Flashcards in Substance Abuse Deck (78):
1
What is considered risky drinking for men and women under 65 yo? Those over 65?
Men = more than 14 drinks / week
Women, and those over 65 = More than 7 drinks/day
2
What, generally, is meant by the term risky use?
Health consequences may arise from using
3
What is the definition of physical dependence?
A state of adaptation that is manifested by withdrawl syndrome produced by an abrupt cessation
4
What is unhealthy use?
Spectrum from risky use to addiction
5
What is meant by the term abuse in terms of drug use?
Any use or amount that deviates from social norms
6
What is misuse in the context of drugs?
Prescription drugs that are taken in an amount greater than prescribed
7
What is cross-tolerance in the context of drug use?
The ability of one drug to be substituted for another to produce the same effects
8
How, generally, do drugs work?
Activation of the reward system based on:
-Reinforcement of behaviors
-Changes to Memory production
9
True or false: the pathway of reward is difference for each drug, but the mechanism is the same
False-mechanism different, but the pathway is the same
10
What is the pathway of reward activation?
Prefrontal cortex to ventral tegmental area nucleus accumbens, to ventral tegmental area
11
What is the role of the nucleus accumbens?
Motivation and goal-directed behavior
12
What is the area of the brain that produces dopamine?
Ventral tegmental area
13
What is the major neurotransmitter involved in the reward pathway?
Dopamine
14
What are the four major functions of serotonin?
-mood
-Memory processing
-Sleep
-Cognition
15
What are the major functions of dopamine (5)
-Reward
-Pleasure
-Motor function
-Compulsion
-Perseveration
16
What is the MOA of cocaine?
Ester--blocks dopamine reuptake
17
What BP drugs should never be combined with cocaine?
Beta blockers
18
How long must drug use continued for to be called a disorder?
12 months
19
What are the mild, moderate, and severe drug use disorder?
Mild = 2-3
Moderate = 4-5
Severe = 6+
20
What are the "impaired control" diagnostic criteria for abuse disorder (4)?
-Taking substance over longer period, or in larger amounts
-Desire to cut down or unsuccessful efforts
-Spend too much time
-Craving
21
What are the "social impairment" diagnostic criteria for abuse disorder (3)?
-Failure to fulfill role
-Social problems
-Social concerns giving up for use
22
What are the "Risky use" diagnostic criteria for abuse disorder (2)?
-Using when physically hazardous
-Using despite negative health consequences
23
What are the "Pharmacological" diagnostic criteria for abuse disorder (2)?
-tolerance
-Withdrawal
24
True or false: either tolerance or withdrawal are needed for a diagnosis of substance abuse disorder
False
25
What are the major ocular changes with: EtOH?
Nystagmus
26
What are the major ocular changes with: sedatives, hypnotics, anxiolytics
Nystagmus
27
What are the major ocular changes with: inhalents
Nystagmus
28
What are the major ocular changes with: hallucinogens
Dilated pupils
29
What are the major ocular changes with: PCP
Nystagmus
30
What are the major ocular changes with: stimulants
Dilated pupils
31
What are the major ocular changes with: Cannabis
Conjunctival reddening
32
What are the major ocular changes with: opioids
Constricted pupils
33
What are the criteria for withdrawal?
-Syndrome caused by cessation
-Clinically significant or impairment
-Cannot be attributed to anything else
34
A short acting substance affects what part of withdrawal?
Intensity
35
A long acting substance affects what part of withdrawal?
Duration
36
What are the following for stimulant use:
-BP changes
-HR changes
-Temp
-Ocular findings
-DTRs
-Ataxia
-Hallucinations
-Delusions
-BP changes = increased
-HR changes = increased
-Temp = increased
-Ocular findings = dilated
-DTRs = increased
-Ataxia = none
-Hallucinations =yes
-Delusions = yes
37
What are the following for PCP use:
-BP changes
-HR changes
-Temp
-Ocular findings
-DTRs
-Ataxia
-Hallucinations
-Delusions
-BP changes = increased
-HR changes = Increased
-Temp = increased
-Ocular findings = nystagmus
-DTRs = increased
-Ataxia = yes
-Hallucinations = yes
-Delusions = yes
38
What are the following for opioid overdose:
-BP changes
-HR changes
-Temp
-Ocular findings
-DTRs
-Ataxia
-Hallucinations
-Delusions
-BP changes = none
-HR changes = none
-Temp = none
-Ocular findings = pinpoint
-DTRs = no changes
-Ataxia = none
-Hallucinations = none
-Delusions = none
39
What are the following for opioid withdrawl:
-BP changes
-HR changes
-Temp
-Ocular findings
-DTRs
-Ataxia
-Hallucinations
-Delusions
-BP changes =no change
-HR changes = no change
-Temp = increased
-Ocular findings = dilated
-DTRs = normal
-Ataxia = none
-Hallucinations = none
-Delusions = none
40
What are the following for sedative intoxication:
-BP changes
-HR changes
-Temp
-Ocular findings
-DTRs
-Ataxia
-Hallucinations
-Delusions
-BP changes = decreased
-HR changes = no changes
-Temp = decreased
-Ocular findings = nystagmus
-DTRs = no changes
-Ataxia = none
-Hallucinations = none
-Delusions = none
41
What are the following for sedative withdrawal:
-BP changes
-HR changes
-Temp
-Ocular findings
-DTRs
-Ataxia
-Hallucinations
-Delusions
-BP changes = variable
-HR changes = increased
-Temp = increased
-Ocular findings = none
-DTRs = normal
-Ataxia = none
-Hallucinations = none
-Delusions = none
42
What are the following for LSD, ecstasy, shrooms:
-BP changes
-HR changes
-Temp
-Ocular findings
-DTRs
-Ataxia
-Hallucinations
-Delusions
-BP changes = increased
-HR changes = no changes
-Temp = increased
-Ocular findings = dilated pupils
-DTRs = increased
-Ataxia = none
-Hallucinations = none
-Delusions = Yes
43
What are the following for THC use:
-BP changes
-HR changes
-Temp
-Ocular findings
-DTRs
-Ataxia
-Hallucinations
-Delusions
-BP changes = none
-HR changes = none
-Temp= decreased
-Ocular findings = red
-DTRs = none
-Ataxia = none
-Hallucinations= yes
-Delusions - yes
44
What are the following for inhalant use:
-BP changes
-HR changes
-Temp
-Ocular findings
-DTRs
-Ataxia
-Hallucinations
-Delusions
-BP changes = none
-HR changes = none
-Temp = none
-Ocular findings = nystagmus
-DTRs = decreased
-Ataxia = yes
-Hallucinations = none
-Delusions = none
45
What are the criteria of substance induced psychosis?
appearance of mental disorder within one month of intoxication or withdrawal of a substance that is capable of producing psychosis
46
What are the drink equivalents in terms of beer, wine and hard liquor?
12 oz
5 oz
1.5 oz
47
True or false: males have higher rates of substance use disorders and intoxication relative to females
Partly false--higher rates yes, but females more likely to be intoxicated
48
Where does EtOH fall in terms of preventable causes of death in the US?
Third
49
What is the positive affect regulation theory of alcohol use?
Feels good, so do it
50
What is the negative affect regulation theory of alcohol use?
Takes away the bad
51
What is the pharmacological vulnerability theory of alcohol use?
Some are more prone to use disorders than others
52
What are some skin changes associated with alcoholism?
Red palms
Caput medusae
53
What type of hematological problems can EtOH cause? (2)
Macrocytosis
Anemia
54
What are the two, non obvious cancers that smoking increases the risk for?
Cervical
Pancreatic
55
What are the characteristics and causes of Mallory Weiss tears? How do these present?
Linear streaks 2/2 chronic vomiting.
Painful hematemesis
56
How can you differentiate between mallory weiss tears and esophageal varices?
Mallory weiss tears = painful hematemesis
Esophageal varices - painless hematemesis
57
What type of seizures are had with EtOH withdrawal? When do they usually occur?
-Tonic clonic
-6-48 hours from last drink
58
What is the classic triad of Wernicke-Korsakoff syndrome?
-Confusion
-Ataxia
-Ophthalmoplegia
59
What is the classic symptom of Wernicke-Korsakoff syndrome?
Confabulation
60
What is the level of BAC for the Buzzed feeling?
30-50 mg/dL
61
What is the level of BAC for the euphoric feeling?
50 mg/dl
62
What is the level of ataxia/slurred speech for the Buzzed feeling?
100 mg/dL
63
What is the level of BAC for the drowsy/confused?
200 mg/dL
64
What is the level of BAC for stupor?
300 mg/dL
65
What is the level of BAC for progression to coma/death?
more than 400 mg/dL
66
When does alcohol withdrawal usually present following the last drink?
4-72 hours
67
What are the s/sx of alcohol withdrawal?
-Insomnia
-Palpitations
-Diaphoresis
-Anxiety
-HAs
-Tremors
-Hallucinations
-Szs
68
What type of hallucinations are more common with substance use: visual or auditory?
Visual
69
When do DTs usually present? How long do they last for?
-begin with 72 hours
-can persist for 7 days
70
What are the lab changes that can occur with DTs? (3)
-Elevated cardiac markers
-Respiratory alkalosis
-Lyte abnormalities
71
What are the risk factors for DTs? (besides obvious)
-presence of concurrent illness
-age over 30
-Withdrawal effects seen while still intoxicated, but at a lower level
72
What is the CIWA scoring system, and what score indicates that you're all good?
Predictor for the development of withdrawal
Less than 10 = no withdrawal
73
What is the treatment for DTs?
Ativan (lorazepam)
74
What is the difference between the MOA of barbiturates and benzos?
Barbiturate = prolong GABA channel opening
Benzos = increase frequency of GABA opening
75
What is the MOA of naltrexone, and what is it used for?
Opioid antagonist
reduced reward from drinking
76
What is the MOA of disulfiram?
Inhibition of acetaldehyde dehydrogenase
77
What are the three components of maintenance therapy for alcohol use disorder?
-Naltrexone
-Acamprosate
-Disulfiram
78