substance-related and addictive disorders

Question 1

true or false:

it is possible to have a substance use disorder without having physiological dependence

Answer 1

true

Question 2

substance-induced mood sxs improve during abstinence while in primary mood sxs it

Answer 2

persists

Question 3

alcohol is sedating but alcohol withdrawal results in

Answer 3

brain excitation and seizures

Question 4

urine drug test positivity:

cocaine

Answer 4

2-4 days

Question 5

urine drug test positivity:

Amphetamines

Answer 5

1-3 days

Question 6

urine drug test positivity:

phencyclidine

Answer 6

4-7 days

Question 7

urine drug test positivity:

short vs long acting benzo

Answer 7

short- up to 5 days

long- up to 30 days

Question 8

urine drug test positivity:

short vs long acting barbitutates

Answer 8

short- 24 hr

long- 3 weeks

Question 9

urine drug test positivity:

opioids

Answer 9

1-3 days

*** methadone and oxycodone will come up negative on a general screen– you have to use a seperate panel

Question 10

urine drug test positivity:

marijuana

Answer 10

single use- 3 days… heavy user- up to 4 weeks

** THC is released from adipose stores

Question 11

alcohol activates _____, _______ and _______ in the CNS and inhibits ______ and __________

Answer 11

alcohol activates GABA, dopamine and serotonin in the CNS and inhibits glutamate receptor activity and voltage-gated calcium channels

** alcohol us a potent CNS depressant

Question 12

Alcohol intoxication:

BAL= 20-50

Answer 12

decreased fine motor control

Question 13

Alcohol intoxication:

BAL= 50-100

Answer 13

impaired judgment and coordination

Question 14

Alcohol intoxication:

BAL= 100-150

Answer 14

ataxic gait and poor balance

Question 15

Alcohol intoxication:

BAL= 150-250

Answer 15

lethargy, difficulty sitting upright, difficulty with memory, N/V

Question 16

Alcohol intoxication:

BAL= 300

Answer 16

coma in the novice drinker

Question 17

Alcohol intoxication:

BAL= 400

Answer 17

respiratory depression, death

Question 18

seizures in delirium tremens treated with

Answer 18

Benzo

Question 19

confabulations, or inventing stories of events that never occurred are often associated with _____________ or alcohol induced neurocognitive disorder. patients are unaware that they are making these up

Answer 19

korsakoff’s psychosis

Question 20

cocaine blocks the reuptake of _______________, __________ and __________ from the synaptic cleft, causing a stimulant effect.___________ plays a role in the behavioral reinforcement “reward” system of the brain

Answer 20

cocaine blocks the reuptake of dopamine, epinephrine and norepinephrine from the synaptic cleft, causing a stimulant effect.___________ plays a role in the behavioral reinforcement “reward” system of the brain

Question 21

intoxication with cocaine results in :

1. general
2. dangerous
3. deadly

Answer 21

1. general- euphoria, heightened self-esteem, increased/decreased blood pressure, tachy/brady-cardia, nausea, dilated pupils, weight loss
2. dangerous- respiratory depression, seizures, arrhytmias and tactile hallucinations
3. deadly- vasoconstrictive that can lead to MI and stroke

Question 22

Post-intoxication cocaine

Answer 22

“crash”- malaise, fatigue, depression, anhedonia, constricted pupils, vivid dreams

Question 23

amphetamines block reuptake and facilitate release of ______________ and ____________ from nerve endings, causing a stimulant effect

Answer 23

amphetamines block reuptake and facilitate release of dopamine and norepinephrine from nerve endings, causing a stimulant effect

Question 24

remember, the sxs of amphetamine abuse are (7)

Answer 24

euphoria, dilated pupils, increased libido, tachycardia, perspiration, grinding teeth, chest pain

Question 25

chronic amphetamine use causes accelerated

Answer 25

tooth decay

Question 26

amphetamine use is associated with ___ tolerance but can also lead to ______

Answer 26

amphetamine use is associated with increased tolerance but can also lead to seizures

Question 27

________________ can produce tachycardia, tachypnea, hallucinations and amnesia

Answer 27

Ketamine "special K"

Question 28

_____ or "angle dust" is a dissociative, hallucinogenic drug that antagonizes NDMA glutamate receptors and activates dopaminergic neurons. It can have stimulant or CND depressant effects, depending on the dose takne

Answer 28

Phencyclidine PCP

Question 29

rotatory nystagmus is stronlgy suggestive for

Answer 29

PCP intoxication

Question 30

PCP intoxication sxs

Answer 30

RED DANES - rage - erythema - dilated pupils - delusions - amnesia - nystagmus - excitation - skin dryness

Question 31

withdrawal with PCP?

Answer 31

no withdrawal sxs, but "flashbacks" may occur ***recurrence of intoxication sxs due to release of the drug from body lipid stores

Question 32

more than with other drugs, intoxication w. _____ results in violence

Answer 32

PCP

Question 33

tactile and visual hallucination are found in both ________________ and _________ intoxication

Answer 33

tactile and visual hallucination are found in both cocaine and PCP intoxication

Question 34

is a dose specific CNS depressant that produces confusion, dizziness, drowsiness, memory loss, respiratory distress, and coma.

Answer 34

GHB- gamma-hydroxybutyrate "date rape drug"

Question 35

of all the drug withdrawals which one has the highest mortality rate?

Answer 35

barbituates

Question 36

flumazenil

Answer 36

short acting BDZ antagonist

Question 37

treatment for barnituates overdose

Answer 37

alkalanize urine w/ sodium bicarbonate to promote renal excretion

Question 38

in general withdrawal from drugs that are sedating/stimulants? is life threatening while withdrawal from sedating/stimulants ? is not

Answer 38

in general withdrawal from drugs that are sedating is life threatening while withdrawal from stimulants is not

Question 39

_____________ is the exception to opioids producing miosis.

Answer 39

meperidine * Demerol dilates pupils

Question 40

Classic triad of opioide overdose

Answer 40

Rebels Admire Morphine - respiratory depression - altered mental status - miosis

Question 41

opioid intoxication causes constricted or dilated pupils?

Answer 41

constricted

Question 42

______________ is the treatment of choice for opiate overdose

Answer 42

naloxone

Question 43

withdrawal from opioids is or is not life-threatening

Answer 43

not! * causes severe sxs

Question 44

Pharm. treatment of opioid use disorder: long acting opioid receptor agonist

Answer 44

methadone

Question 45

Pharm. treatment of opioid use disorder: partial opioid receptor agonist

Answer 45

Buprenorphine

Question 46

Pharm. treatment of opioid use disorder: competitive opioid antagonist, precipitates withdrawal if used within 7 days of heroin use

Answer 46

naltrexone

Question 47

withdrawal sxs: anxiety, insomnia, anorexia, fever, rhinorrhea, piloerection

Answer 47

opiates

Question 48

psilocybin

Answer 48

mushrooms

Question 49

mescaline

Answer 49

peyote cactus

Question 50

LSD flashbacks is a recurrence of sxs mimicking prior LSD trip occurs and lasts?

Answer 50

occurs spontaneously and lasts minutes to hours

Question 51

Dronabinol

Answer 51

pill form of THC-- FDA approved

Question 52

it acts as an adenosine antagonist, causing increase cyclic adenosine monophosphate and stimulating the release of excitatory ntt

Answer 52

caffeine

Question 53

a4b2 nicotinic cholinergic receptor partial agonist that mimics the action of nicotine, reduicng the rewarding aspects and preventing withdrawal sxs

Answer 53

varenicline--chantix

Question 54

antidepressant that is an inhibitor of dopamine and norepinephrine reuptake; helps reduce craving and withdrawal sxs

Answer 54

Bupropion-- Zyban