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Psychiatry > Addictive Psychiatry > Flashcards

Addictive Psychiatry Flashcards

1
Q

Stimulant drugs

A

Cocaine

Amphetamine

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2
Q

Which drug is the most potent natural stimulant?

A

Cocaine

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3
Q

How is cocaine taken?

A

Coca leaves = chewed or brewed
Cocaine hydrochloride = snorted or injected
Cocaine freebase or crack cocaine = smoked

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4
Q

What does cocaine hydrochloride have an association with?

A

Wealth

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5
Q

What does crack cocaine have an association with?

A

Violence and bad backgrounds

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6
Q

Effects of cocaine depend on what?

A

Dose

Rate of entry

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7
Q

How long does smoking cocaine take to have its effects?

A

Almost immediately

Effects of crack smoking very intense but over really quickly (15 mins)

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8
Q

How long does injecting cocaine take to have its effect?

A

15 to 30 secs

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9
Q

How long does snorting cocaine take to have its effect?

A

3 to 5 mins

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10
Q

Effects of cocaine

A 
Stimulant 
Euphoriant 
increased alertness and energy 
increased confidence and impaired judgement 
lessens appetite 
lessens desire for sleep
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11
Q

Side effect of cocaine

A 
Financial impact 
damage to nose and airways
convulsions with respiratory failure
cardiac arrthymias and MI
hypertension and CVA 
Toxic confusion 
paranoid psychosis
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12
Q

Withdrawal effects of cocaine

A 
depression 
irritability 
agitation 
craving
hyperphagia (excessive eating)
hypersomnia
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13
Q

What is the chemical compound of amphetamine?

A

Amphetamine sulphate

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14
Q

How is amphetamine taken?

A

Sniffed
Swallowed
Injected

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15
Q

How long does amphetamine effects last for?

A

2-3 hours (longer than cocaine)

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16
Q

side effects of amphetamines

A

amphetamine psychosis in heavy chronic use
toxic confusion
convulsions
death

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17
Q

types of opiates

A 
opium 
morphine 
Heroin (diamorphine)
methadone
codeine and dihydrocodeine
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18
Q

Effects of opiates

A

Intense but transient feeling of pleasure

  • a rush
  • almost orgasmic
  • physical and emotional anaesthetic
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19
Q

Side effects of opiates

A 
first time = nausea/vomiting and headache
second time
- phlebitis 
- anorexia 
- constipation 
Longer term 
- tolerance
- withdrawal 
- social and health problems
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20
Q

Symptoms of opiate withdrawal syndrome

A 
craving
insomnia
yawning
muscle pain and cramps
increased salivary, nasal and lacrimal secretions
dilated pupils
piloerection
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21
Q

What is heroin available as chemically?

A

Diamorphine

Diamorphine hydrocodiene

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22
Q

How Is heroin presented?

A

Powder

tar like substance

23
Q

How is heroin taken?

A

Snorting
Smoking (chasing the dragon)
Injection (dangerous)

24
Q

Street names for heroin

A

H
Gear
Smack
Brown

25
Q

What is used for heroin withdrawal?

A

Methadone

26
Q

What does methadone in the treatment of heroin addiction allow for?

A

Decriminalises drug use
allowes normalisation of lifestyle
reduces IV misuse

27
Q

effects of heroin

A

analgesia
drowsiness and sleep
mood change (euphoria, intense pleasure)

28
Q

Side effects of heroin

A

Respiratory depression - if taking too much
- can lead to respiratory arrest with a pulse
cough reflex depression
sensitisation of the labyrinth with nausea and vomiting
decreased sympathetic outflow (bradycardia and hypotension)
lowering of body temperature
pupillary constriction
constipation
pinpoint pupils unreactive to light
snoring giving way to shallow respiration (<8 breaths per min)
varying degree of consciousness/coma

29
Q

How is ecstasy used?

A

Orally

30
Q

How long does ecstasy take to work and how long does it last for?

A

after 20 mins

lasting 2-4 hours

31
Q

Effects of ecstasy

A

relaxed euphoric state without hallucinations
followed by a feeling of calm
increased sociability
inability to distinguish between what is desireable and what isn’t

32
Q

What is another name for ecstasy?

A

MDMA

33
Q

Side effects of ecstasy

A 
nausea 
dry mouth 
increased BP 
increased temp 
in clubs users risk dehydration 
large doses can cause anxiety and panic
drug induced psychosis
liver and brain cell damage
34
Q

What is the most commonly used illicit drug?

A

Cannabis

35
Q

What is the psychoactive agent in cannabis?

A

Tetrahydrocannabinol

36
Q

What can cannabis be presented as?

A

Loads of different forms including

  • marijuana
  • hashish (cannabis resin)
  • hash oil
37
Q

How is cannabis taken?

A

Eaten

Smoked (spliffs or blunts)

38
Q

What has a high THC content in cannabis and therefore has higher risk?

A

Skunk (sensimilla)

39
Q

Effects of cannabis

A 
relaxing or stimulating
euphoriant 
increased sociability and hilarity 
increases appetite 
changes in time perception 
synaesthesia
40
Q

Effects of cannabis in higher doses

A

severe anxiety
panic
persecutory ideation
hallucinatory activity

41
Q

Ill effects of cannabis

A

respiratory problems as with tobacco
toxic confusion
exacerbation of mental illness
cannabis psychosis

42
Q

What are some novel psychoactive substances?

A

NPS

Legal highs

43
Q

What do anabolic (androgenic) steroids contain?

A

Testosterone and many synthetic analogues

44
Q

When are anabolic steroids used illegally?

A

In sports requiring muscle mass and strength

To enhance appearance - increase muscle mass and reduce body fat

45
Q

Anabolic steroids are legitimately prescribed in….

A

hypogonadism
muscular dystrophy
various anaemias
wasting in AIDs

46
Q

What do anabolic steroids cause?

A

Muscle hypertrophy

- especially in upper body such as pectoralis, deltoid, trapezius and biceps

47
Q

Side effects of anabolic steriods

A

Acne
Stretch marks
baldness
irritability and anger - ‘roid rage’
hypomania and mania
in males
- feminisation
= hypogonadism and gynaecomastia (occasioning use of anti-oestrogens)
in women
- virilisation
= hirsutism, deep voice, clitoral enlargement, menstrual irregularities, hair thinning
- CVS = increased cholesterol and HTN
- growth deficits = due to premature closure of epiphysis
- liver disease = cholestatic jaundice, liver tumours
depression and suicidality on withdrawal

48
Q

What are the 3 most common drugs abused?

A

Cocaine
Heroin
Diazepam

49
Q

Substitutes for coming off heroin

A

Methadone

Suboxone

50
Q

When is suboxone used?

A

Once have come off methadone

51
Q

What form is methadone?

A

Liquid

52
Q

What form is suboxone?

A

Tablet

53
Q

Comorbidities often involved with drug abuse

A

Viral hepatitis
BBVs
Infection

Psychiatry (18 decks)

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