Drug Abuse Flashcards
1
Q
Which indirect biomarkers of heavy alcohol use is associated with the highest sensitivity and specificity, is cost effective and easy to manage?
A
- Gamma glutamyltransferase (GGT)
- Carbohydrate deficient transferrin (CDT)
- Both appear to increase after the daily alcohol consumption threshold exceeds 40 g.
2
Q
What are the signs of alcohol withdrawal?
A
- Acute onset of tremulousness, agitation, tachycardia, diaphoresis and hypertension.
- Symptoms start 8-12 hrs after the last drink and include insomnia, anxiety and autonomic hyperactivity
3
Q
What is delirium tremens?
A
- Disorientation, severe agitation and fever that occurs 48-96 hours after the last alcoholic drink
4
Q
Which medications and substances enhance GABA inhibitory action?
A
Barbiturates, benzodiazepines and alcohol
5
Q
What is the first line therapy for psychomotor agitation associated with alcohol withdrawal?
A
Benzodiazepines
- Diazepam or Chlordiazepoxide are long acting drugs of choice with self-tapering effects.
- Lorazepam, Oxazepam and Temazepam (LOT) are best for those with liver disease as they do not go oxidative metabolism in the liver
6
Q
What is naloxone used for?
A
- Used for opioid intoxication
- Pure opioid receptor antagonist
- Does not have agonist properties
- Strongest affinity for mu receptors but binds all
- Reverses analgesia, sedation, hypotension and respiratory depression
- Acts in minutes, given parenterally
7
Q
What happens when opioids bind mu receptors?
A
- Physical dependence
- Euphoria
- Respiratory/cardiac depression
- Reduced gastrointestinal motility
- Sedation
- Analgesia (ANS)
8
Q
What happens when opioids bind kappa receptors?
A
- Miosis
- Dysphoria
- Sedation
- Analgesia (PNS)
9
Q
What happens when medications bind delta receptors?
A
- Antidepressant effects
- Analgesia (PNS)
