Substance Use Disorders Flashcards
Two examples of sedative hypnotics
Benzodiazepines, Barbituates
Examples of stimulants
Cocaine, amphetamines, methylphenidate
Ephedrine, Caffeine
Examples of hallucingens
LSD, Mescaline, Peyote, DMT
Examples of dissociative anesthetics
PCP, Ketamine
Preferred opioid for abuse
Prescriptions
Heroin
Describe the neurobiology of addiction
The nucleus accumbens controls dopmine secretion and used this activity to control activity in the forebrain. Pre and post drug use, wiring changes can be seen.
Self-administration of ________ is very similar to stimular self administration
electrical stimulation reward areas
Describe the mechanism of action of Alcohol
Does not have a specific receptor or neurotransmitter
Stimulates domaine release in the NA, stimulates GABA-a receptor, and inhibits NMDA receptor
Describe the mechanism of cocaine action
Blocks reuptake of dopamine in the mesolimbic system
Stimulates NA release peripherally
Blocks Na channels
Describe the mechanism of amphetamine action
Directly stimulates the release of dopamine in the meso-limbic
Describe the mechanism of opiates
Binds to the mu, sigma, and kappa receptors centrally and peripheral
Indirectly stimulate the release of VTA dopamine release
What drug has the strongest withdrawl symptoms
Opiates
What is a substance use disorder
A maladaptive pattern of substance use leading to clinically significnt impairment or distress
Criteria for AUD
- Taken in larger amounts/over a longer period than intended
- Persistent unsuccessful effort to cut down alcohol use
- A great deal of time is spent obtaining alcohol
- Craving or a desire to use a specific substance
- Failure to fulfill major role obligations
- Continued use despite persistent social/problem from OH
- Tolerance
- Withdrawal
Tolerance is defined by what two things…
- A need for markedly increased amounts of the substance to achieve intoxication or desired effect
- Markedly diminished effect with continued use of the same amount of the substance
Withdrawl is defined by…
- The characteristic withdrawl syndrome for the substance
- A closely related substance is taken to relieve or avoid withdrawl symptoms
Difference between early and sustained remission
Early – 3-12 months without use
Sustained – 12 months without use
What does CAGE stand for?
C – Have you ever cut down your drinking?
A – Have you ever been annoyed by criticism of your drinking?
G – Have you ever felt guilty about things you have done while drinking?
E – Do you ever have an eye opener?
GGT is a test for…
Especially sensitive to alcohol
1 beer raises BAC by
0.25
BAL above ____ with no signs of intoxication indicate tolerance
0.8
In liver damage, who is higher, AST or ALT
AST
Five stages of quitting
Precontemplation Contemplation Action Maintenence Relapse
Components of addiction treatment
Management of withdrawl
Behavioral Approaches
Treatment of co-existing mental health issues
Pharmacologic
Three sets of drugs that require detox
Alcohol
Sedative hypnotics
Opiates
Symptoms of alcohol withdrawl
Tremors, diaphoresis, elevated BP
Seizures
Delirium tremens
Treatment for aversion
Disulfram
Treatment for anticraving
Naltrexone, Wellbutrin, Acamprosate
Treatment for replacement
Methadone, Nicotine
How does disulfram work?
Inhibits aldehyde dehydrogenase leading to accumulation of aldehyde
Causes flushing, nausea, and hypotension
So….tell me about naltrexone
Blocks u receptor to decrease OH reinforcing properties
What is Methadone and Buprenorphine?
Replaces heroin and other opiates that the patient is addicted to. Administered in a controlled setting
Antidepressants are related to alcohol.
I’m tired and don’t want to write a question.
