Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatry Terms > Substance Use > Flashcards

Substance Use Flashcards

1
Q

Early Remission vs Sustained Remision

A

Early: 3-12 months with nothing except cravings

Sustained remission: at leat 12 months without meeting criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Alcohol and CDT

A

CDT is a transferrin. Think of it as a deer with horns. In normal people, the horns have 4-5 branches. In alcoholics, they have 0-2 branches (carbohydrate Deficient transferrin) .

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ethyl Gulcuronide (EtG)

A

metabolite of ethanol which is formed din the body by glucouronidation usually from drinking. Lets you know if someone drank in the last 5 days. (pilots, etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What types of seizures happen in alcohol withdrawal?

A

Generalized Tonic clonic seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Peak incidence of alcohol withdrawal seizures after last drink?

A

24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Benzos NOT metabolized by the liver?

A

‘out the liver’ : oxazepam, temazepam, lorazepam.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

4 Symptoms of Wernicke’s Encephalopathy

A

confusion, ataxia, nystagmus, opthalmoplegia (paralysis of eye muscles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What enzyme is inhibited by disulfiram?

A

Aldehyde dehydrogenase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Alcohol withdrawal is due to overabundance of what neurotransmitter?

A

glutamate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is acamprosate metabolized?

A

Renally which defers it from naltrexone and disulfiram.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does acamprosate work?

A

Leads to less glutamate transmission presynaptically, and also binds to post synaptic glutamate receptors. Helps to reduce hyperglutamatergic state in alcohol withdrawal .gg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When does acamprosate work?

A

Initiate as soon as possible after alcohol withdrawal when patient achieves abstinence. Maintain treatment if patient relapses. It increases the likelihood of abstinence.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the clonidine MOA?

A

Presynaptic noradrenergic a2 agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Methadone MOA

A

synthetic opioid AGONIST that is very long acting so it prevents the withdrawal sx. Keeps them comfortable and blunts cravings. Used for pregnant women.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anandamide vs THC

A

Anandamide is the endogenous cannabinoid. THC has a much stronger and longer effect than anadamide on brain cells. THC interferes with Anandamide’s function of protecting neurons and keeping brain activity in balance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

THC and Hippocampal Neurons

A

THC suppresses activity of hippocampal neurons below the level needed to trigger memory formation. With chronic thc expsoure, neuron connections involved in memory are gradually lost due to continual suppression.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Marijuana Psychosis Gene

A

AKT1 gene governs an enzyme that affects Dopamine brain signaling, leading to psychosis (c/c is bad). Another is COMT gene which governs an enzyme that breaks down dopamine (val/val is bad).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Marijuana and collisions

A

2012 meta analyssis found marijuana use doubled collision risk.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

NAC for cannabis use disorder

A

Modulates glutamate at 1200 mg bid. Side effects are vivid dreams, gi sx. No significant decrease i ncravings for cannabis .

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Stimulant withdrawal dreams

A

unpleasant and vivid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Cocaine MOA

A

Causes transient increase in extracellualr dopamine levels in dopaminergic pojections from the VTA area to the nucleus accumbens by binding to the dopamine transporter, thereby inhibiting dopamine reuptake.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cocaine metabolite

A

BE (benzoylecgonine) is present in urine for ~48 hourspost use.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Off label disulfiram use in cocaine use disorder

A

It inhibits dopamin-beta-hydroxylase, plasma esterases, and aldehyde dehydrogenase involved in metabolism of cocaine . It will lead to anxiety, paranoi, and dysphoria after cocaine use which leads to less use overall.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Ketamine and vets

A

Ketamine used on animals. May have a vet or nurse who can access it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Dextromethorphan MOA

A

NMDA receptor antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Adverse events of inhalants

A

sudden cardiac death or seizures.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Pacifier at a rave party

A

Person is on MDMA which causes tooth grinding/bruxism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Most common complication of hydrocarbon use?

A

Pneumonitis (sniffing paint thinner)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Biggest risk factor for developing cannabis use disorder

A

Early use of cannabis before 15 yo.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Naltrexone MOA

A

Full opioid antagonist.

31
Q

LSD intoxication

A

mydriasis, tachycardia, hyperthermia, tremor, salivation, blurring of vision, marked anxiety or depression, paranoid ideation, depersonalization, derealization etc.

32
Q

Endorphin Role

A

motor coordination, learning and memory, gastrointestinal function, the control of seizures, and the hormonal regulation of the reproductive system, yet are most often recognized for their role in the pain modulation

33
Q

Toluene embryopathy and Fetal Alcohol Syndrome

A

Very similar (hydrocarbons) toluene embryopathy include and overlap symptoms seem in fetal alcohol syndrome - growth retardation, microcephaly, micrognathia, small palpebral fissures, deep set eyes, low set ears, flat nasal bridge, and small fingernails.

34
Q

Which anti-alcohol med needs to be cautioned or CI in renal failure?

A

acamprosate

35
Q

What metabolic abnormality can happen with toluene intoxication?

A

Distal or Type 1- Renal Tubular Acidosis classically described as hyperchloremic metabolic acidosis along with hypokalemia, is characterized by a lack of ability to reduce the pH of urine, despite minimal bicarbonate (HCO3-) wastage and severe academia

36
Q

Alcoholic ketoacidosis comes from the person’s deficiency in what?

A

carbs

37
Q

What CIWA score is associated with DT’s?

A

Severe, 16

38
Q

Which substance is associated with the highest percentage of users who develop a use disorder?

A

nicotine

39
Q

What do you give to reverse cocaine intoxication (sweating, tachy, fever)

A

Phenoxybenzamine

40
Q

‘Chasing the dragon’

A

freebasing heroin on heated aluminum foil and breathing it in.

41
Q

NIDA recommends pts on methadone should be on maintenance for a MINIMUM of how long?

A

National Institute on Drug Abuse (NIDA), notes that “For methadone maintenance, 12 months of treatment is the minimum, and some opiate-addicted individuals will continue to benefit from methadone maintenance treatment over a period of years.”

42
Q

opioid short half life to long half life

A

Meperidine, morphine, methadone, buprenorphine

43
Q

What should you look for in gasoline ingestion?

A

all patients presenting with suspicion of hydrocarbon exposure should immediately be placed on a cardiac monitor (because dysrhythmias are the most common cause of death) as well as pulse oximetry. A chest X-ray is indicated in any patient suspected of inhalation or aspiration of hydrocarbons.

44
Q

Possible problem with IV drug use

A

Epidural abscess from bacterial seeding

45
Q

Which disorders are likely to have a caffeine intoxication?

A

Depressive disorder
Bipolar disorder
Sleep disorder
Substance-use related disorder

46
Q

MDMA intoxication can lead to what?

A

serotonin syndrome

47
Q

Describe Wernicke-Korsakoff

A

Wernicke encephalopathy which is characterized by confusion, ataxia and ophthalmoplegia, and Korsakoff syndrome which is characterized by anterograde amnesia, but retrograde amnesia, disorientation and confabulation are also found in this syndrome.

48
Q

What medication can you give to help with cocaine addiction?

A

bupropion

49
Q

What does chronic alcohol intoxication do to GABA receptor sensitivity and to NMDA receptor number?

A

Decrease in GABA-receptor sensitivity and upregulation of NMDA-receptors

50
Q

Sudden Sniffing Death syndrome can be caused by what medication combined with sniffing?

A

. Toluene increases the sensitivity of the myocardium to catecholamines, so they should be avoided in patients with inhalant use disorder to prevent death due to ventricular tachyarrhythmias (known as sudden sniffing death syndrome). Epinephrine is the correct answer, as it is a catecholamine classed as a non-selective agonist that acts on all adrenergic receptors.

51
Q

What is a long term side effect of disulfiram?

A

Peripheral Neuropathy

52
Q

Alcohol withdrawal timeline

  • When can tremulousness happen?
  • When can seizure happen after last drink?
  • When can psychotic sx happen?
  • How long is DT window?
A

Tremulousness is an initial stage of alcohol withdrawal, developing after 6 to 8 hours of abstinence. Psychotic and perceptual symptoms such as delusions and hallucinations can occur in 8 to 12 hours. Alcohol withdrawal seizures occur within the first 12 to 24 hours of abstinence, and can occur even while the blood alcohol level remains elevated and the patient remains partially intoxicated. Alcohol withdrawal delirium (delirium tremens) usually occurs within 72 hours, although patients remain at risk for the first week.

53
Q

Cocaine increases what class of neurotransmitters?

A

catecholamines

54
Q

Which drug is most commonly associated with ER visits?

A

cocaine

55
Q

Dronabinol is which controlled substance category?

A

III

56
Q

What is a precursor to serotonin?

A

5-hydroxyindoleacetic acid (5-HIAA)

57
Q

Rash on face (mouth, nose)?

A

Glue sniffers disorder (inhalant use disorder)

58
Q

Which metabolite of caffeine is responsible for the stimluant and addictive part?

A

Paraxanthines

59
Q

What type of brain damage can cocaine cause?

A

Nonhemorrhagic cerebral infarctions

60
Q

Organophosphate intoxciation is treated with what?

A

Atropine (not physostigmine)

61
Q

What metabolite is seen in a glue sniffer’s blood?

A

Hippuric acid

62
Q

Paternal Cannabis use and baby exposure?

A

Paternal cannabis use can result in infant exposure and increased risk of sudden infant death syndrome

63
Q

Which drug has the highest rates of use and of substance use disorders according to the Substance Abuse and Mental Health Services Administration (SAMHSA)?

A

marijuana

64
Q

Most widely used mood altering drug in the world?

A

caffeine. For use disorder, must consume 250 mg

65
Q

What is 90 in 90?

A

Attending 90 12-step groups in 90 days

66
Q

The pathophysiological changes most likely responsible for symptoms of alcohol withdrawal delirium include which of the following?

A

Decreased GABA and NMDA receptor inhibition, resulting in delirium and sympathetic overdrive

67
Q

Amount of time to be free of alcohol before starting antabuse?

A

12 hours

68
Q

What is the mechanism for sudden death in inhaling?

A

The increased sensitization of myocardium to catecholamines

69
Q

What drug requires occasional eye exams?

A

Lamotrigine associated photopigmentation/photosensitivity occurs due to an unknown mechanism

70
Q

The dangerous symptoms of alcohol withdrawal occur due to overactivity of which neurotransmitter?

A

glutamate

71
Q

What natural things mimic lsd?

A

Catnip and morning glory seeds

72
Q

Easier to OD on methadone or buprenorphine?

A

Methadone

73
Q

MOA of meth

A

Amphetamine works by reversing the function of dopamine transporter proteins which normally transport dopamine back into the neurons and causes an efflux of dopamine out of the neuron for the exchange of amphetamine

Psychiatry Terms (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions