Substance-related and addictive disorders Flashcards by Deja Gause

substance- related disorders are divided into?

substance use disorders and substance induced disorders (intoxication, withdrawal)

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According to the DSM-5 is gambling a substance use disorder

no , it is considered a non-substance-related addictive disorder

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what substances are mostly commonly associted with substance use disorder

alcohol and nicotine (cause physical, psychological and social impairment )

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what is the DSM5 criteria for substance use disorders

most have 2 or more of the following within a year

using substance in larger amounts or for a longer amount of time then expected
repeated failed attempts to cut down on substance use
engaging in substance seeking activities
cravings
problems at work/social
problems with relationships
reduced social/recreational activities
risky choices while using substance (unprotected sex)
continued use with knowing repercussions
drug tolerance
drug withdrawal

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which substances do not cause withdrawal?

hallucinogens and inahlants

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withrawal from what 3 substances can be fatal

alcohol, benzodiazepines, and barbituates

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what are the substance induced disorders

intoxication- alters persons consiousness, cognition, perception

withdrawal- sudden reduction of cessation of the substance after heavy intake causes behavioral, physiological and cognitive changes

substance induced mental health disorders- pysch disorder that occurs within 1 month of intoxication or withdrawal of substance and is NOT attributable to an independent mental disorder

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Alcohol intoxication symptoms: pupils, heart, other

pupils: slowed pupil reaction
Heart: hypotension, tachycardia
other: disinhibition, stupor/coma, dysarthria, ataxia, nystagmus

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alcohol withdrawal symptoms

hypertension, palpitations, sweating

anxiety

alcohol withdrawal seizures, delirium tremens

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Opiod intoxication symptoms : pupils, heart, other

pupils: pinpoint pupils (miosis)
heart: hypotension, bradycardia
other: respiratory depression, sedation, coma, CNS depression, euphoria, seizures, absent gag reflex

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opioid withdrawal symptoms

piloerection, chills, myalgia

diarrhea

mydriasis, tachycardia, insomnia, anxiety

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barbiturates intoxiation symptoms: pupils, heart, other

pupils: miosis
heart: bradycardia, hypotension
other: hypothermia , respiratory depression, sedation

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barbiturates withdrawal symptoms

delirium, severe hypotension, potential cardiovascular collapse

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benzodiazapine intoxication symptoms: pupils, heart, other

pupils: normal in mild intoxication, mydriasis in severe intoxication

heart: hypotension, bradycardia

other: hyporeflexia, ataxia, slurred speech, respiratory depression , sedation

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benzodiazapine withdrawal

sweating, hypertension, seizures, tremors, depressive mood swings

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inhalants intoxications: pupils, heart, other

pupils: normal – mydriasis (severe)

heart: hypertension ro hypotension, tachycardia

other: slurred speech, nystagmus, euphoria , disinhibition

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inhalants withdrawal

sweating, hypertension, seizures, tremors, depressive moods

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amphetamines intoxication symptoms: pupils, heart, other

pupils: mydriasis
heart: tachycardia, hypertension, arrythmias
other: grandiosity, burxism, increased energy and concetration, delusional parasitosis, increased libido, decreased apetitis

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amphetamines withdrawal

anhedonia, anxiety, decreased energy, depression/suicidal thoughts, increased appetite, sleep disturbances

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cocaine intoxication symptoms: pupils, heart, other

pupils: mydriasis
heart: tachycardia, hypertension, arrhythmmia
other: grandiosity, bruxism, angina, sudden cardiac death, nasal septum perforation, tactile acoustic and optic hallucinations

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cocaine withdrawal symptoms

decreased energy, increased appetite , sleep distubrance, anhedonia

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synthetic cathiones intoxication symptoms: pupils, heart, other

pupils: mydriasis
heart:tachycardia, hypertension
other: aggression, confusion, muscle spasms

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synthetic cathinones withdrawal symptoms

anxiety, tremor, depression

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caffeine intoxication symptoms: pupils, heart, other

pupils: mydriasis
heart: hypertension followed by hypotension, tachycardia and arrhythmias
other: agitation, excitement, insomina, tremor, flushed face

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caffeine withdrawal symptoms

depressed mood, drowsiness, difficulty concentrating, muscle pain, flu like symptoms

nicotine intoxication : pupils, heart, other

pupils: normal or mydriasis heart: hypertension and tachycardia is mild hypotension, bradycardia and arrhythmia is severe other: euphoria, restlessness, weight loss, diarrhea,

nicotine withdrawal

frustration, anger, weight gain, impaired concentration

Cannabis intoxication : pupils, heart, other

pupils: mydriasis heart: hypertension, tachycardia, arrhythmias other: perceptual changes, distorted sense of time, paranoia, delusions, pyshcosis, conjunctival injection, dry mouth, increased appetite, impaired reaction time, social detachment

cannabis withdrawal

decreased appetite, anorexia, irritability, anxiety

Lysergic acid diethylamide (LSD) intoxication : pupils, heart, other

pupils: mydriasis heart: hypertension, tachycardia other: flashbacks, delusions, perceptual changes

LSD withdrawal

NONE

MDMA intoxication: pupils, heart, other

pupils: mydriasis heart: hypertension, tachycardia other: bruxism, severe agitation, hyponatremia, hyperthermia, sweating, serotonin syndrome

MDMA (molly) withdrawal

changes in sleep and appetite, difficulty concentrating, depression, fatigue

Phencyclidine (PCP) intoxication: pupils, heart, other

pupils: miosis heart: hypertension, tachycardia other: behavioral changes (violence) horizontal nystagmus, muscle rigidity, hyperthermia

PCP withdrawal

seizures, agitation, muscle twitching, hallucinations

gamma hydroxybutyric acid (GHB) intoxication at low, high, and overdose levels

low: miosis or mydriasis, hypotension, bradycardia, bradypnea, intensified sensory experience, enhanced empathy and libido, disinhibition high: miosis or mydriasis, hypotension, bradycardia, light headed, LOC, self injurous behavior, tics overdose: respiratory arrest, coma, seizures

GHB withdrawal

diaphoresis, agitation, tachycardia, hypertension, tremor, muscle tone and death

what is the most frequent drug testing method in urine

immunoassay testing

what substances are detectable in immunoassay urine drug screens

PCP, opioids, THC, cocaine and amphetamine

substances that can cause cross reactivity and yield false positives

Marijuana: food containing hemp PCP: doxylamine, dextromethorphan , tramadol opioids: poppy seeds, rifampin benzodiazepines: sertraline amphetamines: psuedophedrine, ephedrine, phenylephrine, metformin

mechanism of action for caffeine related disorders

adenosine antagonist that causes increase cAMP and neurological excitation from release of catecholamines

treatment of caffeine overdose and withdrawal

overdose: supportive care with betablockers withdrawal: usually resolve spontaneously

classic hallucinogens

LSD, Psilocybin, DMT

dissociate drugs

PCP, ketamine, dextromethorphan

serotonergic stimulants

MDMA, mescaline

botanical drugs

cannabis saliva divinorum ayahuasca

hallucinogen intoxication treatment

antipsychotics for psychosis benzodiazapenies for agitation external cooling for hyperthermia

hallucinogen withdrawal treatment

usually not associated with withdrawal

PCP intoxication treatment specific

reduction of environmental stimuli GI decontamination

complications of PCP overdose

trauma and intracranial hemorrhage seizures resoprtion of the drug in the GI tract and symptom recurrence

MOA of LSD overdose

5HT2A serotonin receptor agonist that increases serotonin concentrations at the synaptic cleft leading to hallucinations

what substances count as inahlants

hydrocarbon based inhalants: glue, paint thinners, nitrous oxide. (suppress CNS)

treatment of inhalants intoxication (no withdrawal symptoms)

supportive, +/- intubation, psychotherapy

complications of using inhalants

impaired cognition, aplastic anemia, MI

what drugs are opioids

opiates: fentanyl, oxycodone, hydrocodoine, heroin

MOA of opioids

mu opiod receptor agonists (morphine, heroin , codeine, fentanyl) mixed agonist and antagonist- buprenophine

GHB mechanism of action

direct agonist of GABA receptors like benzos (used as a date rape drug)

treatment of GHB

supportive and sedative agents

what is the first line drug for smoking cessation

varenicline

MOA of PCP

inhibition of NMDA receptors and activation of dopaminergic neurons