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*Pharm III > Substance Abuse > Flashcards

Substance Abuse Flashcards

1
Q

A chronic disorder characterized by the compulsive use of substance resulting in physical, psychological, or social harm to be user and continued use despite the harm.

A

Addiction

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2
Q

Physiological adaptation to the effect of drugs so as to diminish effects with constant dosages or to maintain the intensity and duration of effects through increased dosage.

A

Tolerance

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3
Q

Reversible substance-specific syndrome

Due to recent ingestion or exposure to a substance

A

substance intoxication

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4
Q

what is the reward pathway in the brain

A

DA in mesocorticolimbic system

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5
Q

Increased response following repeated intermittent administration of a drug, in contrast to tolerance to drug effects that occur secondary to continuous exposure to a drug

A

Sensitization

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6
Q

CNS depressant
Works in a dose dependent fashion
Sedative, sleep, unconsciousness, coma, respiratory depression and CV collapse

A

alcohol

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7
Q

five or more drinks on the same occasion at least once in the past 30 days

A

Binge use

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8
Q

five or more drinks on the same occasion on at least 5 different days in the past 30 days.

A

heavy use

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9
Q

Major excitatory system in CNS

A

glutamate

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10
Q

what happens to NMDA pathway with alcohol intoxication

A

decrease glutamate activity

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11
Q

what GABA receptor is affected by alcohol

A

GABA A

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12
Q

what happens with chronic ethanol intoxication and GABA

A

down-regulation of GABA A which means they need more alcohol for the same effect

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13
Q

what causes the positive reinforcement and pleasurable effects of ethanol

A

dopamine (DA)

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14
Q

with alcohol If consciousness is impaired then ___________ should be given IV or IM for at least 3 days

A

thiamine

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15
Q

When a person’s maladaptive pattern of alcohol use lease to clinically important distress or impairment, as shown in a single 1-month period

A

Alcohol dependence

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16
Q

Acetaldehyde dehydrogenase (ALDH) inhibitor (irreversible)

A

Disulfiram

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17
Q

What happens if someone has alcohol while on sifulfiram

A

N/V, HA

SOB, sweating, etc

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18
Q

how long must patient have had to be abstinent from ETOH before starting disulfiram

A

12 hours

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19
Q 
Competitive mu (µ) opioid receptor antagonist
 blocks ß- endorphin which stimulates dopamine release
blocks ethanol-induced DA release in NAC
A

naltrexone

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20
Q

what is naltrexone used for

A

narcotic abuse

alcohol dependence

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21
Q

Approved to maintain abstinence after detoxification, works to restore balance between glutamate and GABA

A

acamprosate

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22
Q

main ADR w/ acamprosate

A

transient diarrhea

23
Q

S/S of alcohol withdrawal

A 
Tremor
GI (nausea/vomiting)
Mild diaphoresis
Vital signs increase (mild)
Sleep disturbance
Hallucinations
Seizures (7%)
24
Q

what is the time course for major withdrawal symptoms

A

120-168 hours

25
Q

scale to assess withdrawal from alcohol in patients

A

CIWA scale (t need additional meds)

26
Q

drug to treat seizures from alcohol withdrawal

A

lorazepam

27
Q

what 3 meds can be given if CIWA >8

A

Chlordiazepoxide 50-100 mg
Diazepam 10-20 mg
Lorazepam 2-4 mg

28
Q

what type benzos is preferred therapy for benzos

A

long acting
chlordiazepoxide
diazepam

29
Q

what benzo is best to use in patients w/ liver dz

A

short acting
lorazepam
oxazepam

30
Q

what drugs may people in seizures/ DT needs to correct electorlyte imbalances

A

IV magnesium

IV thaimine

31
Q

when is haloperidol given for DTs

A

only for severe agitation unresponsive to benzos

32
Q

what is given for DTs

A

IV benzos

IV thiamine

33
Q

simple taper for benzos

A

25% dose reduction per week until 50% reached

then decrease by 1/8 every 4-7 days

34
Q

if benzo therapy is >8 weeks how long of a taper is recommended

A

2-3 weeks

35
Q

if therapy if >6 month with benzo how long of a taper

A

4-8 week

36
Q

what symptoms can occur w/ benzo withdrawal

A

Rebound anxiety
Recurrence or relapse of symptoms
Withdrawal symptoms

37
Q

common bdz withdrawal symptoms

A 
anxiety
insomnia
restlessness
muscle tension
irritability
38
Q

signs of stimulant intoxication

A

Hyperthermia, Hypertension, Cardiac arrhythmias, Stroke

39
Q

with stimulant withdrawal when are most of the symptoms

A

first 24 hours give benzos or antipsychotics

40
Q 
with intoxication patients presents with Euphoria
Dysphoria
Apathy
Motor retardation
Sedation
Attention impairment
Miosis
A

opioid

41
Q

how can you reverse opioid intoxication

A

naloxone

42
Q

what happens when chronic opiate users d/c using them

A

Leads to cyclic AMP in the adrenergic neurons becomes overactive

43
Q

is opioid withdrawal fatal?

A

no, usually just discomfort

44
Q

Alpha adrenergic autoreceptors
that helps with opioid withdrawal
help taper off heroin or methadone

A

clonidine

45
Q

µ and ō opioid withdrawal agonist
Suppresses opioid withdrawal symptoms
Blocks effect of other opioids

A

methadone

46
Q

ADRs of methadone

A

Constipation, sweating, urinary retention

Respiratory depression in intolerant individuals

47
Q

µ receptor partial agonist and weak K receptor antagonist
Similar effects as methadone
Opioid antagonist at higher doses
safer than heroin

A

buprenoprhine

48
Q

naltrexoine shouldn’t be initiated until patient is opioid free for how long?

A

7-10 days

49
Q

what test assess nicotine dependence

A

fagerstrom test (>4 indicates dependence)

50
Q

what are smoking cessation drugs

A

Buproprion
Varenicline
Clonidine
TCA’s

51
Q

New name for sustained release buproprion approved by FDA for treatment of tobacco dependence
block NA and NE

A

Zyban

52
Q

antagonizes and blocks nicotinic acetylcholine receptors

BBW for neuropsychiatric symptoms nad suicidality

A

Varenicline (Chantix)

53
Q

can you combine multiple therapies for nicotine addiction

A

yes as long as risk/benefit ration is favorable

ex- cardiac dz and pregnancy

54
Q

what TCA has been used as 2nd line for smoking cessation

A

nortriptyline (inhibit reuptake NE and 5-HT)

disadvantages= ACH burden, cardiac ADRs

*Pharm III (8 decks)

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