Substance Use Disorder Flashcards
drugs and alcohol stimulate what system & pathway?
dopamine system in the brain & mesolimbic pathway
what receptor is deficient in px with substnce use disorders?
DRD2
what brain structures are affected by substance use & its function?
mesolimbic = pearlure a receptio
mesocortical = judgement and decision making
hippocampus = learning & memory
prefrontal cortex = behavior control
what brain structures are affected by substance use & its function?
mesolimbic = pearlure a receptio
mesocortical = judgement and decision making
hippocampus = learning & memory
prefrontal cortex = behavior control
what are criteria of dubstance use disorder
impaired control
social impariment
recurent use
tolerance & wasti
what are the categories of criteria of SA?
mild = 2-3
moderate 4-5
severe 6+
timefram :1ye
what is the diff betw bing-drinking and heavy-used drinking?
Bing-dringing: 5 drinks in a short period of time
heavy
heavy-use drinking: 5 drinks in the same occassion >5x in a month
what is the alcohol content in beer, wine, and liquor?
12 oz glass of bear (355mL)
5ox glass of wine (148mL)
1.5ox of hard liquor 44mL
what are the neurochemical effects of alcohol to the brain?
pleasure = INC Serotonin & dopamine
Tension reduction = stimulation of GABA
cognitive slowing = Glutamate inhibition
what is the primary excitatory neurotransmitter of the brain?
Glutamate
if there is less GABA, what is its effect to GABA?
less Glutamate -> More of GABA
what are signs of alcohol intoxication?
slurred speech
incoordinatoin
nystagmus
impaired memory => in Ernicke-Korsakoff synd
Stupor
Coma
what are the Qs in CAGE questionnaire?
C: effotrs to CUT down?
A: Anger when being confronted with alcohol use
G: Guilt about alcohol consumption
E: Eye-opener
what is the scoring in CAGE questionnaire?
- yes to 2 or more = HIGH likelihood for alcohol use disorder
what are signs & symptoms of alcohol withdrawal?
tremors
psychotic symptoms
seizures
deleirium tremens
out of all the s/sx of alcohol withdrawal, which one is the longest & shortest?
derium - longest
tremors - shortest
what are conditions predisposing to increased severity of withdrawal?
sustained alcohol use
malnutrition/physical illness
comorbid psychiatric conditions
when does delirium commonly begin in alcohol withdrawal?
after 5-15 yrs of heay drinking
when is delirium considered a medical emergency?
if it comes with seizures
what are 3 alcohol-related disorders?
Wernicke’s Encephalopathy
Korsakoff syndrome
Wernicke’s Korsakoff syndrome
what alcohol related disorder is a combination of Wernicke’s encephalopathy & Korsakoff syndrome?
Wernicke’s Korsakoff syndrome
what alcohol-related disorder is an acute disorder characterized by ataxia, vestibular dysfunction, confusion and ocular motility abnormalities?
Wenicke’s encephalopathy
What is the tx for Wernicke’s encephalopathy?
replacement of vitamin B (if not it can progress to Korsakoff syndrome)
what alcohol-related diosrder manifests with impaired mental abilities & anterograde amnesia in an alert &responsive px?
Korsakoff syndrome
what is the addiciting agent of tobacco?
nicotine
what does nicotine do to the body?
stimualtes dopamine neurons & INC cerebral blood flow
what is the common use for of Marijuana?
pain control
what are addictive sedatives that relieve pain and induce sleep?
opiates
what are the different derivatives of opiates?
opium
morphine
heroin
hydrocodone/oxycodone
why are opiates highly addicitng?
INC pleasure
how do Opiates affect the body?
stimulate neural receptors of the body’s own opioid system -> release of endorphins & enkephalins
what are the diff stimulants that can lead to being abused?
amphetamines
cocaine
what was the use of Amphetamines?
relieve stuffy noses, control appetite, treat mild depression
what are the 2 mechanisms that flood the synapse?
- forcing vesicular release of NRE, dopamine & serotonin
- blocking the reuptake of NRE & dopamine
what is aka “crystal meth, ice, or shabu”, a derivative of amphetamine?
methampetamine
what can chronic use of Methamphetamine lead to?
brain damage
what are psychological effects of Amphetamine?
Incerased alertness
INC sociability
euphoria
inc energy & self-confidence
Agitation, confusion & paranoia
what are physiological effects of amphetamine?
heightened wakefulness
reduced appetite
incerased heart rate
hypertension
insmonia
headache
What stimulant has been used as a mild stimulant bcos of its local anesthesthetic and vasoconstrictor action?
Cocain
What is the MOA of Cocaine?
Blocks reuptake of dopamine in mesolimbic areas -> pleasurable states
What are the effects of Cocaine?
INC sexual desire
Feelings of self-confideence
DEC fatigue
Overdose of cocaine can lead ot?
- Sympethetic nervou sytem activation
- chills, insomnia
- paranoia & tactile hallucinations - formicatoin
- malignant HTN, MI, stroke
- Formication = psychotic phenomenon
What happens in formication?
Hallucinations in a tactile sense
- inteased of hearing voices, seeing things, feeling insects under the skin
What hallucinogen produces a subjective expansion of consciousness & hallucinations?
LSD
What is a synthetic hallucinogen that contains compounds of both the hallucinogen & amphetamine families?
Ectasy (MDA + MDMA)
What psychiatric condition is MDMA used for?
PTSD
