substance misuse: chapter 18

Question 1

what are 8 drugs that fall under the class of opioids

Answer 1

heroin, codeine, hydrocodone, hydromorphone, meperidine, morphine, fentayl, oxycodone

Question 2

mechanism of action of opioids

Answer 2

block receptors in the cns

Question 3

effect of opioids (4)

Answer 3

analgesia, drowsiness, euphoria, reduced sensory response

Question 4

indication for methadone. why

Answer 4

opioid dependence. long acting drug to reduce cravings, suppress euphoria, and prevent withdrawal

Question 5

3 contraindications for opioids

Answer 5

high doses or prolonged use with pregnancy, respiratory depression, severe asthma

Question 6

4 cns adverse effects of opioids

Answer 6

diuresis, miosis, convulsions, respiratory depression

Question 7

4 non cns adverse effects of opioids

Answer 7

hypotension, decreased urinary retention, flushing, sweating

Question 8

what is the peak period for opioid withdrawal

Answer 8

1-3 days

Question 9

how long do opioid withdrawal symptoms last for

Answer 9

5-7 days

Question 10

7 signs of opioid withdrawal

Answer 10

drug seeking, dilated pupils, goosebumps, sweating, rhinorrhea, lacrimation, elevated bp and pulse

Question 11

4 symptoms of opioid withdrawl

Answer 11

desire for drugs, muscle cramps, arthralgia, anxiety

Question 12

why is naltrexone used. why

Answer 12

to prevent euphoria that is produced by opioids because it blocks opioid receptors

Question 13

what is methylnatrexone

Answer 13

the injectable form of naltrexone

Question 14

what is naloxone used for. what two drugs is it commonly combined with

Answer 14

used for opioid overdose and respiratory depression. commonly combined with buprenorphine or hydromorphone

Question 15

what are 3 classes of amphetamines

Answer 15

salts of racemic amphetamine, dextroamphetamine, methamphetamine

Question 16

effects of cocaine

Answer 16

creates the temporary illusion of limitless power and energy but leaves the user feeling depressed, edgy, and craving more

Question 17

what 4 things does dextroamphetamine effect

Answer 17

mood, behaviour, cognition, mental status

Question 18

which amphetamine has the strongest effect on the body

Answer 18

methamphetamine

Question 19

what is another name for methylenedioxymethamphetamine

Answer 19

ectasy

Question 20

how do the effects of ecstasy differ from other amphetamines

Answer 20

it has a more calming effect but can also be energizing

Question 21

mechanism of action of amphetamines

Answer 21

stimulate the release of norephinephrine which stimulates the cns and cardiovascular systems

Question 22

what are the general effect of amphetamines (4)

Answer 22

elevate mood, reduce fatigue, increase alertness, increase aggression

Question 23

7 cns adverse effects of amphetamines

Answer 23

fainting, hypoactive reflexes, fever, aggression, delirium, hallucinations, suicidal or homocidal tendencies

Question 24

5 cardiovascular adverse effects of amphetamines

Answer 24

chilliness, pallor/flushing, tachycardia, hyper or hypotension, cardiac arrest

Question 25

2 gi adverse effects of amphetamines

Answer 25

metallic taste, abdominal cramps

Question 26

what is a potentially fatal adverse effect of amphetamines

Answer 26

hyperthermia

Question 27

what is the peak period for withdrawal from amphetamines

Answer 27

1-3 days

Question 28

how long do withdrawal symptoms last from amphetamines

Answer 28

5-7 days

Question 29

3 signs of amphetamine withdrawal

Answer 29

social withdrawal, psychomotor retardation, hypersomnia

Question 30

3 symptoms of amphetamine withdrawl

Answer 30

depression, suicidal thoughts/behaviours, delusions

Question 31

treatment for amphetamine withdrawal/overdose

Answer 31

no pharmacological treatments or antidotes. treatment is supportive and the patient is usually sedated

Question 32

how does death from amphetamine overdose usually occur (3)

Answer 32

convulsions, coma, cerebral hemorrhage

Question 33

what are the two main classes of depressants

Answer 33

benzodiazepines, barbiturates

Question 34

which drug is a benzodiazepam

Answer 34

flunitrazepam

Question 35

mechanism of action of depressants (marihuana)

Answer 35

THC binds to cannabinoid receptors in the cns which stimulates the sympathetic system and inhibits the parasympathetic system

Question 36

4 effects of marihuana

Answer 36

euphoria, memory lapses, enhanced appetite, distortion of time and space

Question 37

4 cns adverse effects while on depressants

Answer 37

sedation, loss of coordination, dizziness, hallucinations

Question 38

what can long term use of marihuana during childhood lead to

Answer 38

cognitive and psychomotor problems

Question 39

what chronic syndrome has been seen in adolescents who regularly use marihuana

Answer 39

chronic, depressive "amotivational" syndrome

Question 40

peak period of depressant withdrawal (short acting and long acting)

Answer 40

2-4 days for short acting, 4-7 days for long acting

Question 41

duration of depressant withdrawal symptoms

Answer 41

4-7 days for short acting, 7-12 days for long acting

Question 42

5 signs of depressant withdrawal

Answer 42

increased psychomotor activity, hyperthermia, delirium, increased bp and pulse, muscle weakness

Question 43

treatment for benzodiazepine withdrawl

Answer 43

7-10 day taper or 10-14 day taper for long acting

Question 44

which drug is used for the tapering of benzodiazepines

Answer 44

diazepam

Question 45

treatment for barbiturate withdrawal

Answer 45

7-10 day taper or 10-14 day taper

Question 46

what is a benzodiazepine reversal drug

Answer 46

flumazenil

Question 47

mechanism of action of alcohol (2)

Answer 47

cause cns depression by dissolving lipid membranes in the cns, enhance gaba

Question 48

effects of alcohol (5)

Answer 48

vasodilation, sweating, diuretic effect, respiratory stimulation or depression

Question 49

what are systemic uses of alcohol (what can it treat)

Answer 49

methyl alcohol and ethylene glycol intoxication (drinking automotive antifreeze)

Question 50

what are 5 adverse effects of long term excessive ingestion

Answer 50

neurological and mental health disorders, seizures, alcoholic hepatitis, cardiomyopathy, vitamin b deficiency

Question 51

what 4 things can vitamin b deficiency lead to

Answer 51

wernicke's encephalopathy, korsakoff's psychosis, polyneuritis, nicotinic acid deficiency encephalopathy

Question 52

what is fetal alcohol syndrome characterized by (3)

Answer 52

craniofacial abnormalities, cns depression, prenatal and postnatal growth restriction

Question 53

when can alcohol withdrawal begin

Answer 53

6-12hrs after the last drink

Question 54

peak period of alcohol withdrawal

Answer 54

2-3 days

Question 55

how long can alcohol withdrawal symptoms last for

Answer 55

7 days

Question 56

mild signs and symptoms of alcohol withdrawal (bp, hr, temp)

Answer 56

systolic bp greater than 150mmhg, diastolic bp higher than 90mmgh, hr greater than 110, temp above 37.7

Question 57

moderate signs and symptoms of alcohol withdrawal (bp, hr, temp)

Answer 57

systolic bp 150-200mmhg, diastolic bp 90-140mmhg, hr 110-140, temp 37.7-38.3

Question 58

severe signs and symptoms of alcohol withdrawal (bp, hr, temp)

Answer 58

systolic bp above 200mmhg, diastolic bp above 140mmhg, hr above 140, temp above 38.3

Question 59

treatment for alcohol withdrawal

Answer 59

supportive to stabilize the patient and maintain airway. can use benzodiazepines

Question 60

what does disulfiram do

Answer 60

alter metabolism of alcohol so that severe effects are seen which much lower amounts of alcohol

Question 61

what happens if a patient drank alcohol within 3-4 days of taking disulfiram. what 6 specific signs and symptoms are seen

Answer 61

acetaldehyde syndrome. signs and symptoms include whole body vasodilation, hypotension, chest pain, intense headache, vertigo, difficulty breathing

Question 62

why is acamprosate used for alcoholics/overdose

Answer 62

prevents relapse, restores balance between glutamate and gaba

Question 63

3 mechanisms of action of nicotine

Answer 63

stimulate autonomic ganglia followed by depression of ganglia, stimulate cns and respiratory system, cause the release of epinephrine

Question 64

3 effects of nicotine

Answer 64

increased heart rate and bp, increase activity in the bowels, increased stress

Question 65

what can large doses of nicotine lead to. why

Answer 65

death due to respiratory failure

Question 66

3 manifestations of nicotine withdrawal

Answer 66

cigarette craving, irritability, decrease in hr and bp

Question 67

what 3 things can be used to help with nicotine withdrawal. how do these things help

Answer 67

nicotine transdermal patch, nicotine polacrilex (gum), inhalers. provide a lower dose of nicotine to gradually decrease dose

Question 68

what drug is used as first line therapy for smoking cessation

Answer 68

bupropion

Question 69

mechanism of action of varenicline

Answer 69

activate and antagonize nicotinic receptors in the brain

Question 70

3 effects of varenicline

Answer 70

reduce the pleasurable effects of smoking, drowsiness, psychiatric symptoms such as depression and suicidality

Question 71

is varenicline safe to use during pregnancy

Answer 71

no