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Board Studying. > substances > Flashcards

substances Flashcards

1
Q

wernicke’s

A

lesions to CNS after exhaustion of thiamine (B1) reserves.

sx: opthalmoplegia, ataxia, confusion.
hypothermia, hypotension, peripheral neuropathy, wekaness, amnesia, hyperhidrosis, foot drop, decreased proprioception

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2
Q

opiate intoxication

A

depressed respiartory rate, diminished bowel sounds, dec tidal vol

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3
Q

n-hexane

A

mc due to inhaling household glues
metabolized to 2,5 hexanedione which is neurotoxic

CNS depression

glue sniffer neuropathy: progressive, symmetric, ascending sensorimotor, peripheral axonopathy
similar to GBS pathology

neuropathy may be associated with autonomic dysfunction. bluish discoloration, decreased temperature of involved extremities.

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4
Q

highest smoking rate in US adults

A

native american males

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5
Q

difference in men and women ETOH metabolism

A

lower levels of etoh dehydrogenase are present in the gastric mucosae of women compared to men

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6
Q

Diclemente and Prochaska’s stages of change

A

precontemplation (not ready)
Contemplation (getting ready)
Preparation (ready)
Action- changed behavior, learning how to strengthen committments
maintenance

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7
Q

plant where LSD comes from

A

ergot fungus

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8
Q

benzos to use with liver dz

A

LOT

lorazepam, oxazepam, temazepam

or OTL: out the liver

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9
Q

moa of buprenorphine

A

partial agonist at Mu receptors but binds with very high affinity, hindering other opiates while in system

blockade system
often resistant to naloxone reversal due to high binding affinity

20-40x stronger per gram weight of morphine

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10
Q

how to discontinue sterioids

A

taper to avoid withdrawal sx

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11
Q

how neuronal and neurotransmitters activities are implicated in addiction

A

most addictive substances overwhelm limbic reward pathways, producing greater firing than usual rewards experienced in day to day survival-relevant functioning.

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12
Q

acammprosate structurally resembles…

A

GABA

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13
Q

scheduled 3 drug approved by FDA for treatment of cataplexy in pts with narcolepsy

A

Xyrem

active ingredient is sodium oxybate or gamma hydroxybutyrate , is scheduled 1

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14
Q

gene that inc risk of developing psychosis after using cannabis

A

AKT1

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15
Q

ketamine street names

A

kit kat, cat valium, special k, vit k, super acid, special la coke, purple, jet

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16
Q

location of hemorrage after ingesting methyl alcohol

A

putamen

methyl etoh metabolized to formaldehyde and formate, leades to neurotoxicity

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17
Q

“OARS” microskills

A

open ended questions

affirmation.

reflective statement.

summary statements

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18
Q

nitrites

A

present in liquid incense

used to heighten sexual pleasure

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19
Q

varenicline in smoking addiction

A

alpha-4-beta-2 nicotinic ACH receptor partial agonist

stables nicotinic receptors in intermediate state, keeping channel less open than a full agonist like nicotine

activity at alpha4beta2 subtype of nicotinic receptor

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20
Q

has vivid dreams as SE

A

amphetamine
cocaine

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21
Q

difference between cocaine and amphetamine MOA

A

cocaine prevents dopamine reuptake

amphetamine blocks dopamine and norepinephrine transporters in addition to VMAT 2 inhibition, and monoamine oxidase inhibition

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22
Q

what COMBINE trial showed

A

naltrexone effectively delayed time to relapse compared to placebo.

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23
Q

how naloxone must be administered when buprenorphine present

A

injected- it blocks effect when injected

remains active when injected with buprenoprphine.
given to prevent abuse since it will work when injected.

essentially inactivated if given oral.

it’s inactivited with oral administration ,
will be active if sublingual formulation is injected

injection would precipitate withdrawal sydnrome if there are exogenous opiods present

24
Q

percentage of patients with chronic ETOH use disorder and parent with ETOH use DO

A

30%

25
Q

percentage of relapse for opioid addicted pts after 1 year

A

82%

26
Q

ETOH w/d timeline

A

starts 6-8hrs after last drink

peaks 24-28 hours

resolves within about 7 days

3-10% have alcohol hallucinosis with sever

DT: autonomic instability, fevers, auditiory and visual hallucinations, disorientation

27
Q

how MJ is addictive

A

releases dopamine in mesolimbic system

28
Q

clonidine MOA in opiate w/d

A

alpha 2 adrenergic receptor AGONIST

binds alpha 2 autoreceptors

reduces levels of norepinephrine

decreases locus coeruleus cell firing

reduces noradrenergic release

withdrawal syndrome is the result of hyperactivity of upregulated noradrenergic cells in locus ceruleus.

NOT FDA approved for opioid withdrawal.

29
Q

mirtazapine MOA

A

tetracyclic
alpha 2 antagonism at presynaptic receptors

antagonism of postsynaptic serotonin 5HT3 and 5HT2

30
Q

derived from morning glory seed, ergot alkaloids, rye fungus

A

LSD

31
Q

mild, moderate and severe criteria for substance use DO

A

mild- 2/3 sx
mod- 4-5 sx
severe- 6 sx

32
Q

increases risk of rhabdo

A

restraints and combativeness

PCP use

33
Q

AST:ALT in alcoholic liver disease

A

> 1.5

34
Q

bruxism

A

grinding teeth
effect of MDMA/ecstasy

meth, dextroamphetamine

35
Q

topimax

A

antagonizes glutamate

suppresses ETOH induced dopamine release

36
Q

naloxone

A

strong mu opioid antagonist

medium kappa antagonist

weak delta antagonist

37
Q

buprenorphine MOA

A

partial agonist at mu receptors, binds high affinity so hinders other opiates while in system

38
Q

opioid withdrawal sx

A

jt pain, muscle pain, dysphoria, piloerection, diarrhea, lacrimation, rhinorrhea, yawning, autonomic hyperactivity

39
Q

acamprosates levels inc when given with..

A

naltrexone

40
Q

naltrexone

A

opioid antagoint- can be used to treat opiod DO but NOT given with buprenorphine (that’s naloxone)

given with bupropion to treat obesity in adults.

41
Q

acamprosate MOA

A

antagonizes glutamatergic function via NMDA receptors
INC GLUTAMATE

RESEMBLES GABA

42
Q

disulfram MOA

A

blocks dopamine beta hydroxylase in the brain

blocks aldehyde dehydrogenase, leads to accumulation of acetaldehyde at toxic levels and causing unpleasant hangover like side effects

43
Q

treating steroid abuse

A

gradually taper off outpatient to give adrenal glands time to return to normal

don’t abruptly stop.

44
Q

Lysergic acid amide (LSA)

A

hallucinogen derived from morning glory seeds, ergot alkaloids, rye fungus

**opium is from poppy seeds

45
Q

contingency management

A

positive contingencies effective for addiciton, cocaine

uses a point system that leads to prize and negative contingencies involve removal of privleges

46
Q

GHB withdrawal

A

GHB = Xyrem,
treats cataplexy in narcolepsy

active ingredient is sodium oxybate- schedule ONE controlled substance.

shares features of alcohol and benzo withdrawal

rare due to rapid elimination of drugs

withdrawal sx: anxiety, insomnia, tremor, confusion, nausea, vomiting

47
Q

amphetamine w/d

A

acute: vivid dreams, agitation, SI

INTOXICATION can include muscle cramping, hypomagnesemia, hypokalemia

48
Q

most specifict biomarker of ETOH abuse

A

CDT

carbohydrate deficient transferrin

-returns to normal after 2-4 weeks of stopping ETOH use

49
Q

countertransference

A

physician projects feelings about another person onto a patient

transference: patient projects feelings about another individual onto physician

projection: attributing an unacceptable internal impulse to an external source ie. student wants to cheat on exam but accuses friends of having cheated on their exams

50
Q

long time nitrous oxide exposure

A

ie dental offices

causes viatmin b12 deficientcy,

sensory neuropathy, myelopathy, encephalopathy

51
Q

state dependent learing

A

assumes that both learning and memory recall occur most effectively under the same circumstances.

52
Q

fastest to slowest peak nicotine level

A

cigarette>spray>inhaler>lozenge>gum>patch

53
Q

fetal alcohol syndrome

A

IDD
wide set eyes
short palpebral fissure
short and broad-bridge nose
hypoplastic philtrum

THIN UPPER LIP

flattened midline face

breast feeding with ETOH has been shown to impair motor development , but not mental.

54
Q

reinforcement

v

punishment

A

reinforcement: maintains or INCREASES a behavior

punishment: DECREASES A BEHAVIOR

if stimulus is added, it’s positive

if taken away, it’s negative

NEGATIVE REINFORCEMENT is powerful predictor of future behavior, frequently perpetuates substance use when they are dependent and experience w/d sx

55
Q

halo effect

A

researcher’s evaluation of a subject’s current performance is altered based on his or her opinion of the previous performance of the subject

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