Substance Use Disorders Flashcards

1
Q

Deadliness

A

Die 20 years early

Must treat as a medical disorder`

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Substance use disorder diagnostic

A

<2 items in 12 months

Fialure to fulfill responsibilities
Use in hazardous situations 
Craving
Social.interpersonal probs 
Use larger amounts or longer
Cannot cut down
increase time spent to get
Give up or decrease other parts of life
Ongoing use despite probs
Toleracne 
Withdraswl 

Mild 2-3
Mod 4-5
Severe 6+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Tolerance and withdrawl

A

Tol = need for increased amounts to achieve previous affect…diminished effect with ontinued use of the same amount of substance

W/d - characteristic withdrawl syndrome when not taken

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Physical dep key points `

A

NOT required for diagnosis but must know if physicially dependent because w/d can be life threatening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Substance induced intoxication

A

Reversible substance specific syndrome due to recent substance ingestion

Effects lead to maladaptive behavioral or psych changes due to effect on CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Substance induced w/d

A

Substance specific syndrome due to cessation of substance use

CS distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Substance induced mental disorders

A

Screen everyone for these because it is common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

General rules for substance induced mood disorders

A

Chronic CNS dep - depressive moods

CNS stimulants - mixed/manic moods and psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

SUD etiology

A

50% genetic and 50% enviorment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Alcohol intoxication

A

CNS dep and metabolism in liver

Decreased BP and HR
Dec temp (because vasodilator…why homeless die in winter)
Dec RR
Eventual coma and death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Alcohol withdrawl mild

A

Within hours of last drink
Resolvesin 48 hours
Tremor, nauseua, irritability, insomnia, tachycardia, HTN, diaphoresis
TX is supportive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Alcohol related med problems

A
CNS 
PNS - peripheral neuropathy)
cardiac - cardiomyopathy
Bllod - thinning of blood of macrocytic anemia 
GI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Alcohol withdrawl seizure

A

12-48 hours after last drink…this is important
Tonic-clonic type
Tx with benzos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Delirium tremens

A

72-96 hours after last drink
Resolves in 3-5 days
Mortalitiy high
Tx with benzos and autonomic instability/fluid/electrolyre probs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Wernicke’s encephalopathy

A

Severe thiamine edficiency

Triad of delirium, opthalmoplegia (nystagmus), and ataxia

Tx with thiamine replacement BEFORE glucose b/c thimaine needed to metabolize glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Korsakoff’s syndrome

A

AMnestic syndrome caused by thiamine def…preced by wernickes

Anterograde and retregrade amenia with cofabulation

Tx is daily thiamine

Brain - lesionjs in mammillary bodies and meidal dorsal nucles of the thalamus

17
Q

Alcohol dep tx

A

Disulfiram - inhibits acetaldehyde dehydrogenase…build up acetaldehyde after alcohol consume

Naltrexone - blocks mu receptor so decrease reward…best if fam hx

Acamprosate - unclear…decreased craving

18
Q

Education

A

Males - 2 or less recommended
Females - 1
Drunking 3 or more drinks per days increases of binge drinking (5 or more) increased

1 std drink - .6 fluid ounces or 14 grams of pure alcohol

19
Q

Brief intervention for those without AUD

A

Make recommendations

Drunk 2 or less a day

20
Q

Cannabis intox

A
Impaired motor coordination
Conjunctival injection
Increased appetite
Dry mouth
Tachycardia and BP increases 

Increased psychosis risk

21
Q

Cannbis withdrlawl

A

Usually after daily/near daily nuse for months with 3 of following

Irritable, angry aggressive
Nervous/ancious
Sleep probs
Decrease appetite or weight loss
Restlessness
Depressed mood
22
Q

Caffeine induced anxiety DO

A

Seen in med students and interns

Trial of caffeine abstinence may help diagnose

23
Q

Cocaine intox

A

Mydriasis

N/V

24
Q

Stimulant med probs

A

CV
CNS
Pulm

25
Q

Cocaine w/d

A
Sleep probs 
Dysphoric mood 
Hallucinations
Dreams 
Increased appetite
26
Q

Methamphetamine

A

Immediate release of dopamine and looks similar to cocaine

27
Q

MDMA

A

Primary effect is on serotonin

Tkane to enhance attachment and feeling

Psychomotor agitation

Disco dump

28
Q

MDMA severe effects

A

Rhabdomyolysis, ARF

Hyponatremia

29
Q

Hallucinogens

A

Mostly causes an illusion, NOT hallucination

Preserves consciousness

30
Q

PCP

A

Dissociative anesthetics - at NMDA receptor

31
Q

PCP intox

A

Belligerence, assaultiveness
Vertical nystagmus
Diminished pain response

32
Q

Ketamine intox

A
Similar to PCP but without the aggressiveness
Increased BPO and HR 
Ataxia 
Dissociative expereicne 
N/V