Substance Abuse II Flashcards

1
Q

What are the criteria for caffeine use disorder?

A

No such thing

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2
Q

What is considered “high dose” caffeine?

A

250 mg

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3
Q

What are the criteria for caffeine intoxication? (non -obvious)? How many are needed?

A

-Flushed face

5

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4
Q

What are the criteria for caffeine withdrawal? How many within a 24 hours timeframe are needed to diganose?

A

At least 3 within 24 hours:

  • HA
  • Fatigue
  • Dysphoric
  • Flu-like s/sx
  • Difficulty concentring
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5
Q

What is the major issue with Li and Caffeine use?

A

Diuretic aspect of caffeine may alter [Li]

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6
Q

What is the most widely used illicit substance?

A

Marijunana

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7
Q

What is the age range that has the highest marijuana use?

A

18-29 years

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8
Q

True or false: regular users of marijuana had concurrent metal disorders

A

True

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9
Q

True or false: most individuals who use cannabis report that they use it solely for pleasure

A

False–cope with mood, sleep, pain etc

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10
Q

What are the four criteria for marijuana intoxication? How many are needed? Within what time frame?

A

2 within 2 hours:

  • Conjunctival injection
  • Increased appetite
  • Dry mouth
  • Tachycardia
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11
Q

What is “K2?

A

Synthetic cannabinoid–sprayed onto herbal/plant matter

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12
Q

What are the major effects of synthetic cannabinoid?

A
  • Anxious
  • Irritable
  • Cognitive impairment
  • Psychosis
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13
Q

How reliable are tox screens for K2?

A

Not very

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14
Q

What are the physical effects of K2?

A

Conjunctival injection

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15
Q

What are the s/sx of cannabis withdrawal?

A
  • Sleep difficulty
  • Anxiety
  • Decreased appetite
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16
Q

What are the major phencyclidines?

A
  • PCP

- Ketamine

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17
Q

What are the s/sx of phencyclidine (PCP) use? (5)

A
  • Dissociative symptoms
  • Nystagmus
  • HTN
  • Violent behavior
  • Analgesia
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18
Q

What are the complications that can result from phencyclidine use?

A
  • Cognitive deficits
  • Szs
  • Intracranial hemorrhage
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19
Q

What is MDMA?

A

Ecstasy

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20
Q

What are the eye findings with phencyclidine use?

A
  • Pupillary dilation

- Nystagmus

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21
Q

What are the muscle findings of phencyclidine?

A
  • Rigidity
  • Ataxia
  • Dysarthria
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22
Q

What are the CV effects of Phencyclidine intoxication?

A
  • Tachycardia

- HTN

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23
Q

How mayn diagnostic criteria are needed, and in what timeframe, for phencyclidine intoxication?

A

Within 1 hour, at least 2

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24
Q

What are the ocular s/sx of hallucinogenic intoxication?

A

Dilation

Blurred vision

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25
Q

True or false: there is no withdrawal with inhalant use

A

True

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26
Q

What are the general features of inhalant intoxication?

A
  • Belligerence
  • lethargy
  • Impaired judgement
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27
Q

What are the the ocular findings of inhalant use?

A
  • Nystagmus
  • Blurred vision
  • Diplopia
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28
Q

What are the motor findings of inhalant intoxication? (4)

A
  • Incoordination
  • Psychomotor retardation
  • Tremor
  • Generalized weakness
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29
Q

What is the common cause of death with inhalant use?

A

Cardiac arrhythmias

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30
Q

What is the general MOA of opioids?

A

Mu-opioid receptor agonist

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31
Q

What happens after the euphoric-Perceptual motor phase with opioid use?

A

Apathy and dysphoria

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32
Q

What happens to motor function with opioid intoxication?

A

Agitation or retardation

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33
Q

What are the diagnostic criteria for opioid intoxication? (4)

A

Pupillary constriction + 1 or more of:

  • Slurred speech
  • Drowsiness
  • Impairment in attention or memory
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34
Q

How many criteria are needed to diagnose opioid withdrawal? In what timeframe?

A

3 or more within minutes to days

35
Q

What are the ocular findings with opioid withdrawal?

A

Pupillary dilation

36
Q

What are the general s/sx of opioid withdrawal?

A
  • Dysphoria
  • N/v
  • myalgias
37
Q

What are the ANS findings of opioid withdrawal? (3)

A
  • Lacrimation / rhinorrhea
  • Piloerection
  • Diaphoresis
38
Q

What are the GI findings of opioid withdrawal?

A

Diarrhea

39
Q

What is the name of the diagnostic algorithm used to diagnose opioid withdrawal?

A

COWS

40
Q

What are the three major medication used in opioid withdrawal?

A
  • Methadone
  • Buprenorphine
  • Naltrexone
41
Q

What is the MOA of methadone?

A

Long acting synthetic opioid agonist

42
Q

What s the MOA of buprenorphine?

A

Synthetic partial agonist of opioid receptors

43
Q

What is the MOA of naltrexone?

A

opioid antagonist

44
Q

Why give buprenorphine and naloxone as a combination?

A

Naloxone is not enterically absorbed, so if used PO, then the buprenorphine will give only a small high. If injected, then naloxone will cause withdrawal symptoms

45
Q

True or false: craving is not typical with Sedatives / hypnotics / Anxiolytic use

A

False

46
Q

Sedatives / hypnotics / Anxiolytic use appears very similar to what other substance?

A

EtOH

47
Q

True or false: if you experience withdrawal from prescribed use of Sedatives / hypnotics / Anxiolytic, then you are diagnosed with use disorder

A

False

48
Q

What are the s/sx of Sedatives / hypnotics / Anxiolytic intoxication?

A
  • Impaired judgement
  • Mood lability
  • Inappropriate or sexual behavior
49
Q

What are the motor findings of Sedatives / hypnotics / Anxiolytic use?

A
  • Slurred speech
  • Incoordination
  • Unsteady gait
50
Q

What are the ocular findings of Sedatives / hypnotics / Anxiolytic intoxication?

A

Nystagmus

51
Q

How many diagnostic criteria are needed for Sedatives / hypnotics / Anxiolytic intoxication?

A

1 or more

52
Q

What are the cognitive effects of Sedatives / hypnotics / Anxiolytic intoxication?

A
  • Impairment

- Stupor/coma

53
Q

What is the reversal agent for benzos? MOA?

A
  • Flumazenil

- GABA antagonist

54
Q

How many diagnostic criteria are needed to diagnose anxiolytic/sedative withdrawal? In what timeframe?

A

2 or more within hour to days

55
Q

What are the nervous system withdrawal symptoms of anxiolytic withdrawal?

A
  • ANS hyperactivity
  • Psychomotor agitation
  • Hallucinations
  • Seizures
56
Q

True or false: reality testing is intact with withdrawal from anxiolytic use

A

True

57
Q

What are the results of long term use of stimulants? (4)

A
  • Chaotic behavior
  • Social isolation
  • Sexual dysfunction
  • Aggressive behavior
58
Q

What are the non-obvious s/sx of stimulant use intoxication?

A
  • Stereotyped and repetitive behavior

- Tension and anxiety

59
Q

What are the pupillary findings of stimulant use?

A

Dilation

60
Q

What are the CV criteria for stimulant intoxication?

A
  • Tachycardia or bradycardia
  • HTN or hypotension
  • Cardiac arrhythmias
61
Q

What are the psychomotor criteria for stimulant intoxication?

A

Retardation or agitation

62
Q

What are the GI criteria for stimulant intoxication?

A
  • n/v

- Weight loss

63
Q

NDMA is structurally similar to what other illicit drug?

A

Methamphetamine

64
Q

What are the CNS complications from cocaine use?

A
  • SAH
  • HA
  • CVA
  • Szs
65
Q

What is the major muscular complication from cocaine use?

A

Rhabdomyolysis

66
Q

What are the GI complications from cocaine use?

A

Intestinal ischemia

-gangrene

67
Q

What are the OB complications from cocaine use?

A
  • Abruptio placenta
  • Spontaneous abortion
  • Premature labor
  • Perinatal mortality
68
Q

True or false: cocaine can cause DKA

A

True

69
Q

What are the diagnostic criteria for stimulant withdrawal (1 + 5)

A

Dysphoric mood +

  • Fatigue
  • Vivid dreams
  • Sleep changes
  • Increased appetite
  • Psychomotor retardation
70
Q

True or false: there is NO tobacco intoxication

A

True

71
Q

What are the criteria for tobacco use disorder?

A

Daily use

72
Q

What are some of the intranasal complications from cocaine use?

A
  • Anosmia

- Necrosis and perforation of the nasal septum

73
Q

What is the timeframe and symptoms amount needed to diagnose tobacco withdrawal?

A

Within 24 hours

4 or more

74
Q

What happens to appetite with tobacco withdrawal?

A

INcreased

75
Q

What happens to mood with tobacco withdrawal?

A

Depression / dysphoria

76
Q

What is the first step in the treatment of withdrawal? What are the limitations of this?

A

Detox

-Does not address social/psych concerns

77
Q

What is the hopsital model for short term residential rehab?

A
  • 3-6 week hospital inpt tratment
  • outpatient care
  • self help group
78
Q

What is the long term residental model for rehab?

A
  • 6-12 months
  • Resocialization
  • Struturalization
79
Q

What are the focuses of outpatient rehab programs?

A
  • group counseling

- Intensive day treatment

80
Q

What are the focuses of individual rehab counseling?

A
  • Areas of impaired functioning

- Short term behavioral goals

81
Q

What is the cost for alcoholics anonymous?

A

Free

82
Q

What are the three keys to alcoholics anonymous?

A
  • Acceptance
  • Surrender-
  • 12 step program
83
Q

What is the role of Gas chromatography and mass spec in drug testing?

A

Confirmatory