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Neuro - Week 7 > Substancea buse 2 > Flashcards

Substancea buse 2 Flashcards

1
Q

What are the “5 C’s” of addiction?

A

Chronicity
Impaired control over drug use
Compulsive use
Continued use despite harm
Craving

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2
Q

Ability of a second drug of the same class (similar MOA) to maintain the dependence of an original drug

A

Cross-dependence

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3
Q

Pharmacological treatment is always necessary for withdrawal from these two types of substances, since it can be life threatening

A

Alcohol and depressants

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4
Q

Subjective need or compulsion to use the drug in order to maintain a feeling of well being
May be present even in the absence of physical dependence

A

Psychological dependence

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5
Q

This intoxication sign is common to most drugs with the sole exception of nicotine

A

Euphoria

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6
Q

Euphoria is common to most drugs with the sole exception of this

A

Nicotine

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7
Q

All used substances appear to activate the same reward pathway with this as the final common neurotransmitter

A

Dopamine

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8
Q

Increased response to repeated and intermittent administration of the drug

A

Sensitization

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9
Q

These three enzymes metabolize alcohol

A

Alcohol and aldehyde dehydrogenase
Catalase
Alcohol oxidase (CYP)

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10
Q

This enzyme converts alcohol to aldehyde

A

Alcohol dehydrogenase

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11
Q

Is alcohol dehydrogenase zero or first oder?

A

Zero order

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12
Q

This enzyme is the primary route for alcohol metabolism

A

Alcohol dehydrogenase

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13
Q

Is alcohol dehydrogenase inducible?

A

No

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14
Q

Are alcohol oxidase and catalase zero or first oder?

A

First

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15
Q

Are alcohol oxidase and catalase induced?

A

Yes (by ethanol and other drugs)

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16
Q

This enzyme converts acetaldehyde to acetic acid

A

Aldehyde dehydrogenase

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17
Q

This enzyme is the point of “disulfiram-like” inhibition

A

Aldehyde dehydrogenase

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18
Q

Is ethanol withdrawal serious?

A

Yes - potentially lethal

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19
Q

1-2 days after start of withdrawal from ethanol, these appear and increase in intensity, may be life threatening

A

Convulsions

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20
Q

Early signs (within one day) of withdrawal from this substance include vivid dreams, insomnia, tachycardia, and hypertension

A

Ethanol

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21
Q

Visual hallucinations may occur anytime after the start of withdrawal from this substance

A

Alcohol

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22
Q

This symptom of ethanol withdrawal may occur anytime after the start of withdrawal

A

Visual hallucinations

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23
Q

1-2 days after start of withdrawal from this substance, convulsions appear and increase in intensity, may be life threatening

A

Ethanol

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24
Q

About 3 days after start of withdrawal from this substance, delirium tremens appear

A

Ethanol

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25
Q

About 3 days after start of withdrawal from ethanol, this symptom appears
Can include tremors, delirium, confusion, and sympathetic overdrive leading to cardiovascular instability and death

A

Delirium tremens

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26
Q

Delirium tremens is associated with withdrawal from this substance

A

Ethanol

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27
Q

Uncomplicated withdrawal from alcohol is treated with this

A

Benzodiazepines

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28
Q

Alcohol related seizures (complicated withdrawal) is a medical emergency and is treated also with this drug, but in an intensive care setting

A

Benzodiazepines

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29
Q

Seizures generally present after this much time of alcohol withdrawal

A

At the end of the first day

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30
Q

Delirium tremens usually occurs this much time after cessation of alcohol

A

48-72 hours

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31
Q

This symptom of alcohol withdrawal is a medial emergency, and involves autonomic hyperactivity, disorientation, visual or tactile hallucinations
Fluctuate from lethargic to agitated

A

Delirium tremens

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32
Q

This drug for alcohol craving reduction is administered oral or by extended-release injection

A

Naltrexone

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33
Q

This drug for alcohol craving reduction is a competitive mu-opiate receptor antagonist that reduces drug cravings

A

Naltrexone

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34
Q

Naltrexone is a competitive antagonist of this receptor

A

Mu-opiate receptor

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35
Q

Is naltrexone an agonist or antagonist of the mu-opiate receptor?

A

Antagonist

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36
Q

This drug for alcohol craving reduction appears weak at preventing a lapse, but better at preventing a lapse from becoming a relapse

A

Naltrexone

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37
Q

This drug for alcohol craving reduction is a GABAergic agonist that modulates alcohol cravings

A

Acamprosate

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38
Q

This drug for alcohol craving reduction appears good at preventing a lapse

A

Acamprosate

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39
Q

Is Naltrexone or Acamprosate better at preventing a lapse of alcohol use?

A

Acamprosate
(naltrexone is better at preventing a lapse from becoming a relapse)

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40
Q

Acamprosate is an agonist of this

A

GABA

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41
Q

Is acamprosate an agonist or antagonist of GABA?

A

Agonist

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42
Q

This drug is used as aversive therapy for ethanol

A

Disulfiram

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43
Q

Disulfiram inhibits this enzyme

A

Aldehyde dehydrogenase

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44
Q

This drug is reserved for the motivated ethanol abstinent patient that fears relapse

A

Disulfiram

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45
Q

Use of disulfiram results in the buildup of this compound, which makes the user sick after alcohol

A

Acetaldehyde

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46
Q

Do cross tolerance and cross dependence occur with depressants?

A

Yes

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47
Q

Does tolerance to depressants develop slowly or rapidly?

A

Slowly

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48
Q

Tolerance of depressants to this symptom is slow to develop and has a ceiling

A

Respiratory depression

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49
Q

Tolerance to respiratory depression is slow to develop and has a ceiling with these substances

A

Depressants

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50
Q

Does alcohol or benzoes have a shorter half life?

A

Alcohol
(so symptom of abstinence syndrome develop earlier)

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51
Q

Is withdrawal from depressants serious?

A

Yes - potentially life threatening
(regardless of half life)

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52
Q

Withdrawal from this type of depressant has the highest mortality rate

A

Barbiturate

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53
Q

How is depressant withdrawal treated?

A
  1. establish a stabilizing dose of the drug
  2. begin a slow taper process
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54
Q

Pinpoint pupils, respiratory depression, and constipation are signs of intoxication with this type of substance

A

Opioid

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55
Q

Is withdrawal from opioids serious?

A

Rarely life threatening
Hypertension, racing heart, and loss of electrolytes (vomiting and diarrhea) may be complications

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56
Q

Withdrawal from this type of substance is rarely life-threatening but hypertension, racing heart and loss of electrolytes (vomiting and diarrhea) may be complicating factors

A

Opioids

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57
Q

If decision is made to relieve symptoms of opioid withdrawal with opiate replacement, either of these 2 drugs are recommended

A

Methadone
Buprenorphine

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58
Q

Methadone and Buprenorphine are recommended to relieve symptoms of withdrawal from this type of substance

A

Opioids

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59
Q

This drug can be used to treat the hypersympathetic activity of opioid withdrawal

A

Clonidine

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60
Q

Clonidine can be used to treat the hypersympathetic activity of withdrawal from this type of substance

A

Opioids

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61
Q

Clonidine can be used to treat this activity that occurs with opioid withdrawal

A

Hypersympathetic

62
Q

Buprenorphine-Naloxone combinations are used for this

A

Opioid dependence maintenance

63
Q

Combinations of these two drugs are used for opioid dependence maintenance

A

Buprenorphine-Naloxone

64
Q

This drug is used for aversive therapy from opiates

A

Naltrexone

65
Q

This drug blocks opiate activity, preventing any desirable effects of opiates
Requires an abstaining opiate user motivated to stay opiate-free but fears relapse

A

Naltrexone

66
Q

Naltrexone is used as aversive therapy from this type of substance

67
Q

D-isomer of opiate normally used as antitussive

A

Dextromethorphan

68
Q

Dextromethorphan is used to treat this

A

Cough
Is antitussive

69
Q

This drug is the antidote to Dextromethorphan
(especially higher dose effects)

70
Q

Intoxication with this antitussive is achieved by large oral doses
High dose: Hyperexcitability, lethargy, ataxia, slurred speech, diaphoresis, hypertension, nystagmus, mydriasis
Higher dose: Dissociative anesthetic-like sensations

A

Dextromethorphan

71
Q

This is a partial nicotine agonist
Has been noted to increase the risk of seizures, and risk is increased when combined with bupropion

A

Varenicline

72
Q

Varenicline is a partial agonist to this

73
Q

Varenicline has an increased risk of this, and the risk is increased when combined with bupropion

74
Q

Varenicline increases the risk of seizures, and this risk is increased when combined with this drug

75
Q

Bupropion decreases drug craving, drug reward, and withdrawal symptoms of this type of substance

76
Q

This is the most widely consumed behaviorally active substance

77
Q

Peripheral actions of caffeine includes inhibition of this type of enzyme

A

PDEs
(results in sustained levels of cAMP and cGMP)

78
Q

Central actions of caffeine involve antagonism of these two compounds

A

Adenosine and GABA-inhibitory action

79
Q

Does caffeine dilate or constrict coronary vessels?

80
Q

Does caffeine dilate or constrict cerebral vessels?

A

Constricts

81
Q

Does caffeine relax or stimulate smooth muscle?

82
Q

Does caffeine relax or stimulate skeletal muscle?

83
Q

In coronary insufficiency, what effect does caffeine have on cardiac function?

A

Cardiac depressant
(is usually a cardiac stimulant)

84
Q

In coronary insufficiency, what effect does caffeine have on coronary vessels?

A

Constricts
(usually dilates)

85
Q

Caffeine actions in a patient with this condition may be reversed of what is normal
(cardiac depressant, coronary vessel constrictor)

A

Coronary insufficiency

86
Q

What is the half-life of cocaine?

87
Q

What is the half-life of amphetamine?

88
Q

cocaine is this type of substance

89
Q

Amphetamine is this type of substance

90
Q

This pattern of misuse of stimulants is an intense pleasure as drug is administered

91
Q

This pattern of misuse of stimulants is periods of intense drug use, also called binge

92
Q

This pattern of misuse of stimulants is the end of a run, characterized by prolonged sleep, depression, hunger and weakness

93
Q

Rush, run, and crash are patterns of misuse of this type of substance

A

Stimulants

94
Q

Withdrawal from this type of substance begins shortly after last dose with increased drug cravings, intense dysphoria, depression, anxiety and agitation

A

Stimulants

95
Q

Within a day or so of withdrawal from this type of substance, hypersomnia, increased appetite, and cravings vary in intensity

A

Stimulants

96
Q

Within a day or so of withdrawal from stimulants, does insomnia or hypersomnia occur?

A

Hypersomnia

97
Q

Within a day or so of withdrawal from stimulants, is appetite increased or decreased?

98
Q

In withdrawal from this type of substance, patients without depression or suicidal tendencies can be treated outpatient

A

Stimulants

99
Q

Cocaine is metabolized to this compound in the presence of alcohol

A

Cocaethylene
(a longer acting psychoactive compound; has a higher risk of death)

100
Q

Cocaine is metabolized to cocaethylene in the presence of this

101
Q

This is metabolized to cocaethylene in the presence of ethanol

102
Q

This stimulant produces profoundly positive feelings (empathy, relief of anxiety, extreme relaxation) at recreational doses

103
Q

This type of cannabinoid receptor is found in CNS; mediates the rewarding properties of cannabinoids

104
Q

This type of cannabinoid receptor is prominent in the immune system

105
Q

These are homologs of marijuana produced in the brain

A

Endocannabinoids

106
Q

Marijuana is derived from this

A

Cannabis sativa

107
Q

This active ingredient of Cannabis stimulates appetite and reduces nausea

A

9-Tetrahydrocannabinol (THC)

108
Q

This active ingredient of Cannabis is used for reducing pain and inflammation, and controlling epileptic seizures
Non-psychoactive

A

Cannabidiol

109
Q

Is 9-Tetrahydrocannabinol (THC) or Cannabidiol a psychoactive component of Cannabis?

110
Q

What effect does cannabis have on heart rate and BP?

A

Mild increase

111
Q

In heavy users of this substance, amotivational syndrome of apathy, dullness, impaired judgement, decreased concentration and memory, loss of interest in personal hygiene, and a general reduction of goal-directed behavior may occur

112
Q

A hyperesmesis syndrome may occur in current, heavy users of this substance
Abdominal pain, epigastric or periumbilical
Recurrent episodes of severe nausea and intractable vomiting
Resolution of symptoms with cessation

113
Q

Do hallucinogens change mood and thought patterns?

A

Generally yes

114
Q

Do hallucinogens cause constricted or dilated pupils?

115
Q

Cross-over sensory patterns (hear sights, smell sounds, etc) may occur with higher doses of this type of substance

A

Hallucinogen

116
Q

Powerful hallucinatory drugs (such as LSD) can trigger this
Most typically observed in recurrent users or have underlying personality disorders

A

Flashbacks

117
Q

Are hallucinogens considered addictive?

118
Q

Phencyclidine (PCP) is this type of substance

A

Hallucinogen

119
Q

Phencyclidine (PCP) is a dissociative anesthetic chemically related in action to this compound

120
Q

This is a dissociative anesthetic chemically related in action to ketamine

A

Phencyclidine (PCP)

121
Q

This drug provides feelings of detachment from environment and self
Often used as a spike for another drug

A

Phencyclidine (PCP)

122
Q

Chronic effects of this drug include flashbacks, persistent speech problems, social withdrawal and isolation, toxic psychosis

A

Phencyclidine (PCP)

123
Q

Rash/irritation around mouth and nose, Red, glassy, watery eyes, Excitability and unpredictable behavior and Odor on clothes, skin and breath are signs of use of this type of substance

124
Q

Chronic use outcomes of this type of substance include cardiac arrhythmias, liver and kidney damage, cancer, and gateway use to other drugs of misuse

125
Q

In general approach to substance use disorder, is pharmacological treatments or psychosocial therapy primary?

A

Psychosocial therapy
(Pharmacological treatments are secondary to psychosocial therapy)

126
Q

What are the five stages of change in substance use disorder?

A

Precontemplation
Contemplation
Preparation
Action
Maintenance

127
Q

A person with no intent to change and sees positive aspects of behavior rather than negative, may be in this stage of change

A

Precontemplation

128
Q

A person who is willing to consider changing, and is mostly ambivalent and becomes quickly resistant or defensive, may be in this stage of change

A

Contemplation

129
Q

This drug is the first-line for alcohol withdrawal prevention

130
Q

This drug reduces alcohol cravings but should not be used in patients taking opioids

A

Naltrexone

131
Q

Naltrexone reduces alcohol cravings, but should not be used in patients taking these drugs

132
Q

This drug for alcohol use disorder is safe in liver disease but avoided in renal failure

A

Acamprosate

133
Q

Acamprosate is avoided in patients with this organ failure

134
Q

This drug is short acting and given for opioid overdose

135
Q

This drug is given in controlled settings for opioid use disorder, and is a long-acting full opioid agonist

136
Q

This drug is a partial opioid agonist with a ceiling effect (less respiratory depression)

A

Buprenorphine

137
Q

Is methadone a partial or full opioid agonist?

A

Full
(prevents withdrawal; long half life)

138
Q

Is Buprenorphine a partial or full opioid agonist?

A

Partial
(reduces cravings)

139
Q

Is Buprenorphine a partial or full opioid agonist?

140
Q

Suboxone is a combination of these two drugs, and is discourages misuse of opioids
Blocks euphoric effects if injected

A

Buprenorphine + Naloxone

141
Q

This drug used for opioid withdrawal has adverse effects of respiratory depression and QT prolongation

142
Q

What is the first line treatment for stimulant use disorder?

A

Supportive therapy
*No FDA approved medications

143
Q

Agitation in stimulant use disorder should be managed with this drug

144
Q

This type of drug should be avoided in acute cocaine intoxication due to unopposed alpha-adrenergic vasoconstriction

A

Beta blockers

145
Q

What is the first line treatment for cannabis use disorder?

A

Supportive therapy
*No FDA approved medications

146
Q

In treatment of withdrawal from this type of substance, gradual taper is key

A

Benzodiazepine

147
Q

Benzodiazepine withdrawal is similar to withdrawal from this substance

148
Q

Opioid overdose should be treated with this drug

149
Q

Opioid maintenance therapy should involve either of these 2 drugs

A

Methadone
Buprenorphine

150
Q

Is withdrawal from stimulants life threatening?

A

No
(treat with CBT)

151
Q

Are there FDA-approved treatments for stimulant, cannabis, or benzodiazepine use disorders?

Neuro - Week 7 (5 decks)

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