics, and duration of illness?
- 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
What are the key features of frontotemporal dementia?
- 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
What are the pathologic features of frontotemporal dementia?
neuronal loss, microvacuolization, astrocytic gliosis in cortical layer 2
Prominent features of creutzfeldt-jakob disease
- rapidly progressive dementia and periodic generalized sharp waves on EEG plus 2 clinical features:
- myoclonus
- cortical blindness
- ataxia or pyramidal signs
- atrophy
- mutism
What are changes seen in NORMAL aging?
decr brain weight, decr brain bass and incr. fat, impaired vision and hearing, and minor forgetfulness
What is the best TCA to use in an elderly person and why?
nortriptyline- fewest anticholinergic side effects
What is complicated grief?
grief lasting >6 mo and including 4/8 sx:
- difficulty moving on
- numbness/detachment
- bitterness
- feeling empty
- trouble accepting the loss
- feeling that the future holds no meaning
- agitation
- difficulty trusting others
When should you tread for MDD in a pt who has had a loss?
treat if 2 consecutive weeks of depressive sx 6-8 wks AFTER the loss occurs
What are the safest sedative hypnotics in the elderly?
hydroxyzine or trazodone
