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Psychiatry > SM_118b: Substance Intoxication and Withdrawal > Flashcards

SM_118b: Substance Intoxication and Withdrawal Flashcards

1
Q

This is most consistent with ____

A

This is most consistent with opioid withdrawal

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2
Q

Beta-endorphin preferentially binds to the ____ opioid receptor

A

Beta-endorphin preferentially binds to the mu opioid receptor

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3
Q

Enkephalins preferentially bind to the ____ opioid receptor

A

Enkephalins preferentially bind to the delta opioid receptor

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4
Q

Dynoprhins prefentially bind to the ____ opioid receptor

A

Dynoprhins prefentially bind to the kappa opioid receptor

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5
Q

Opioid intoxication presents with ____, ____, ____, ____, ____, ____, and ____

A

Opioid intoxication presents with

  • Respiratory depression
  • Constipation, dry mouth
  • Euphoria, mood changes
  • Sedation
  • Meiosis
  • Flushing
  • Impaired reflexes
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6
Q

____ include moprhine, codeine, thebaine, hydromorphone, hydrocodone, oxycodone, dihydrocodeine, and heroin

A

Opioids include moprhine, codeine, thebaine, hydromorphone, hydrocodone, oxycodone, dihydrocodeine, and heroin

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7
Q

Descibe symptoms of opioid withdrawal

A

Opioid withdrawal symptoms

  • Pulse rate
  • GI upset: vomiting, diarrhea
  • Sweating
  • Tremor
  • Restlessness
  • Yawning
  • Mydriasis
  • Anxiety / irritability
  • Myalgias, arthralgias
  • Piloerection
  • Rhinorrhea, tearing
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8
Q

This is most consistent with ____

A

This is most consistent with stimulant intoxication

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9
Q

Methamphetamines and cocaine are ____

A

Methamphetamines and cocaine are stimulants

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10
Q

Stimulate intoxication presents with ____, ____, ____, ____, ____, ____, and ____

A

Stimulate intoxication presents with

  • Euphoria, irritability, anger, tension
  • Anxiety
  • Psychomotor agitation: stereotypes, dyskinesia, restlessness
  • Energy, less need for sleep
  • Increased sympathetic ANS tone: tachycardia, HTN, mydriasis, and diaphoresis
  • Chest pain, arrhytmias
  • Seizures
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11
Q

Stimulant withdrawal presents with ____, ____, ____, ____, ____, ____, and ____

A

Stimulant withdrawal presents with

  • Depression, dysphoria
  • Appetite stimulation
  • Fatigue
  • Sedation, slowing
  • Cravings
  • Irritability
  • Suicidality
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12
Q

This is most consistent with ____

A

This is most consistent with alcohol withdrawal

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13
Q

Prolonged drinking results in ____, ____, and ____

A

Prolonged drinking results in

  • Down-regulation of GABAA receptors with prolonged stimulation
  • Upregulation / alteration of NMDA receptors with inhibition
  • Inhibition of catecholamines
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14
Q

Alcohol abstinence involves ____, ____, ____, an d____

A

Alcohol abstinence involves

  • Decreased signaling and fewer GABAA receptors
  • Increased glutamate transmission and signaling via altered receptors
  • Increased catecholamine release
  • Increased dopamine tranmission and plasma levels of homovallinic acid
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15
Q

Describe stages of alcohol withdrawal

A

Alcohol withdrawal stages

  1. Autonomic instability (minor withdrawal): in 6-48 hours
  2. Seizures in 12-48 hours
  3. Hallucinosis: 12-48 hours
  4. Delirium tremens: 3-5 days
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16
Q

____ stage of alcohol withdrawal occurs at 6-48 hours and involves insomnia / tremor / anxiety, GI upset / anorexia / headache, and diaphoresis / palpitations

A

Autonomic instability stage of alcohol withdrawal occurs at 6-48 hours and involves insomnia / tremor / anxiety, GI upset / anorexia / headache, and diaphoresis / palpitations

(increased adrenergic transmission)

17
Q

Seizure stage of alcohol withdrawal occurs ____ after last drink and involves ____ seizures

(decreased GABAA transmission and increased NMDA transmission)

A

Seizure stage of alcohol withdrawal occurs 12-48 hours after last drink and involves GTC seizures

(phenytoin is less effective)

18
Q

____ stage of alcohol withdrawal occurs at 12-24 hours after last drink until 48 hours and usually involves clear sensorium

A

Hallucinosis stage of alcohol withdrawal occurs at 12-24 hours after last drink until 48 hours and usually involves clear sensorium

(increased dopamine transmission)

19
Q

____ stage of alcohol withdrawal involves perception change, disorientation, ANS changes, agitation, and diaphoresis and typically occurs ____ after last drink

A

Delirium tremens stage of alcohol withdrawal involves perception change, disorientation, ANS changes, agitation, and diaphoresis and typically occurs 3-5 days after last drink

(5% incidence, 5% mortality)

20
Q

____ stage of alcohol withdrawl may involve mortality due to arrhythmiasn or complicating illness

A

Delirium tremens stage of alcohol withdrawl may involve mortality due to arrhythmiasn or complicating illness

21
Q

____ and ____ are key for management of alcohol withdrawal

A

Early recognition and treatment are key for management of alcohol withdrawal

22
Q

This is most consistent with ____

A

This is most consistent with hallucinogen intoxication

23
Q

PCP has ____, ____, ____, and ____ effects

A

PCP has dissociation, perception, autonomic, and neuromuscular effects

24
Q

PCP exerts dissociative properties by ____

A

PCP exerts dissociative properties by antagonizing the NMDA glutamate receptor

25
Q

PCP, mescaline, psilocybin, and MDMA are ____

A

PCP, mescaline, psilocybin, and MDMA are hallucinogens

26
Q

Hallucinations, light trails, micro/macropsia, and synesthesia are symptoms of ____ or ____ use

A

Hallucinations, light trails, micro/macropsia, and synesthesia are symptoms of psilocybin or mescaline use

27
Q

____ affects the serotonergic systems and causes symptoms of euophoria, sense of connectedness, enhanced senses, extroversion, and well-being

A

MDMA affects the serotonergic systems and causes symptoms of euophoria, sense of connectedness, enhanced senses, extroversion, and well-being

28
Q

Describe adverse effects of MDMA

A

MDMA adverse effects

  • Side effects: nausea, bruxism, dry mouth, reduced appetite, headache, motor restlessness
  • Serotonin syndrome: clonus, hyperthermia, HTN, delirium, rhabdomyolysis, seizures
  • Long-term: aggression, poor impulse control, reduced serotonergic transmission
29
Q

This is most consistent with ____

A

This is most consistent with cannabinoid withdrawal

30
Q

Cannabinoids signal via the ____ and ____ receptors

A

Cannabinoids signal via the CB1 and CB2 receptors

  • CB1 (CNS): analgesia, psychoactive, GI
  • CB2: immune tissue
31
Q

____ may cause a change in psychomotor behavior, impaired short-term memory, appetite stimulation, and analgesia

A

Cannabinoids may cause a change in psychomotor behavior, impaired short-term memory, appetite stimulation, and analgesia

32
Q

____ is a synthetic cannabinoid that causes significant delays in gastric emptying and chemo-induced nausea and vomiting

A

Dronabinol is a synthetic cannabinoid that causes significant delays in gastric emptying and chemo-induced nausea and vomiting

33
Q

Synthetic cannabinoids are often ____ in urine drug screens and are fragrant, longer-acting, and more potent

A

Synthetic cannabinoids are often undetected in urine drug screens and are fragrant, longer-acting, and more potent

34
Q

Cannibinoid withdrawal presents with ____, ____, ____, and ____

A

Cannibinoid withdrawal presents with

  • Significant depression / anxiety / irritability
  • Fatigue
  • Concentration deficits
  • Nausea / vomiting
35
Q

____ is recurrent episodes of nausea and profuse vomiting, involves dehydration, and may be relieved with hot showers (compulsive)

A

Cannabinoid hyperemesis syndrome is recurrent episodes of nausea and profuse vomiting, involves dehydration, and may be relieved with hot showers (compulsive)

Psychiatry (37 decks)

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