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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

25
percentage of relapse for opioid addicted pts after 1 year
82%
26
ETOH w/d timeline
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
how MJ is addictive
releases dopamine in mesolimbic system
28
clonidine MOA in opiate w/d
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
mirtazapine MOA
tetracyclic alpha 2 antagonism at presynaptic receptors antagonism of postsynaptic serotonin 5HT3 and 5HT2
30
derived from morning glory seed, ergot alkaloids, rye fungus
LSD
31
mild, moderate and severe criteria for substance use DO
mild- 2/3 sx mod- 4-5 sx severe- 6 sx
32
increases risk of rhabdo
restraints and combativeness PCP use
33
AST:ALT in alcoholic liver disease
>1.5
34
bruxism
grinding teeth effect of MDMA/ecstasy meth, dextroamphetamine
35
topimax
antagonizes glutamate suppresses ETOH induced dopamine release
36
naloxone
strong mu opioid antagonist medium kappa antagonist weak delta antagonist
37
buprenorphine MOA
partial agonist at mu receptors, binds high affinity so hinders other opiates while in system
38
opioid withdrawal sx
jt pain, muscle pain, dysphoria, piloerection, diarrhea, lacrimation, rhinorrhea, yawning, autonomic hyperactivity
39
acamprosates levels inc when given with..
naltrexone
40
naltrexone
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
acamprosate MOA
antagonizes glutamatergic function via NMDA receptors INC GLUTAMATE RESEMBLES GABA
42
disulfram MOA
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
treating steroid abuse
gradually taper off outpatient to give adrenal glands time to return to normal don't abruptly stop.
44
Lysergic acid amide (LSA)
hallucinogen derived from morning glory seeds, ergot alkaloids, rye fungus **opium is from poppy seeds
45
contingency management
positive contingencies effective for addiciton, cocaine uses a point system that leads to prize and negative contingencies involve removal of privleges
46
GHB withdrawal
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
amphetamine w/d
acute: vivid dreams, agitation, SI INTOXICATION can include muscle cramping, hypomagnesemia, hypokalemia
48
most specifict biomarker of ETOH abuse
CDT carbohydrate deficient transferrin -returns to normal after 2-4 weeks of stopping ETOH use
49
countertransference
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
long time nitrous oxide exposure
ie dental offices causes viatmin b12 deficientcy, sensory neuropathy, myelopathy, encephalopathy
51
state dependent learing
assumes that both learning and memory recall occur most effectively under the same circumstances.
52
fastest to slowest peak nicotine level
cigarette>spray>inhaler>lozenge>gum>patch
53
fetal alcohol syndrome
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
reinforcement v punishment
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
halo effect
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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