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IM 6 Test 2 > Substance Use Disorder > Flashcards

Substance Use Disorder Flashcards

1
Q

goals of substance use treatment X4

A

recognition of acute toxicity

facilitation of withdrawal

dx and tx of complications

education/counseling/therapy

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2
Q

CNS Depressants X3

A

alcohol
barbiturates
benzos

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3
Q

Opiates X9

A 
oxycodone
fentanyl
heorin
meperidine
morphine
codeine
methadone
hydromorphone
opium
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4
Q

CNS Stimulants X3

A

cocaine/crack
amphetamines
methamphetamines

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5
Q

Club drugs X4

A

ectasy
GBH
ketamine
rohypnol

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6
Q

Hallucinogens X2

A

PCP

LSD

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7
Q

abuse

A

habitual use of a substance which falls outside of medical necessity or societal acceptance

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8
Q

addiction

A

chronic, relapsing disease characterized by compulsive substance seeking behaviors

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9
Q

psychological risk factors

A 
low frustration levels
poor impulse control
lack of meaningful
relationships
childhood trauma
low self-esteem
propensity for risk taking behaviors
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10
Q

societal considerations

A

peer influences

family acceptance

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11
Q

gender influences on substance use

A

men at greater risk

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12
Q

genetic

A

member of family in which SUD prevalent

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13
Q

brain reward system

A

reinforcement of behaviors and production of memories/limbic system

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14
Q

neurobiology and neurotransmitters

A

substances of abuse affect neurotransmitters - varies by specific drug

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15
Q

genetic risk for substance disorder

A

increased risk associated with genetic links

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16
Q

Acute MOA of Alcohol

A

binding with GABA receptor and glutamate receptors - activates the reward circuit

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17
Q

how does alcohol act as a diuretic

A

inhibits the release of ADH

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18
Q

heavy or at risk alcohol use in men

A

> 4 drinks on one day or more than 14 in one week

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19
Q

heavy or at risk alcohol use in women

A

> 3 drinks on one day or more than 7 in one week

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20
Q

breast feeding moms and alcohol

A

bBAC of mom is the same as in breast mil

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21
Q

high BAL with few symptoms =

A

high tolerance

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22
Q

early signs of alcohol withdrawal

A

sweating
tremors
elevated BP

peaks within 24 to 48 hours

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23
Q

when does alcohol withdrawal go away

A

rapidly and dramatically disappears unless it progresses to delirum

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24
Q

when are grand mal seizures possible in alcohol withdrawal

A

7-48 hours after cessatoin

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25
Q

withdrawal delirium

A

medical emergency d/t possible fatality

autonomic hyperactivity
perceptual disturbances
fluctuation LOC
paranoid delusions
fever
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26
Q

when does alcohol withdrawal delirium peak

A

2-3 days after cessation and reduction`

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27
Q

sedatives used in alcohol withdrawal

A

benzos
diazepam
chlordiazepoxide

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28
Q

meds used for seizure control in alcohol withdrawal

A

carbamazepine
magnesium sulfate
thiamine

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29
Q

alleviation of ANS symptoms in alcohol withdrawal

A

betablockers

clonidine

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30
Q

CIWA-AR

A

max of 67

lower than 10 do not require treatment

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31
Q

wernicke’s encephalopathy

A

d/t chronic alcohol use

inflammatory henorrhagic degenerative condition of the brain caused by thamine deficiency from poor diet

32
Q

how is wernicke’s encephalopathy treated

A

thiamine

33
Q

if untreated, wernicke’s encephalopathy leads to

A

korsakoff’s psychosis

34
Q

korsakoff’s psycosis

A

irreversible form of amnesia characterized by:
short-term memory loss/long term memory gaps
inability to learn

35
Q

drugs used to maintain alcohol sobriety X4

A

naltrexone
acamprosate
disulfiram
gabapentin

36
Q

how does naltrexone stop alcoholism

A

blocks feel good results

37
Q

how does acamprostate stop alcoholism

A

blocks s/s of withdrawal

38
Q

how does disulfram stop alchoolism

A

makes you sick when drinking

39
Q

benzo toxicity

A 
severe confusion
drowsiness
lack of coordination/balance
lighteheadedness
muscle weakness
fainting
memory loss
40
Q

what does a benzo OD usually occur with

A

usually occurs with cross use of

alcohol
opiates
TCAs
CNS depressants

41
Q

benzo withdrawal

A

body pain, muscle tension, cramping, vomiting, sweating, seizures

42
Q

benzo reversal agent

A

flumazenil

43
Q

opioid intoxication

A 
constricte dpupils
decreased RR
sedation
hypotension
intially euphoric - progresses to dysphoria
44
Q

opioid toxicity

A

triad symptoms

leads to death d/t shock, seizures, cardiac arrest

45
Q

withdrawal opioids

A

yawning, insomnia, irritabilty, rhinorrhea, panic, increased BP and HR

BONE PAIN

46
Q

what are triad symptoms

A

pinpoint puils
decreased RR
coma

47
Q

opioid toxicity treatement

A

AIRWAY
oxygenation

naloxone - short acting - multiple doses
nalmefene - longer acting

48
Q

why is heroin so addictive

A

high lipid solubility - crosses BBB easily to convert to active form (morphine)

49
Q

how fast does heroin take place

A

IV 7-8 seconds

smoked/snorted - 10-15 minurwa

50
Q

Oxycodone OD risk

A

if no tolerance has been developed - OD risk is higher

51
Q

meperidine use

A

effective when taken orally

no obvious signs of IV drug use

52
Q

meperidine pupil response

A

less pupillary constriction than other opioids

53
Q

meperidine effects on smooth muscle

A

minimal effects on smooth muscle

less constipation and urinary retention

54
Q

treatment for opioid sobriety X3 meds

A

methodone
buprenorphine
naltrexone

55
Q

methodone interventions opioids

A

daily clinic visits

decreasing doses

56
Q

buprenorphine maintenance opioids dose route

A

SL tabs or film used once daily

57
Q

naltrexone is used for

A

maintenance after opioid detox

58
Q

cocaine intoxication

A 
euphoria
dilated pupils
elevated BP and HR
grandiosity
altered judgment
59
Q

cocaine use in preganncy

A 
preemie
small head
decreased BW
LBW
ADD/ADHD
memory/language development
60
Q

methamphetamine intoxication

A

delusions of increased strength and mental capacity
littel need for sleep/food
talkative

61
Q

meth withdrawal

A

strong cravings, dysphoria, depression lasting for months

62
Q

meth overdose

A

cerebral and systemic vasculitis

63
Q

what does meth induced psychosis mimic

A

paranoid schizophrenia

64
Q

meds for meth treatment

A

none FDA approved
bupropion and modafinil used

ibudilast is in clinical trials

65
Q

matrix model meth tx

A

CBT/group therapy
family edu
drug testing
non-drug related activities

66
Q

Ecstasy intoxication

A

muscle cramping
involuntary teeth clenching
feelings of trust and love

67
Q

ecstasy AE

A

hyperthermia
memory impairment
CV stimulation - HTN

68
Q

ketamine intoxication

A

dreamlike state
hallucinations
sedation

69
Q

ketamine long term effects

A 
bladder pain/ulcers
kidney problems
stomach pain
depression
poor memory
70
Q

bath salts intoxication

A

extreme agitation and violent behavior

increased HR and BP

71
Q

X2 date rape drugs

A

GHB

flunitrazepam

72
Q

LSD intoxication

A

pupil dilation

synesthesi

73
Q

LSD OD

A 
psychosis
CVA
Resp arrest
sz
HTN crisis
74
Q

LSD tx

A

acidify urine to hasten excretion

diazepam/haloperidol

75
Q

PCP intoxication

A 
hallucinations
bizzare behavior
violence
sz
elevated vitals
muscle rigidity
76
Q

PCP toxicity

A 
hallucinations
HTN
coma
Seizures
depressed respirations
77
Q

X2 inhalents

A

nitrous oxide and ether

IM 6 Test 2 (5 decks)

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