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Neuro > Substance abuse 0427 > Flashcards

Substance abuse 0427 Flashcards

1
Q

substance dependence

A

maladaptive pattern of substance use w/ 3 or more in 1 yr:

  1. tolerance
  2. withdrawal
  3. substance taken in larger amts or for longer time
  4. persistent desire or unsuccessful attempts to cut down
  5. significant energy spent over substance
  6. important social, occupational, recreational activities reduced
  7. continued use despite knowing problems caused by substance
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2
Q

substance abuse

A

maladaptive pattern leading to clinically significant impairment or distress

  1. recurrent use resulting in failure to fulfill major obligations at work, school, home
  2. recurrent use in physically hazardous situations
  3. recurrent substance-related legal problems
  4. continued use despite persistent problems caused by use
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3
Q

depressants

A

alcohol
opioids (morphine, heroine, methadone)
barbiturates
benzodiazepines

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4
Q

nonspecific effects of depressant intoxication

A 
mood elevation
decreased anxiety
sedation
behav disinhibition
resp depression
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5
Q

nonspecific effects of depressant withdrawal

A

anxiety
tremor
seizures
insomnia

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6
Q

alcohol intoxication

A 
emotional lability
slurred speech
ataxia
coma
blackouts

indicator: serum gamma-glutamyltransferase.
AST is double ALT.

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7
Q

alcohol withdrawal

A

mild: similar to other depressants
severe: delirium tremens (treat with benzos)

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8
Q

opioid intoxication

A 
CNS depression
nausea, vomiting
bradycardia
constipation
PINPOINT PUPILS
seizures

tx: naloxone, naltrexone

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9
Q

opioid withdrawal

A 
sweating
dilated pupils
piloerection "cold turkey" 
fever
rhinorrhea
nausea, cramps, diarrhea
FLU LIKE SX

tx: symptomatic

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10
Q

barbs intoxication

A

low safety margin
marked resp depression

tx: symptomatic

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11
Q

barbs withdrawal

A

delirium

life-threatening CV COLLAPSE

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12
Q

benzos intoxication

A

greater safety margin
ataxia
minor resp depression

tx: flumazenil

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13
Q

stimulants

A

amphetamines
cocaine
caffeine
nicotine

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14
Q

nonspecific effects of stimulant intoxication

A 
mood elevation
psychomotor agitation
insomnia
cardiac arrhythmias
tachycardia
anxiety
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15
Q

nonspecific effects of stimulant withdrawal

A 
post-use "crash" 
depression
lethargy
weight gain
headache
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16
Q

amphetamine intox

A 
impaired judgment
pupillary dilation
prolonged wakefulness and attention
delusions
hallucinations
fever
17
Q

amphetamine withdrawal

A

stomach cramps
hunger
hypersomnolence

18
Q

cocaine intox

A 
impaired judgment
pupillary dilation
hallucinations (tactile)
paranoid ideations
angina
sudden cardiac death

tx: benzos

19
Q

cocaine withdrawal

A

suicidality
hypersomnolence
malaise
severe psychological craving

20
Q

caffeine intox

A

restlessness
increased diuresis
muscle twitching

21
Q

nicotine intox

A

restlessness

22
Q

nicotine withdrawal

A

irritability
anxiety
craving

tx: nicotine patch, gum, lozenges.
buproppion/varenicline

23
Q

hallucinogens

A

PCP (phencyclidine)
LSD
marijuana

24
Q

PCP intox

A 
BELLIGERENCE
impulsiveness
fever
psychomotor agitation
vertical/horizontal nystagmus
tachycardia
homicidality
psychosis 
delirium
25
Q

PCP withdrawal

A 
depression
anxiety
irritability
restlessness
anergia
disturbed thought and sleep
26
Q

LSD intox

A 
marked anxiety or depression
delusions
visual hallucinations
FLASHBACKS
pupillary dilation
27
Q

marijuana intox

A 
euphoria
anxiety
paranoid delusions
perception of slowed time
impaired judgment
social withdrawal
increased appetite
dry mouth
conjunctival injection
hallucinations
28
Q

marijuana withdrawal

A 
irritability
depression
insomnia
nausea
anorexia
  • sx peak in 48 hr, last 5-7 d
  • detected in urine up to 1 mo. after last use
29
Q

heroin addiction

A

increased risk for hepatitis, abscess, overdose, hemorrhoids, AIDS, right-sided endocarditis

30
Q

heroin tx - methadone

A

long-acting oral opiate - used for detox and longterm maintenance

31
Q

heroin tx - suboxone

A

( = naloxone + buprenorphine)

long-acting with fewer withdrawal sx than methadone.

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