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Psych > substance use / addictive disorders (2) > Flashcards

substance use / addictive disorders (2) Flashcards

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1
Q

thw use of alcohol/drugs for the purpose of intoxication, or, in the case of prescription drugs, for purposes beyond their intended use

A

abuse

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2
Q

an irresistable psychological/physiological need to continue the substance use or behavior despite the harm it causes; may or may not include physical dependence

A

addiction

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3
Q

physiological requirement for the substance by the brain, as evidenced by development of tolerance and withdraw when use decreases or stops

A

physical dependence

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4
Q

an urgent desire for a substance or behavior to which one is addicted, often in response to triggers, that is very difficult to resist

A

craving

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5
Q

Physiological adaptation to a substance such that increasing amounts are needed to achieve the same effect

A

tolerance

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6
Q

Substances that are pharmacologically interchangeable in terms of how the body responds. Example if one develops a tolerance to alcohol, he also has tolerance for benzodiazepines and would require a higher dose of the benzo to achieve the usual effect. We take advantage of this property to treat dependence

A

cross tolerance

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7
Q

State characterized by adverse physical and psychological symptoms occurring when one ceases using a substance to which the brain has acclimated

A

withdrawal

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8
Q

Anything which cues or prompts a response

A

trigger

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9
Q

Safely withdrawing a person from an addictive substance, usually under medical supervision, by providing a substance for which there is cross tolerance in gradually decreasing amounts

A

detoxification

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10
Q

The reoccurrence of alcohol or drug dependent behavior in an individual who has previously abstained for significant time beyond the period of detoxification

A

relapse

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11
Q

Why should we not assume that a negative tox screening means that the person is not abusing substances or the other way around

A

Some common meds can cause false positives, and some may not show up

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12
Q

Which theory of addiction is when the nature of the substance itself reinforces its use. Once the brain has been exposed it has to have it

A

Chemical Hook theory

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13
Q

Which experiment related to theories of addiction was where addicted rats were divided into two groups, one placed in a rat park with toys and tunnels and food and company, while the other was in a traditional rat cage lacking amenities. This time when offered the drugged water and plain water the rats and the Rat Park chose the plain water, while rats in the standard cage continued to abuse the drug. It concluded that if we have what we need we will not self medicate

A

Alexander experiment

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14
Q

Which addiction theory states that with accumulating exposure to rewarding activities or substances, the brain narrows its focus to just those behaviors or substances, resulting in an every increasing focus on thoughts and actions that cue evokes. At the same time the brain becomes less and less able to control one’s response to those cues, an example is seeking out cocaine after seeing any white powder

A

Impaired response inhibition and salience attribution (iRISA)

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15
Q

Are there genetic predispositions to addiction

A

yes

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16
Q

Is alcohol abuse associated with a higher risk for cancer

A

yea

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17
Q

What kind of questions are asked in an alcohol use disorder assessment

A
  • Have you had times when you ended up drinking more or longer than you intended?
  • Have you more than once wanted to cut down or stop drinking or try to but couldn’t?
  • Have you spent a lot of time drinking? Being sick or getting over the after effects?
  • Have you experienced craving or found that drinking often interfered with taking care of your home or family
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18
Q

Which neurotransmitter increases in response to alcohol?

A

GABA

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19
Q

What condition is when alcohol causes gastric irritation, reduces absorption of B vitamins, interferes with conversion of thiamine into thiamine pyrophosphate?

A

Wernicke’s Encephalopathy

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20
Q

What are symptoms of Wernicke’s Encephalopathy?

A

Acute onset; oculomotor dysfunction, Ataxia, ptosis and confusion

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21
Q

What kind of treatment does Wernicke’s encephalopathy require? (And what med)

A

Emergency treatment to prevent permanent damage
IV THIAMINE

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22
Q

Which syndrome has a gradual onset and is characterized by retrograde and anterograde amnesia with sparing of intellectual function and some aspects of memory

A

Korsakoff’s syndrome

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23
Q

characteristic features of Korsakoff’s syndrome

A

apathy or increased talkativeness, confabulation and cackling laugh

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24
Q

can wernicke’s and Korsakoff’s happen together

A

yes

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25
Q

How soon can alcohol withdrawal occur

A

As soon as two hours after the last drink

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26
Q

What are early symptoms of alcohol withdrawal!!!!

A

Tremors, diaphoresis, rapid pulse over a hundred, elevated blood pressure >150/90, headache

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27
Q

Describe the three main problems in alcohol withdrawal syndrome

A
  • Hallucinosis (Partially visual, usually recognizes it as not real, starts 24+ hours after last drink)
  • Grand Mal seizures (Generally self limiting, starts 24-48 hours after the last drink)
  • Changes in cognition (At any point), May last 30 to 50 days
28
Q

What is severe alcohol withdrawal also called

A

Delirium tremens

29
Q

A severe alcohol withdrawal, or delirium tremens, a medical emergency?

A

yes

30
Q

What is the onset of delirium tremens

A

3-5 days after last drink or cross-tolerence meds

31
Q

How long does delirium tremens last?

A

2-3 days

32
Q

Treatment of severe alcohol withdrawal or delirium tremens

A

-replace thiamine, niacin, folate, magnesium IV
- Replace electrolytes
-glycogen
-benzos
-baclofen
-antipsychotic

33
Q

Which medication for alcohol dependence is used adjunctively for aversion therapy, it causes unpleasant side effects when consumed with alcohol

A

disulfiram

34
Q

Which medication that reduces alcohol cravings binds with opioid receptors to block euphoric effects of alcohol and reduce cravings

A

naltrexone

35
Q

Which medication that helps reduce alcohol cravings is an anti-convulsant that reduces dysphoria and insomnia when stopping alcohol use, helps reducing relapse and amount of alcohols consumed

A

gabapentin

36
Q

Which CNS stimulate produces a euphoric rush of mental alertness and energy, less 10 to 20 minutes and is followed by intense let down

A

cocaine

37
Q

Which three neurotransmitters does cocaine increase?

A

Dopamine, norepinephrine, serotonin

38
Q

What is characterized by CNS stimulation followed by depression

A

intoxication

39
Q

What kind of symptoms is toxicity classified with

A

Mydrysis, encephalopathy, seizures, decreased responsiveness, hypertension, rapid and possibly irregular pulse, hyperpyrexia, coma, respiratory and cardiovascular failure

40
Q

Which substance blocks reuptake of norepineprene dopamine, affects peripheral nervous system

A

amphetamines

41
Q

What are the main meds used to treat alcohol withdrawal

A

benzos and anticonvulsants

42
Q

When is nicotine toxic

A

In high doses to young children

43
Q

Which medication for treatment of tobacco addiction reduces cravings and weight gain associated with smoking cessation

A

bupropion

44
Q

Which medication blocks nicotine receptors

A

varenicline

45
Q

Which dose of caffeine can cause tremors, poor motor performance, and insomnia

A

300 mg

46
Q

Which dose of caffeine can cause tachycardia, Stimulate respiratory, vasomotor, and vagal centers in cardiac muscles; dilate pulmonary and coronary blood vessels, and constrict blood flow in the brain

A

> 500mg

47
Q

How is benzodiazepine withdrawal treated?

A

tapering

48
Q

What negative symptoms can Molly or other club drugs cause?

A

Severe dehydration or hyperthermia

49
Q

What is a crystalline form of MDMA but often cut with other drugs

A

molly

50
Q

Which club drug has users reporting euphoria, sense of emotional openness, increased empathy or sympathy, increased energy, heightened sexual arousal and pleasure, increased sensory sensitivity

A

ecstasy

51
Q

Which addictive club drug is also the treatment for narcolepsy

A

GHB

52
Q

What does opiate withdrawal syndrome include

A

Rebound hyper excitability

53
Q

What are some autonomic symptoms of opiate withdrawal

A

Diarrhea, rhinoria, diaphoresis, lacrimation, shivering, nausea, vomiting, fever, low or high blood pressure, low or high heart rate, piloerection

54
Q

What are central nervous system symptoms of opiate withdrawal

A

Sleeplessness, restlessness, agitation, fasciculations and tremor, yawning, impaired concentration, dysphoria, irritability

55
Q

Which medication is taken every other day for opiate addiction

A

LAAM

56
Q

Which medication is taken daily for opiate withdrawal

A

methadone

57
Q

describe what kind of drugs LAAM and methadone are and how they sre given

A

They’re both opioid agonists and schedule two narcotic drugs, they are only given in special programs, they replace other opiates and although they are addicting they do not significantly impair functioning or produce significant euphoria. They replaced other more addictive opioids with medications that reduce craving

58
Q

Which medication for opiate addiction is a narcotic antagonist used in emergency treatment of opioid intoxication or overdose to reverse the effects of the narcotic, causes immediate withdrawal by displacing opiates from their receptors

A

naloxone (narcan)

59
Q

Which medication for opiate addiction is taken every three days and mimics the effects of narcotics in some ways but not others. Has ceiling action where it blocks further effects of opioids when present and higher amounts. Given sublingual

A

buprenorphine

60
Q

Which addiction medications are related to opioid antagonists that reduce opioid receptor response to abused opioids, essentially blocking the effects of them

A

nalmefene / naltrexone

61
Q

Which intervention for addiction is given during ER visits, teaches how to reduce drug use, provides harm reduction information, gives information about consequences of drug convictions, provides information on and discuss harm reduction strategies, and offers and arranges follow up visits

A

Brief intervention therapy

62
Q

how is someone with a dual diagnosis treated?

A

integrated treatment model, treat both at once in the same setting

63
Q

what are the main steps of integrated treatment for a person with a dual diagnosis

A

-engage
-persuade
-actively treat
-provide relapse prevention interventions
-intensive case management

64
Q

what is ambivalence and is it normal?

A

resistance, yes

65
Q

differences in professional treatment vs. support group

A

-trained professional vs. volunteer
-groups don’t involve detox or pharm treatments
-support groups are free
-access to professional treatment may be difficult

66
Q

what is AA based on?

A

belief of a higher power

67
Q
A

Psych (19 decks)

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