Substance Use & Toxicology Flashcards
What is the prevalence of cigarette smoking among patients in addiction treatment and mental health treatment settings in the United States?
50% - 90%
When is the time from that symptoms of heroin withdrawal will peak (after cessation)?
36-72 hours after cessation (1.5 to 3 days). Though the duration varies with the half-life of the drug used and the period of drug use.
Signs of excessive cholinergic activity (as in organophosphate poisoning) and treatment.
SLUDGE signs (salivation, lacrimation, urination, diaphoresis (or defecation), gastrointestinal motility, and emesis). Treat with atropine (muscarinic acetylcholine receptor antagonist)
What is the primary mechanism of action of hallucinogens such as lysergic acid diethylamide (LSD)
5-hydroxytryptamine receptor (5-HT) agonism
Use of what medication causes decreased elimination of caffeine, increasing risk for caffeine intoxication?
OCPs
Treatment for hallucinogen persisting perception disorder?
Antipsychotics that are 5-HT2A antagonists are used to reverse the psychological effects and hallucinations
Most common cause of hepatitis in IV drug users
Hepatitis C
Most common reason for liver transplantation in the US
Hepatitis C
Urinary manifestations of cocaine use
Tea-colored urine (from rhabdomyolysis)
What is the window of detection for phosphatidylethanol (PEth)?
Useful in detecting prolonged, or binge, drinking. Detection period is 4 weeks but PEth can remain in the blood for longer.
What is the window of detection for Ethyl glucuronide (EtG)?
It is detectable in blood for up to 36 hrs and in the urine for up to 5 days. Sensitivity is dose and time-dependent and starts decreasing after 24-48 hrs. Can be useful to test of ethanol use and monitor for abstinence in settings where drinking is prohibited.
Chronic exposure to benzene, an inhalant found in gasoline, is associated with what medical complications (3)?
1) Bone Marrow Injury (leading to aplastic anemia, MDS, multiple myeloma)
2) Increased risk for leukemia
3) Reproductive system toxicity
Toluene is found in what substances? Chronic exposure to toluene can lead to damage to what systems?
1) Gasoline, paint thinners, correction fluid
2) Brain, liver, and kidney damage
Brain damage results in loss of tissue -> impaired cognition, ataxia, spasms, hearing/vision loss
A CIWA score of at least what is associated with severe withdrawal and increased risk for DTs?
16
In acute alcohol withdrawal, psychotic and perceptual disturbances begin when? What about seziures?
1) 8-12 hrs
2) 12-24 hrs
The onset of delirium tremens occurs when?
Between 3 days to 7 days
What gene variant likely provides a protective effect against nonmedical use of codeine? How?
1) Polymorphisms in the gene that encodes P450 2D6. 2) They act by modulating accumulation of toxic metabolites that are aversive
In adults, lead poisoning causes a motor polyneuropathy that often presents as?
Bilateral wrist drop and/or foot drop
What are examples of changes to the immune system, in the setting of alcoholism, that can predispose a patient to infections?
Alcoholism can cause increased sequestration of neutrophils, decrease in fixed macrophage phagocytic capacity, decreased white blood cell production, and overall decreased cell mediated immunity.
What is the timeline for caffeine withdrawal symptoms?
They begin 12-24 hrs after cessation –> peak at 1-2 days –> and last as long as 2-9 days
What is the most significant cause of drug-induced stroke (also a cause of seizures)?
Cocaine (IV and inhaled»_space;»» intranasal)
How does PCP exert its hallucinogenic effects?
Antagonism of NMDA receptors
Ecstasy, also known as methylenedioxymethamphetamine, exerts its effects on which two neurotransmitters?
DA and 5-HT
Mechanism of MDMA (ecstasy)?
Blocks reuptake of serotonin, induces massive release of serotonin, increases NE and to a smaller extent DA
