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Tim's Cards > II Pharm IV > Flashcards

II Pharm IV Flashcards

1
Q

What are the most abused drugs in all age groups?

A

Alcohol and tobacco

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2
Q

4 Factors that increase potential for abuse:

A

Potency

Rapid onset

Inexpensive

Easy to obtain/distribute

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3
Q

What are “potential” pts?

A

call office seeking pain meds w/o being seen

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4
Q

In order to give a script:

2 things

A

pt of record

dental need

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5
Q

Why is a drug “scheduled”

A

Potential for abuse

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6
Q

Drugs that are used in a manner/amount inconsistent w/ med or social pattern of culture

A

Drug Abuse

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7
Q

When a drug necessitates continued administration to prevent withdrawal:

A

Physical dependence

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8
Q

Physical dependence is addiction

A

False

*chronically dependent opiates for pain = physical dependence but not an addict

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9
Q

You can be physically dependent on a drug and not be addicted to the drug:

A

True

*but addicts are usually physically dependent

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10
Q

Perceived need or craving for a drug:

A

Psychological dependence

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11
Q

What is the primary reason for relapse:

A

Psychological dependence

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12
Q

3 signs of addiction:

A

Compulsive drug-seeking behavior

Continued use despite serious consequences

ALWAYS psychological dependence (so relapse common)

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13
Q

Physiologic tolerance or psychological dependence short of addiction:

A

Habituation

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14
Q

4 behaviors associated w/ addiction:

A

Anal retentive

OCD

Controlling

Manipulative

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15
Q

T/F

Habituation will ALWAYS lead to addiction or dependency

A

True

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16
Q

With repeated dosing, drug must be increased to produce same effect:

A

Tolerance

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17
Q

What kind of tolerance to Psychoactive drugs produce?

A

Central tolerance

*definite decrease in the response of brain tissue to constantly increasing amounts of drug

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18
Q

Is tolerance the same as Metabolic Tolerance?

A

NO

*it is central tolerance - would need accelerated metabolic rate - not really a factor w/ most psychoactives

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19
Q

Behavior of others associated with user that results in continued drug abuse:

A

Enabling

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20
Q

The state of being free of drugs:

A

Abstinence Syndrome

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21
Q

Using opiates for sleeping aid would be considered what?

A

Misuse

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22
Q

T/F

Nicotine/EtOH are considered “gateway” drugs

A

True

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23
Q

If pt has Hx of drug abuse, what must you watch out for?

3 things can’t use w/ these pts:

A

Relapsing disease

opiates, benzodiazepines, nitrous oxides

*ANY substance that can promote relapse

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24
Q

A primary, chronic, progressive, relapsing disease process with genetic, psychosocial, and environmental factors influencing its development and manifestations:

A

Chemical Dependency

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25
Q

When comparing drugs in the same group, the time required to produce physical dependence is shortest with a rapidly metabolized drug.

A

True

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26
Q

The time course of withdrawal rxns is related to the half-life of the drug

A

True

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27
Q

How do we Tx abuse:

3 things

A

counseling

education

self-help groups

*but person must WANT help

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28
Q

The leading cause of ER visits and accidental overdose among kids (esp in AZ)

A

Access to stored meds

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29
Q

3 considerations for Drugs and Children:

A

Increased mem. permeability

Dosing based on weight

Half adult dose

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30
Q

Poison Prevention Act 1970:`

A

prescriptions must have Child-resistant containers

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31
Q

2 psychological trends in children seeking drugs:

Appearance:

A

If anxiety - seek downers

Low self esteem - uppers

Appear drunk/intoxicated

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32
Q

Kids are abusing prescription drugs more than cocaine, heroin, hallucinogens, and Ecstasy combined

A

True

*prescription drugs more popular than recreational drugs

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33
Q

What causes more overdoses in adolescents than cocaine and heroin combined?

A

Opiates (hydrocodone w/ acetaminophen especially)

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34
Q

2 reasons inhalants are abused:

A

Huffing/Sniffing very easy

Accessible (markers, glue, white out)

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35
Q

What is difluoroethane?

Why important for Dentistry?

Can lead to what?

A

Inhalant - halogenated hydrocarbons

Increase heart muscle sensitivity to Epinephrine

Sudden Death

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36
Q

Inhalants known as poppers, snappers?

A

Amyl nitrite

Butyl nitrite

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37
Q

Whippets are:

A

Nitrous oxide

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38
Q

T/F

Kids abuse prescription drugs more than street drugs and this is known as “pharming”

A

True

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39
Q

5 signs of inhalants

*produce similar effects as anesthetics

A

Intoxication

Slurred speech

Inability to coordinate movements

Euphoria

Dizziness

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40
Q

What is the most abused drug among children?

A

Vicoden

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41
Q

5 causes of death due to inhalants:

A

Hepatotoxicity

Suffocation

Resp depression

Sudden sniffing death

Cardiac death (difluoroethane)

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42
Q

What is in Robitussin

A

Dextromethorphan

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43
Q

What does Dextromethorphan do at low dose?

High dose?

What drug is it similar to and where does it act?

A

Antitussive

Hallucinogenic

Morphine, centrally

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44
Q

Robotripping involves drinking ____oz’s of DXM (Robitussin) until nausea causes you to ____ and ______

A

4 ounces

vomit, hallucinate

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45
Q

A lot of cold meds are _______ and considered ________

This means they can’t be used in people that have ______

A

Adrenergic Agonists

Vasoconstrictors

Hypertension

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46
Q

What cold med doesn’t have Acetominophen but still contains DXM (dextromethorphan)?

A

Coricidin HBP

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47
Q

What is Coricidin’s street name?

A

Skittles

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48
Q

T/F

Alcohol use is on the rise, including binge drinking

A

False

*continues to decline

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49
Q

Alcohol use is decreasing except for what demographic?

A

College age girls

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50
Q

Roofie:

A

Rohyponol

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51
Q

Why are women more susceptible to alcohol poisoning?

A

Don’t make as much Alcohol Dehydrogenase as men

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52
Q

As of _____, cigarette use reached an all-time low due to peer disapproval

A

2014

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53
Q

More popular among teens: cigarettes or e-cigs?

A

e-cigs

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54
Q

The FDA regulates e-cigs

A

True

but, legislation just passed

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55
Q

In 1998 ____% students had tried tobacco

In 2014 ___%

A

56%

23%

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56
Q

The greatest decline of illicig drug use has been with what drug?

A

Synthetic marijuana

K-2, spice

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57
Q

Most students recognize synthetic marijuana as a dangerous class of drug:

A

False

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58
Q

Amphetamine-like stimulant found naturally in the Khat plant:

A

Bath salts

less than 1% student use

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59
Q

The use of exctasy, salvia, and shrooms have declined

A

True

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60
Q

10 illicit drugs that have remained unchanged in use:

A

heroin

crack

meth

ritalin/adderall

LSD

Inhalants

Powder cocaine

tranquilizers

sedatives

anabolic steroids

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61
Q

What receptor does ecstasy bind to in the brain?

A

NMDA receptors

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62
Q

Most teens get their drugs from a friend/relative

A

True

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63
Q

3,4 methylenedioxypyrovalerone (MDPV):

aka, drone, meph, meow meow, methylone

A

Bath Salts

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64
Q

Substance abuse disorders are expected to double by 2020 and the Tx admission for substance abuse has doubled since 1992

A

True

*baby boomers

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65
Q

1/3 Baby Boomers use Rec. drugs

A

True

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66
Q

Elderly adults w/ substance abuse put themselves at risk for what 3 things?

A

Cancer

Infections

Infectious diseases

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67
Q

Newest demographic for HIV

A

Women over 65

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68
Q

Adults over 65, increasing use of what?

A

Alcohol

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69
Q

5 diseases Elderly Smokers will die from:

A

COPD

Heart disease

Stroke

Cancer

Alzheimer’s

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70
Q

Most commonly used recreational drug?

A

Marijuana

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71
Q

The proportion of older adults seeking Tx for substance abuse is increasing compared to younger adults

A

True

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72
Q

Alcohol/Rec. drug dependency often come about by what 3 things?

A

Chronic pain use - initial

Psychological probs - sleeping, anxiety, depression

Loneliness, boredom

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73
Q

4 Recreational and OTC meds abused by older adults:

A

Opioids

Benzodiazepines

Alcohol

Sleeping preparations

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74
Q

4 substances abused by older adults:

A

Rx and OTC meds

Alcohol/tobacco

Marijuana

Cocaine/Heroine (diminished after 60)

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75
Q

Most commonly abused CNS depressants?

2 other classes used fairly commonly:

A

Opioid analgesics

benzodiazepines, barbiturates

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76
Q

What are the 2 most commonly abused CNS stimulants?

A

Amphetamines

Methylphenidate

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77
Q

5 Examples of depressants:

A

Alcohol

Benzodiazepines

Opioids

Inhalants

Nitrous oxide

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78
Q

The most frequently abused drug:

A

Alcohol

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79
Q

Alcohol is oxidized to what in the liver?

A

Acetaldehyde

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80
Q

Acetaldehyde is metabolized to what?

Excreted where?

A

CO2 and water

lungs/urine

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81
Q

6 cancers linked to Acetaldehyde:

A

Oral

Pharyngeal

Gastric

Pancreatic

Liver

Bladder

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82
Q

Alcohol is eliminated from the body via _____ kinetics

What is the rate?

A

Zero-order

1g/hour

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83
Q

4 signs alcohol intoxication?

A

Dilated pupils

Slurred speech

Nystagmus (involuntary eye movement)

Incoordination

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84
Q

3 severe, centrally mediated signs of intoxication:

A

seizures

coma

death

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85
Q

4 physiologic considerations of Alcohol Use in older adults:

A

Decreased body water/body mass (higher conc. alcohol)

Decline liver/kidney

Malnutrition/Weight loss

Injuries/Falls

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86
Q

4 reasons the Elderly are more sensitive to Alcohol:

*this is why older people develop problems with alcohol even if drinking habits have not changed

A

Metabolize more slowly

Stays in body longer

Decrease body water

Lower body’s tolerance

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87
Q

Alcohol induced changes in the Elderly Brain that is often misdiagnosed as dimentia:

A

Biological Brain Disorder

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88
Q

Biological Brian Disorder: withdrawal, Seizures, Organic hallucinations, Psychosis, Dementia, and _______

A

Delirium tremens (DT’s)

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89
Q

4 consequences of Chronic Alcoholism in the Elderly:

A

Systemic (neuropathies)

Fatigue/weight loss

Existing conditions worsen (HTN, diabetes, etc)

Psychological (isolation, depression, anxiety, suicide)

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90
Q

Mixing alcohol with what can cause GI bleeding?

A

Aspirin/NSAIDS

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91
Q

Alcohol plus what can cause liver damage?

A

Acetaminophen

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92
Q

Cold/allergy meds + antihistamines + alcohol = 4 things

A

Drowsiness

Impaired judgement

Reaction time

Decreased coordination

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93
Q

CNS drugs + alcohol = 5 things

A

Sleepiness

Poor coordination

Dyspnea

Tachycardia

Memory problems

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94
Q

Alcohol withdrawal occurs in stages and includes what 4 things?

A

Paranoid behavior

Disorientation

Grand mal seizures

DT’s (delirium tremens), shaky tremor movements

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95
Q

Chronic signs of alcoholism, watch what 4 things:

A

Bleeding

Oropharyngeal cancer

Liver cancer

Peripheral neuropathy

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96
Q

Mothers that drink:

A

Fetal Alcohol Syndrome

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97
Q

2 features of Fetal Alcohol Syndrome:

A

Intellectual disabilities

Craniofacial probs

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98
Q

What drug inhibits the metabolism of Aldehyde Dehydrogenase, increasing serum levels of Acetaldehyde?

A

disulfiram (Antabuse )

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99
Q

disulfiram is used for what?

A

Tx alcoholism

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100
Q

If you drink while taking disulfiram you will _____

A

vomit

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101
Q

Other than alcohol, what is a contraindication when taking disulfiram (Antabuse)

A

Alcohol containing mouth rinses

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102
Q

For an Alcoholic, 5 Dental Tx Considerations:

A

Poor OH

Bilateral Parotid gland enlargement

Liver failure (bleeding)

Ascites

Difficulty metabolizing drugs

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103
Q

7 oral complications of Alcoholism

*must know

A

Glossitis

No Tongue Papillae

Angular Cheilitis

Fungal infections

Bleeding

Oral cancer (squamous cell)

leukoplakia, ulceration of lateral borders of tongue

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104
Q

If you’re Tx an alcoholic, examine the tongue carefully for what?

A

Precancerous lesions

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105
Q

4 abused opioids:

A

Heroin

Methadone

Morphine

Oxydodone

*oxycontin widely abused by dentists

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106
Q

Why are opioids typically abused?

A

Produce complete satiation for all drives of body

*only in absence of pain

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107
Q

What drug is widely abused by dentists?

A

Oxycontin

*brand that is oxycodone only

108
Q

T/F

Physical dependency increases motivation to obtain the drug and fear of withdrawal overrides motivation to stop using

A

True

*addicts often resort to criminal activity to obtain drug

109
Q

Oxycodone, when asked by name, should be a Red Flag?

A

Roxicet

*most concentrated part of oxy in middle of tablet

110
Q

T/F

Oxycodone can be smoked,

A

True

111
Q

What pain meds are included in REMS program?

Risk Eval and Mitigation Strategy (FDA)

A

Extended-release, oral-dosage forms of opioids

*potential for abuse very high

112
Q

Number of women dying from opioid painkiller overdose increased how much between 1999 and 2010?

*deaths up ____%

A

Fivefold

*deaths up 400%

113
Q

T/F

In 2007 it was the first tome in 100 yrs that drug induced death exceeded death from motor vehicles

A

True

114
Q

3 reasons women have more opioid overdoses?

A

Chronic pain

More likely to get a prescription

Engage in doctor shopping

115
Q

Abuse of prescription (Rx) painkillers by pregnant women can affect the infant how?

This increased by ____% between 2000 and 2009

A

Neonatal abstinence syndrome

300%

116
Q

CDC Opoid recommendations for Rx’s

5

A

follow responsible guidelines

Use states’ Rx drug monitoring programs

Discuss pain Tx options

Discuss risks/benefits

Avoid prescribing combos of Rx painkillers and benzodiazepines

117
Q

2 Things clinicians must avoid when prescribing pain meds (and other controlled substances)

A

Overprescribing

Big quantities (always limit quantity)

118
Q

Why injecting heroin is a problem:

3 consequences

A

HIV

Hep

Heart valve damage

119
Q

If a pt has heart valve damage secondary to heroin use, what would they need prior to dental Tx?

A

Antibiotic premedication

120
Q

The heroin death rate has increased by how much across 28 states?

A

2x

121
Q

7 signs of Acute Opioid Overdose

*must KNOW

A

Pinpoint pupils

Depressed respiration

Hypotension

Shock

Slow/absent reflexes

Drowsiness

Coma

122
Q

What is the drug to use if you overdose on an opioid?

A

naloxone (Narcan)

*used for acute narcotic overdose

123
Q

What is used to treat opioid withdrawal?

A

Methadone

124
Q

2 reasons Methadone is used to Tx opioid withdrawal:

A

Physiologically equivalent to heroin

Replace heroin and gradually withdrawn

125
Q

Dental implication to Opioid-tolerant pts?

A

Require more pain meds

  • asking for more pain meds may be sign of addiction
  • use NSAIDS
126
Q

diazepam (Valim), lorazepam (Ativan), alprozolam (Xanax) are what class of drugs?

A

Benzodiazepans

BDZ’s

127
Q

Unavailability of BDZ (unavailability due to hospitalization/other med problem):

A

Benzo-abstinence syndrome

*go through withdrawal

128
Q

3 indications for BDZ’s

*significant physical dependence/addiction

A

Chronic anxiety

Depression

Sleep disturbance

129
Q

BDZ’s have significant ______ effect with other sedatives.

Never combine BDZ’s with what?

A

Additive

Alcohol

130
Q

BDZ’s have a prolonged ______, which predisposes to easy intoxication

BDZ withdrawal is similar to what kind of withdrawal?

A

Half life

Alcohol

131
Q

Dangerous DDI with BDZ’s

A

Alcohol

132
Q

When giving a BDZ Rx teach pts to do what?

A

Avoid Alcohol

!!

133
Q

Consequence of long half life of BDZ’s:

A

Linger days after - alcohol can still be dangerous

134
Q

What is the Antidote to BDZ overdose?

A

flumazenil

*generic only

135
Q

Flumazenil used for BDZ overdose WON’T block _____ effects from alcohol, barbiturates, general anesthetics, or opiates (won’t block other depressants)

may not reverse what?

may cause what?

A

CNS

respiratory depression/hypoventilation

seizures

136
Q

3 uses for BDZ’s in dentistry:

A

Anxiety

Sedation

Pre-anesthetic (amnesiac)

137
Q

What are 2 the most commonly abused Legal stimulants?

2 Illegal?

A

Caffeine, Nicotine

Cocaine, methamphetamine

138
Q

Most potent vasoconstrictor in all of medicine?

A

Cocaine

139
Q

Only reason cocaine is used medically?

A

Eye surgery

140
Q

Profound sense of euphoria, produces intense psychological dependency but no tolerance or withdrawal

A

Cocaine

141
Q

If over-use cocaine, euphoria stays but what increases?

A

Paranoia

142
Q

4 signs of Cocaine use:

*know these!

A

Nasal bleeding/necrosis

Dilated pupils

Hypertension

Localized gingival recession/bleeding and alveolar bone necrosis in maxillary premolar area

143
Q

What should a dentist never do within 24 hrs of cocaine use?

(b/c hypertension)

A

give Epinephrine

144
Q

What is the most commonly abused form of amphetamines?

A

Methamphetamine (crystal meth)

145
Q

What produces LONGER effects, cocaine or meth?

A

Methamphetamine

146
Q

Amphetamines are considered what?

A

Sympathomimetics

147
Q

dextroamphetamine (Dexadrine) is used for what?

What does it inhibit?

A

ADHD (stimulant)

Monamine oxidase

148
Q

A selective norepinephrine reuptake inhibitor used for ADHD?

Is this an amphetamine?

A

atomoxetine (Straterra)

no

149
Q

Main drug for ADHD

A

methylphenidate (Ritalin)

150
Q

Stimulant psychedelic, first used as an appetite suppressant?

A

Ecstasy

151
Q

Ecstasy side effects include: Anorexia, nausea, muscle stiffness, ataxia, sweating, tachycardia, hypertension _______ and ______

A

Trismus

Bruxism

152
Q

6 side effects of Ecstasy:

A

Trismus/Bruxism

Fatigue, insomnia

Tolerance

Hepatotoxic

Long term psychiatric

Fatal

153
Q

Meth is a stimulant where?

A

CNS

154
Q

What form of meth is used for ADHD, narcolepsy, and obesity?

*medical form

A

dextromethamphetamine (Desoxyn)

*know both names

155
Q

Meth is dangerous b/c it uses multiple pathways in the brain and downregulates ______

*brain structure/function become altered with chronic use

A

dopamine

156
Q

1st time on meth:

A

surge of dopamine

and norepinephrine and serotonin

157
Q

Sensation of insects crawling beneath the skin, seen in meth use (crank bugs)

A

formication

158
Q

Meth is especially neurotoxic to what?

A

dopaminergic neurons

159
Q

Degradation of dopamine produces what?

*secondary to Meth use

A

ROS - reactive oxygen species

*likely what kills neurons after meth use

160
Q

What are 4 manifestations of Amphetamine Psychosis?

A

Hallucinations

Paranoia

Delusions

Thought disorders

161
Q

T/F

Parents often miss meth withdrawal signs, b/c they include prolonged sleep moodiness, and depression

A

True

162
Q

Depression with Meth is often longer/deeper than with Cocaine, which is why _____ is common

A

relapse

163
Q

What is the antidote to meth?

A

None

*nothing comparable to heroin addicts

164
Q

2 most common routes of taking meth?

A

oral

smoking

165
Q

Who uses meth?

A

increasing in college and young professionals

166
Q

Meth OD is heart failure, and long term physical damage to kidneys, liver, and lungs

A

True

167
Q

Meth Use

*know these 7 signs!!

A

Dilated pupils

HTN/tachycardia

Anorexia

increased sweating

moodiness

xerostomia

bruxism

168
Q

T/F

Like cocaine, there is no tolerance effect to prolonged use of Meth

A

False

*tolerance develops

169
Q

Erosion, poor OH, caries, perio infection, bruxism, tissue damage, oral ulcerations/infections, oral burns:

A

Meth Mouth

170
Q

Signs of Acute OD of CNS stimulants

*know these 8

A

dilated pupils

HTN

elevated pulse

arrhythmias

extreme sweating

hyperthermia

hyperactivity

tremors

171
Q

Withdrawal rxns to CNS stimulants in a Modest Abuser:

Heavy Abuser:

A

fatigue, prolonged sleep

Prolonged sleep, depression, suicidal tendency

172
Q

Consequences of smoking: lung cancer, oral cancer, lowered ______, heart disease, periodontal disease

A

estrogen levels

osteoporosis

173
Q

Nicotine turns on what cytokine?

function?

A

IL-6

turns on osteoclasts - leads to osteoporosis/rapid bone loss in perio disease

174
Q

When burned, how many chemicals are in cigarette smoke?

A

4000

175
Q

2 reasons nicotine is especially detrimental to women?

A

Estrogen gone as protective barrier - increase in IL-6 (normally suppressed by estrogen)

IL-6 increases osteoclastic activity

176
Q

Orally, in smokers, where will you most often see narrow, deep, perio defects with fibrotic tissue.

A

Around anterior

177
Q

What is a secondary reason meth users will have bad teeth?

A

Meth users crave sugar

178
Q

Irritability, HTN, increased pulse, nausea/vomiting, dizzy, coronary artery disease, lung and oral cancer:

A

Nicotine

179
Q

8 notable chemicals in cigarettes:

A

Tar

hydrogen cyanide-genocidal agent WWII

Benzene

Acetone

Formaldehyde

Ammonia

CO

nicotine

180
Q

Erosion, poor OH, Caries, perio infection, bruxism, tissue damage, oral ulcerations, oral burns:

A

Meth Mouth

181
Q

Anxiety, irritability, difficulty concentrating, headaches, drowsiness, increased apetite, sleep disturbances, and craving

A

Nicotine (tobacco) withdrawal

182
Q

T/F

Cigars are safer than cigarettes

A

False

*and more nicotine

183
Q

Major cause of esophageal cancer:

A

Cigarettes

184
Q

3 ways smoking contributes to cancer:

3 types of cancer

A

Esophageal cancer

Mouth cancer

Oral cavity/pharynx cancer

185
Q

T/F

Girls smoke more than boys

A

True

*boys do it to look cool, girls establish at younger age

186
Q

What are “light” cigarettes?

Are they less dangerous?

A

Less tar

No

187
Q

E-cig nicotine can help people to quit long term

A

True

188
Q

What is the only cancer that hasn’t had any statistical changes for a 5 year prognosis?

A

Oral cancer

189
Q

Why are women more likely to be successful when attempting to stop smoking?

A

more likely to use support group

190
Q

Ask, Advise, Refer:

A

Program to assist dental professionals with helping pts to quit smoking

191
Q

4 hallucinogens:

A

LSD

PCP

Mescaline

Marijuana

192
Q

Why must pts completely stop smoking before initiating smoking cessation therapy?

A

Nicotine is a vasoconstrictor

*raises CV risk - can’t smoke and take nic patches at same time

193
Q

T/F

The safety and efficacy of nicotine therapy are not established in children

A

True

194
Q

People require how many attempts on average to stop smoking?

A

5-8

195
Q

7-12 weeks (3 months) less dosage than through smoking, designed to decrease nicotine craving:

A

Step-down approach

196
Q

3 risks to bupropion (Zyban) for smoking cessation:

A

seizures

HTN

psycho

197
Q

Dopamine reuptake inhibitor used as an antidepressant and for smoking cessation:

A

bupropion (Zyban)

***wellbutrin if antidepressant

198
Q

smoking cessation drug that is a partial neuronal alpha4 B2 nicotinic receptor agonist (occupies nicotine receptor sites in brain)

A

varenicline (Chantix)

199
Q

varenicline (Chantix) mechanism:

A

stimulates dopamine activity

*but less than nicotine - decreases craving/withdrawal symptoms

200
Q

Some people have a higher chance of relapse at certain times of day

A

True

201
Q

What drug used for smoking cessation has the highest success rate?

A

verenicline (Chantix)

202
Q

2 contraindications to nicotine replacements:

A

Pregnancy

CV

203
Q

Hallucinogens (psychodelics) foster _____ dependence

_____ develops quickly

A

psychological

tolerance

204
Q

3 consequences of long-term use of hallucinogens:

A

depression

panic disorders

schizo

205
Q

Hallucinogens are powerful _______ and ______

A

stimulants

sympathomimetics

206
Q

2 major psychoactive chemicals in marijuana:

A

delta-9-tetrahydrocannabinol (THC)

Cannibidiol (CBD)

207
Q

What marijuana chemical is an appetite stimulant?

Which is neuroprotective?

A

THC

CBD

208
Q

What does long-term chronic use of marijuana cause?

A

physical dependence

Withdrawal

psychological dependence

addiction

209
Q

Teens with genetic predisposition for depression, schizophrenia, and psychotic disorders are at increased risk for these if they use marijuana

A

True

210
Q

4 oral complications to marijuana use:

A

xerostomia

gingivitis

leukoplakia

hyperkeratinized tissues

211
Q

What herbal mixture produces the same effect as marijuana and acts on same receptors as THC?

A

K2/spice

212
Q

K2/spice has what type of effects?

A

sympathetic

213
Q

What is the synthetic version of marijuana?

Schedule ____ drug

Approved for what 2 things?

A

dronabinol (Marinol)

III

nausea, appetite stimulation

214
Q

4 predatory drugs:

A

ecstasy

gamma hydroxy-butyrate

ketamine

rohypnol

215
Q

Another name for Rohypnol:

it is a _______

A

flunitrazepam

benzodiazepine

216
Q

What euphoric sedative (anabolic) drug is associated with sexual assualt cases?

analogue found in industrial solvents:

A

GHB - gamma hydroxy-butyrate

sodium oxybate (Xyrem)

217
Q

A sedative hyptnotic drug, analgesic and hallucinogenic

also used as general anesthetic in vetrinary medicine

A

Ketamine

218
Q

nightmares

suicidal thoughts

adverse cardiac events

xerostomia

headache

nausea

A

verenicline (Chantix)

*side effects

219
Q

The high of marijuana:

medical effects:

A

THC

CBD

220
Q

What molecule is implicated in a lot of psychiatric disorders such as anxiety, depression, OCD, and schizophrenia?

A

Serotonin (5-HT)

221
Q

Headaches and migraines involve a disregulation of what?

A

serotonin

222
Q

What receptors are important for pain modulation in descending pathways, especially chronic pain?

A

Serotonin (5-HT) - stimulation produced analgesia

223
Q

Data supports that migraines are caused by what?

A

Chronic 5-HT dysregulation

224
Q

What family of drugs is a vasoconstrictor that inhibits depolarization of Dural blood vessel-associated nociceptors and possibly blocks neurogenic inflammation?

A

Ergot derivatives

225
Q

2 examples of Ergot derivatives used to “abort” a migraine?

A

ergotamine

ergotamine + caffeine

226
Q

Timing is an important factor for migraine drugs, and taking them at the beginning of the episode will be more effective

A

True

227
Q

What ergot derivative is used for chronic, protracted migraine in a hospital setting?

A

dihydroergotamine (Migranal)

228
Q

3 families of drugs that can be used to treat migraines:

A

Ergot derivatives

Triptans

Antiemetics

229
Q

What anti-emetic is used for migraines?

A

isometheptene (Midrin)

230
Q

Family of drugs that cause vasoconstriction and reduce neurogenic inflammation and provide relief from nausea (antiemetic)?

A

Triptans

231
Q

First drug in the class of Triptans?

vasoconstrictor, reduces neurogenic inflammation

A

sumatriptan (Imitrex)

232
Q

2 examples of Triptans?

A

sumatriptan

zolmitriptan

233
Q

Acetaminophen + sedative that helps migraines and tension headaches?

A

isometheptene

234
Q

2 components of isometheptene and what they do:

A

acetaminophen - analgesic

dichrolalphenazone - tranquilizing

235
Q

Why are anti-emetics used to treat migraines?

A

Control nausea/gastric irritation

236
Q

Because antiemetics are also antipsychotics, they cause _______ effects in the brain and result in ______

A

extrapyramidal

movement disorders

237
Q

3 antiemetics:

A

prochloroperazine

metoclopramide

promethazine

238
Q

8 classes of drugs that can be used for migraine prophylaxis:

A

tricyclic antidepressants

SSRI’s

Selective 5-HT and NE reuptake inhibitor

Beta blockers

Antiseizure meds

Ca ++ channel blockers

NSAIDS

Corticosteroids

239
Q

NSAID used for migraine prophylaxis:

A

indomethacin (Indocin)

240
Q

Intractable migraine, only drug to use after hasn’t responded to other interventions?

A

corticosteroids

241
Q

4 corticosteroid mechanisms:

migraine specific

A

GABA receptor modulators

Suppress neurogenic inflammaiton

Block neurogenic extravasation

Block high-voltage activated Ca++ currents by blocking Ca++ channels

242
Q

A form of arthritis caused by accumulation of uric acid crystals in joints:

A

Gout

243
Q

Overload of uric acid in Gout leads to what?

A

Formation of tiny crystals of urate

244
Q

Gout is considered a chronic and progressive disease

A

True

245
Q

Gout affects joints, but does not affect organs

A

False

*decreases kidney function

246
Q

Gout can be inherited

A

True

247
Q

Gout, uric acid is a breakdown product of ______, resulting in overload of uric acid in the body that produces painful ______ attacks and deposits of lumps of crystals in body tissue

A

purines

arthritic

248
Q

Where is gout usually found?

A

Extremities, esp big toe

249
Q

Elevated levels of Uric Acid w/o symptoms:

A

Asymptomatic hyperuricemia

250
Q

2 types of Gout:

A

Excessive production of uric acid

Reduced excretion of uric acid

251
Q

With gout, what foods should you avoid?

A

Purine-rich

252
Q

5 things that predispose to Gout:

A

Dehydration

Fever

Infection

After surgery

Injury to joint

253
Q

5 foods that are protective against Gout:

A

Cherry juice

Veggies

Dairy

Dark pure chocolate

Pineapple

254
Q

Pts with longstanding hyperuricemia can have uric acid crystal deposits called what?

*this is in other tissue

A

Tophi

255
Q

4 distinct stages of Gout:

A

Asymptomatic

Acute phase

Intercritical phase

Chronic

256
Q

Drug used to treat Acute attack of Gout (only use for drug)

*inhibits neutrophil migration/phagocytic activity of inflamed joints

A

colchicine (Colcrys)

257
Q

Original drug on the market for gout?

A

colchicine

258
Q

4 side effects for colchicine (for gout)

A

GI toxicity

bone marrow depression

myopathy

alopecia

259
Q

Drug of choice for pts that make too much uric acid

*works by inhibitying synth of uric acid

A

allopurinol (Zyloprim)

260
Q

Drug used for management of Chronic Gout

*also used during chemo and radiation

A

allopurinol

261
Q

4 side effects of allopurinol:

A

hepatotoxic

pruritic rash

allergic skin

blood rxns

262
Q

What drug for Gout works by increasing the excretion of uric acid?

*Uricosuric Agent

A

probenecid (Bememid)

263
Q

probenecid (Bememid) is indicated for what?

*2 things

A

Chronic gout

Acute gout w/ increased severity/frequency

264
Q

What drug interferes with the Uricosuric action of probenecid?

A

Aspirin

*only at LOW DOSE

265
Q

probenecid can be combined with what antibiotic to delay the excretion of the antibiotic?

A

penicillin

*allows you to keep penicillin in body for longer

266
Q

What is the purpose of NSAIDS to treat Gout?

A

Relieves pain, tenderness, swelling of Joint

*no mechanism against gout itself

Tim's Cards (140 decks)

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