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Amboss > Substance-related and addictive disorders > Flashcards

Substance-related and addictive disorders Flashcards

1
Q

substance- related disorders are divided into?

A

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

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2
Q

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

A

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

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3
Q

what substances are mostly commonly associted with substance use disorder

A

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

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4
Q

what is the DSM5 criteria for substance use disorders

A

most have 2 or more of the following within a year

  1. using substance in larger amounts or for a longer amount of time then expected
  2. repeated failed attempts to cut down on substance use
  3. engaging in substance seeking activities
  4. cravings
  5. problems at work/social
  6. problems with relationships
  7. reduced social/recreational activities
  8. risky choices while using substance (unprotected sex)
  9. continued use with knowing repercussions
  10. drug tolerance
  11. drug withdrawal
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5
Q

which substances do not cause withdrawal?

A

hallucinogens and inahlants

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6
Q

withrawal from what 3 substances can be fatal

A

alcohol, benzodiazepines, and barbituates

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7
Q

what are the substance induced disorders

A

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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8
Q

Alcohol intoxication symptoms: pupils, heart, other

A

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

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9
Q

alcohol withdrawal symptoms

A

hypertension, palpitations, sweating

anxiety

alcohol withdrawal seizures, delirium tremens

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10
Q

Opiod intoxication symptoms : pupils, heart, other

A

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

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11
Q

opioid withdrawal symptoms

A

piloerection, chills, myalgia

diarrhea

mydriasis, tachycardia, insomnia, anxiety

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12
Q

barbiturates intoxiation symptoms: pupils, heart, other

A

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

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13
Q

barbiturates withdrawal symptoms

A

delirium, severe hypotension, potential cardiovascular collapse

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14
Q

benzodiazapine intoxication symptoms: pupils, heart, other

A

pupils: normal in mild intoxication, mydriasis in severe intoxication

heart: hypotension, bradycardia

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

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15
Q

benzodiazapine withdrawal

A

sweating, hypertension, seizures, tremors, depressive mood swings

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16
Q

inhalants intoxications: pupils, heart, other

A

pupils: normal – mydriasis (severe)

heart: hypertension ro hypotension, tachycardia

other: slurred speech, nystagmus, euphoria , disinhibition

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17
Q

inhalants withdrawal

A

sweating, hypertension, seizures, tremors, depressive moods

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18
Q

amphetamines intoxication symptoms: pupils, heart, other

A

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

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19
Q

amphetamines withdrawal

A

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

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20
Q

cocaine intoxication symptoms: pupils, heart, other

A

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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21
Q

cocaine withdrawal symptoms

A

decreased energy, increased appetite , sleep distubrance, anhedonia

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22
Q

synthetic cathiones intoxication symptoms: pupils, heart, other

A

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

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23
Q

synthetic cathinones withdrawal symptoms

A

anxiety, tremor, depression

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24
Q

caffeine intoxication symptoms: pupils, heart, other

A

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

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25
Q

caffeine withdrawal symptoms

A

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

26
Q

nicotine intoxication : pupils, heart, other

A

pupils: normal or mydriasis

heart: hypertension and tachycardia is mild

hypotension, bradycardia and arrhythmia is severe

other: euphoria, restlessness, weight loss, diarrhea,

27
Q

nicotine withdrawal

A

frustration, anger, weight gain, impaired concentration

28
Q

Cannabis intoxication : pupils, heart, other

A

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

29
Q

cannabis withdrawal

A

decreased appetite, anorexia, irritability, anxiety

30
Q

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

A

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

31
Q

LSD withdrawal

A

NONE

32
Q

MDMA intoxication: pupils, heart, other

A

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

33
Q

MDMA (molly) withdrawal

A

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

34
Q

Phencyclidine (PCP) intoxication: pupils, heart, other

A

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

35
Q

PCP withdrawal

A

seizures, agitation, muscle twitching, hallucinations

36
Q

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

A

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

37
Q

GHB withdrawal

A

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

38
Q

what is the most frequent drug testing method in urine

A

immunoassay testing

39
Q

what substances are detectable in immunoassay urine drug screens

A

PCP, opioids, THC, cocaine and amphetamine

40
Q

substances that can cause cross reactivity and yield false positives

A

Marijuana: food containing hemp

PCP: doxylamine, dextromethorphan , tramadol

opioids: poppy seeds, rifampin

benzodiazepines: sertraline

amphetamines: psuedophedrine, ephedrine, phenylephrine, metformin

41
Q

mechanism of action for caffeine related disorders

A

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

42
Q

treatment of caffeine overdose and withdrawal

A

overdose: supportive care with betablockers

withdrawal: usually resolve spontaneously

43
Q

classic hallucinogens

A

LSD, Psilocybin, DMT

44
Q

dissociate drugs

A

PCP, ketamine, dextromethorphan

45
Q

serotonergic stimulants

A

MDMA, mescaline

46
Q

botanical drugs

A

cannabis
saliva divinorum
ayahuasca

47
Q

hallucinogen intoxication treatment

A

antipsychotics for psychosis

benzodiazapenies for agitation

external cooling for hyperthermia

48
Q

hallucinogen withdrawal treatment

A

usually not associated with withdrawal

49
Q

PCP intoxication treatment specific

A

reduction of environmental stimuli

GI decontamination

50
Q

complications of PCP overdose

A

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

51
Q

MOA of LSD overdose

A

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

52
Q

what substances count as inahlants

A

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

53
Q

treatment of inhalants intoxication (no withdrawal symptoms)

A

supportive, +/- intubation, psychotherapy

54
Q

complications of using inhalants

A

impaired cognition, aplastic anemia, MI

55
Q

what drugs are opioids

A

opiates: fentanyl, oxycodone, hydrocodoine, heroin

56
Q

MOA of opioids

A

mu opiod receptor agonists (morphine, heroin , codeine, fentanyl)

mixed agonist and antagonist- buprenophine

57
Q

GHB mechanism of action

A

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

58
Q

treatment of GHB

A

supportive and sedative agents

59
Q

what is the first line drug for smoking cessation

A

varenicline

60
Q

MOA of PCP

A

inhibition of NMDA receptors and activation of dopaminergic neurons

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