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Psychiatry > SM_123b: Substance Use Disorders > Flashcards

SM_123b: Substance Use Disorders Flashcards

1
Q

Substance disorders consist of ____, ____, ____, and ____

A

Substance disorders consist of risk harmful use, social impairment, impaired control, and physical dependence

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2
Q

____ represent 50% of the risk for substance abuse disorders

A

Genetics represent 50% of the risk for substance abuse disorders

  • Impaired breakdown of alcohol: decrease risk
  • Low level sensitivity to alcohol: increase risk
  • Some psychiatric disorders: increase risk
  • Some personality traits: increase risk
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3
Q

____ and ____ are traits that increase risk for substance abuse disorders

A

Negative emotionality and poor executive function are traits that increase risk for substance abuse disorders

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4
Q

Environmental risk factors for substance abuse include ____, ____, ____, ____, ____, and ____

A

Environmental risk factors for substance abuse include family, peers, social / cultural, adverse effects, current status, and current situation

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5
Q

Psychosocial risk factors include ____, ____, ____, and ____

A

Psychosocial risk factors include social control, social learning, behavioral choice, and stress & coping

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6
Q

Motivations have two dimensions ____ and ____

A

Motivations have two dimensions valence (direction of mood change) and source (change mood by altering)

  • Valence: positive mood, negative mood
  • Source: internal state, external situation
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7
Q

Motives for substance abuse include ____, ____, and ____

A

Motives for substance abuse include social, enhancement, and coping

  • Social: be sociable
  • Enhancement: get high, fun
  • Coping: forget problems, cheer up
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8
Q

Motives link ____ traits to influence substance abuse

A

Motives link personality traits to influence substance abuse

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9
Q

____ is main neurotransmitter implicated in substance abuse

A

Dopamine is main neurotransmitter implicated in substance abuse

(mediates reward)

(there are others)

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10
Q

Drugs ____ dopamine D2 receptors

A

Drugs decrease dopamine D2 receptors

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11
Q

Neural systems for ____, ____, ____, and ____ are involved in substance abuse

A

Neural systems for inhibitory control, motivation / drive, learning / memory, and reward / salience are involved in substance abuse

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12
Q

Substance use disorders are characterized by ____, ____, ____, and ____

A

Substance use disorders are characterized by loss of control, compulsive behavior, continued use despite negative consequences, and changes in brain structure and function

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13
Q

Treatment for substance abuse should match ____

A

Treatment for substance abuse should match severity

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14
Q

Psychosocial treatment for substance abuse involves ____, ____, ____, ____, and ____

A

Psychosocial treatment for substance abuse involves motivational interviewing, 12-step facilitation, cognitive behavioral therapy, contingency management, and couples / family therapy

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15
Q

Psychosocial treatment for substance use targets ____, ____, ____, and ____

A

Psychosocial treatment for substance use targets social control, social learning, behavioral choice, and stress and coping

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16
Q
A
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17
Q

Alcohol has ____ and ____ effects

A

Alcohol has direct and indirect effects

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18
Q

Advers effects of alcohol include ____, ____, and ____

A

Advers effects of alcohol include depression, mild-moderate cognitive deficits, and Wernicke’s encephalopathy / Wernicke-Karsakoff syndrome

19
Q

____ is a mu opioid antagonist used to treat alcohol abuse by decreasing positive reinforcement

A

Naltrexone is a mu opioid antagonist used to treat alcohol abuse by decreasing positive reinforcement

20
Q

____ is glutamate antagonist used to treat alcohol abuse by reducing craving, dysphoria, and anxiety

A

Acamprosate is glutamate antagonist used to treat alcohol abuse by reducing craving, dysphoria, and anxiety

21
Q

Disulfiram is used to treat alcohol abuse and acts by ____

A

Disulfiram is used to treat alcohol abuse and acts by preventing conversion of acetaldehyde to acetate by irreversible inhibiting acetaldehyde dehydrogenase, causing accumulation of acetaldehyde

(flushing, nausea, vomiting)

22
Q

____ are used to treat alcohol abuse but have side effects of motor and cognitive impairment

A

Benzodiazepines are used to treat alcohol abuse but have side effects of motor and cognitive impairment

23
Q

Cannabinoids have psychoactive component which is ____ (agonist) and non-psychoactive component which is ____ (antagonist)

A

Cannabinoids have psychoactive component which is THC (agonist) and non-psychoactive component which is cannabidiol (antagonist)

24
Q

Endocannabinoids act on the CB1 receptor to cause ____

A

Endocannabinoids act on the CB1 receptor to cause psychoactive effects

(CNS)

25
Q

Endocannabinoids act on the CB2 receptor to cause ____

A

Endocannabinoids act on the CB2 receptor to cause immune upregulation / inflammation

(immune cells)

26
Q

Describe adverse effects of marijuana

A

Marijuana adverse effects

  • Cannabis use disorder: high
  • Motor vehicle accidents: high
  • Symptoms of chronic bronchitis: high
  • Diminished lifetime achievement: high
  • Progression to toher drug use: medium
  • Schizophrenia: medium
  • Depression / anxiety: medium
  • Abnormal brain development: medium
  • Lung cancer: low
27
Q

Synthetic cannibinoids have ____ than THC because they are ____ at the CB1 receptor

A

Synthetic cannibinoids have greater potency than THC because they are full agonists at the CB1 receptor

28
Q

____ are not detected in urine toxicology

A

Synthetic cannibinoids are not detected in urine toxicology

29
Q

Cocaine ____ dopamine reuptake, metabolizes ____, and has effects lasting ____

A

Cocaine decreases dopamine reuptake, metabolizes rapidly, and has effects lasting 1-2 hours

30
Q

Amphetamine ____ dopamine reuptake and ____ dopamine release, metabolizes ____, and has effects lasting ____

A

Amphetamine decreases dopamine reuptake and increases dopamine release, metabolizes slowly, and has effects lasting 10-20 hours

31
Q

Adverse effects of stimulants are ____, ____, ____, ____, and ____

A

Adverse effects of stimulants are myocardial infarction, stroke, persistent psychosis, decreased inhibitory control, and altered risk-reward decision making

32
Q

____, ____, and ____ are serotonergic hallucinogens

A

LSD, psilocybin, and mescaline are serotonergic hallucinogens

33
Q

PCP and ketamine are dissociative anesthetics that are ____

A

PCP and ketamine are dissociative anesthetics that are NMDA glutamate receptor antagonists

34
Q

Opioids include ____, ____, and ____

A

Opioids include opiates, semi-synthetics, and synthetics

  • Opiates: detected on urine toxicology screen
  • Semi-synthetics: sometimes detected on urine toxicology screen
  • Synthetics: NOT detected on urine toxicology screen
35
Q

Endogenous opioid receptors include ____, ____, and ____

A

Endogenous opioid receptors include mu, delta, kappa

  • Mu: euphoria, analgesia, decreased breathing / muscle tone
  • Delta: decreased breathing, euphoria
  • Kappa: analgesia, sedation, and miosis
36
Q

B-endorphins act on ____ opioid receptors

A

B-endorphins act on mu opioid receptors

(also delta)

37
Q

Enkephalins act on ____ opioid receptors

A

Enkephalins act on delta opioid receptors

38
Q

Dynorphins act on ____ opioid receptors

A

Dynorphins act on kappa opioid receptors

39
Q

Adverse effects of opioids include ____, ____, ____, ____, and ____

A

Adverse effects of opioids include nausea / vomiting, constipation, itching, cognitive slowing / fatigue / drowsiness, and overdose

40
Q

____ is a mu opioid receptor agonist used to treat opioid abuse

A

Methadone is a mu opioid receptor agonist used to treat opioid abuse

41
Q

____ is a mu opioid receptor partial agonist used to treat opioid abuse

A

Buprenorphine is a mu opioid receptor partial agonist used to treat opioid abuse

(combined with naloxone to decrease diversion)

42
Q

____ is a mu opioid receptor antagonist used to treat opioid abuse in select populations

A

Naltrexone is a mu opioid receptor antagonist used to treat opioid abuse in select populations

43
Q

Mechanisms of action of drugs of abuse include ____, ____, and ____

A

Mechanisms of action of drugs of abuse include blocking dopamine / 5 HT / NE receptors, modulating ion channels, and modulating receptors

Psychiatry (37 decks)

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