Addiction and Substance Misuse Flashcards Preview

3MB Psychiatry > Addiction and Substance Misuse > Flashcards

Flashcards in Addiction and Substance Misuse Deck (38):
1

List the ICD-10 criteria for dependence

Strong desire to take the substance
Difficulty in controlling substance use
Withdrawal state
Neglect other pleasures
Persistence despite evidence of harm

2

Which dopaminergic pathway, associated with reward, is involved in addiction?

Mesolimbic pathway

3

What is the effect of dopamine release upon behaviour?

Motivates us to repeat behaviour
Involved in pleasurable experience

4

What effect do drugs like amphetamine and cocaine have on dopamine?

Increase release of dopamine

5

If dopamine receptors are repeatedly stimulated, what can eventually develop?

Tolerance
due to downregulation/decreased sensitivity of receptors

6

What is the consequence of developing tolerance in addiction?

Threshold for feeling reward is increased; normal pleasurable experience don't evoke enough of a reward response

7

Frontal lobe areas associated with executive functioning develop before those areas associated with emotion. True/False?

False
Other way around!

8

Which parts of the brain are associated with memory learning?

Amygdala
Hippocampus

9

Which parts of the brain are associated with inhibitory motor control?

Prefrontal cortex
Anterior cingulate gyrus

10

Which parts of the brain are associated with motivation/drive?

Orbito-frontal cortex
Subcallosal cortex

11

Which parts of the brain are associated with reward?

Nucleus accumbens
Ventral pallidum
[mesolimbic pathway]

12

How many ml of alcohol = 1 unit?

10ml

13

What is the equation for calculating no. of units of alcohol?

[% x volume]/10

14

What are the current guidelines for low risk alcohol drinking?

No more than 14 units per week, ideally spread over 3 or more days

15

What are the parameters of increased risk alcohol drinking?

Regular consumption of 15-35 units a week

16

What are the parameters of high risk alcohol drinking?

Regular consumption of over 35 units a week

17

Which marker can be an indicator of alcoholic liver injury?

GGT

18

Which marker identifies men who have been drinking 5+ units of alcohol a day for a year or more?

Carbohydrate deficient transferin

19

What is the most common cause of a raised MCV?

Alcoholism

20

What effect does alcohol have on excitatory glutamatory ion channels?

Inhibits action of glutamate receptors

21

What effect does alcohol have on inhibitory GABA ion channels?

Potentiates action of GABA receptors

22

Alcohol withdrawal leads to less/more glutamate activity and less/more GABA activity

Alcohol withdrawal leads to more glutamate activity and less GABA activity

23

List clinical features of alcohol withdrawal

Restlessness, tremor
Sweating
Anxiety
Loss of appetite and sleep
Tachycardia
Seizure, delirium tremens

24

Which drugs are used to manage alcohol withdrawal?

Benzodiazepine
Thiamine (parenteral)

25

Which drug is the 1st line agent for alcohol detox relapse prevention?

Naltrexone

26

Which drug should be started as soon as alcohol detox is complete?

Acamprosate

27

Which alpha-2-receptor agonist can help with opiate detox?

Lofexidine

28

What are the 2 main detox agents used for opiate misuse?

Methadone
Bruprenorphine

29

What effect does mephedrone have on neurotransmitters?

Inhibits reuptake of serotonin, noradrenaline and dopamine

30

What are the user effects of taking mephedrone?

Feeling of ecstasy, openness
Increased confidence and desires

31

Taking mephedrone increases susceptibility to ladybird attacks. True/False?

True

32

List the main categories of legal highs

Stimulants
Empathogens
Psychedelics
Dissociatives
Cannabinoids
Depressants
Opioids

33

What is sympathetic toxidrome and which drug is it related to?

Amphetamines
Range of toxic autonomic effects e.g. tremor, sweating, pain, confusion, vomiting etc.

34

What is serotonin syndrome?

Excess serotonin causes hypomania, agitation, myoclonus and hyperactive autonomic state

35

Which drugs can cause serotonin syndrome?

Antidepressants
Cough medication
Tramadol
Antibiotics
Herbal products

36

What effect on neurotransmission does methamphetamine have?

Inhibits reuptake of noradrenaline and dopamine

37

Synthetic cannabinoids can be more potent than cannabis. True/False?

True
800x more potent!

38

Which legal high causes a detachment from reality, including depersonalisation and derealisation?
[dissociative]

Ketamine