Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ALU 202 > Chapter 12 > Flashcards

Chapter 12 Flashcards

1
Q

What is the primary source of information on the use of illicit drugs, alcohol, and tobacco in the U.S. for 12+

A

The NAtional survey on drugs Use andhealth (NSDUH), sponsered by Substance abuse and MEntal health service administration (SAMHSA), a division of the Department of HEalth and Human Services (DHHS).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Substance-related disorders are subdivided into two groups according to the new DSM-V (diagnostic and statistical manual of mental disorders, 5th edition)

A
  1. substance use disorders

2. substance-induced disorders.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define substance use disorder:

A

patterns of sxs resulting from use of a substance that the individual continues to take, despite experiencing problems as a result.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are examples of substance-induced disorders?

A

intoxication, withdrawal, and substance abuse- mental disorders (depression, psychosis, bipolar, axiety, sleep, neurocogniitive, sexual dysfunction, delirium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The presence and severity of substance use disorders is determined using 11 criterias. What are they.

A
  1. substance is ofeten taken in larger amounts or over a longer period than was intended
  2. a persistent desire or unsuccessful effort to cut down or control use
  3. a great deal of time is spent in activities necessary to obtain, use, or recover from the effects of substance.
  4. craving of a strong desire to urge to use the substance is present
  5. recurrent use, resulting in failure to fulfill major role obligations at work, school, or home
  6. continued use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance if present.
  7. important social, occupational, or recreational acitvities are given up or reduced because of use.
  8. recurrent use in situations in which it is physically hazadous occurs
  9. use is continued despite knowledge of having a persistent or persisten or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
  10. the repsence of tolerance,
  11. occurance of withdrawl,
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

define tolerance

A

1) need for markedly increased amount of the substance to acheive intozication or desired effect
2) a markedly dimished effect with contined use of the asame amount of the subtance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

define withdrawal

A

a) the characterisitics withdrawl syndrome from the subtance,
b) the substance or closely related substance is taken to relieve or avoid wihtdrawl symtpoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does one classify the severity of substance use disorder

A
  1. mild: presence of 2-3 criteria as above
  2. moderate: presence of 405 criteria
  3. severe: presence of 6 or more criteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

True or False

Alcohol is the 3rd leading cause of preventable deaths in the U.S. ?

A

YEs, only exceeded by tobacco use and obesity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the metabolism of alcohol

A

ethanol > CNS > depressant. [ ] depends on the ^ ETOH.

  • 1/4 absorbed into the stomach and rest in small intestine.
  • metabolized at 0.5 ounc/hour
  • is a depressant, but has byphasic effect. Low levels stimulate nerve cells, high levels depress.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What affects the degree in which the alcohol affects the body?

A
  1. amount consumed
  2. concentration of the drink
  3. the speed of consumption
  4. the presence of absence of food in the stomach
  5. level of hydration
  6. body type
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does alcohol affect the two type of neuronal receptors: GABA and NMDA?

A

increases GABA receptor inhibitory acitvity (sedative effects), chronic use creates dependence.
decrease the excitatory activity of the NMDA receptor, (memory formation, complex thiking, and neuronal excitability. chronic use followed by withdrawal can lead to seizures.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Does alcohol increase the release of dopamine?

A

yes, which causes the increase of pleasure feeling,s. it can also decrease, and people will seek to keep drinking to get the same feeling back.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

there are studies being done to assess the dependence of alcohol on the population. What are some epudemiology traits of substance dependence

A
  1. alterations in the metabolism of alcohol via the ALDH enzymes.
  2. serotonin dysfunction- implicated as a predoisposing factor
  3. rate of alcoholosm are substantially higher in relatives with alcoholics.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What systems in the body are affected by chronic alochol use?

A
  1. liver
  2. Gastrointestinal tract (GI)
  3. the cardiovascular
  4. nervous
  5. immune systems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does chronic alcohol use affect the GI system?

A
  1. suppressed appetitie
  2. inflammation of digestive tract
  3. decreased peristalsis and esophageal sphincter tone - GERD.
  4. impaired enzyme activity/vitamin absorption
  5. gi bleeds
  6. chronic pancreatitis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does chronic alcohol use affect the liver?

A
  1. hepatic steatosis
  2. alcoholic hepatitis
  3. cirrhosis.
    - — mechanisms that damage the liver
  4. production of acetaldehydes, free radicals, and cytokines as alcohol metabolizes. Alcohol indcued inflammation and cell dealth > Scarrring.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does chronic alcoholism affect the cardiovascular system ?

A
  1. cardiomyopathy
  2. HTN
  3. stoke
  4. A fib, atrial flutter, SVT, and Ventricular arrhthmias and sudden death.
  5. ## ishemich/hemorrhagic stroke d/t HTN, coagulation and A fib.caused by ethanol or its metabolites acetaldehyde. Increases systemic BP caused by ETOH contribute to myocardial dysfunction.
    -
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does chronic alcohol intake affect the nervouse system

A

CNS and PNS affected by ETOH-induced alterations in neurotransmitter levels and neuronal cell membrane function.

  • Frontal lobe the most affected.
  • toxic poluneuropahty is the most frequent CNS concequence, caused by deficiency of thiamine and B vitamins.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how is the immune system affected by excessive alcohol intake?

A
  1. increasing the risk of frequent and severe infections
  2. immune system damaged from nutrition deficiency.
  3. alcohol impaires B-cell lymphocyte production and function.
  4. alcohol increases Hep C replication,
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does excessive chronic alcohol intake affect cancer risk?

A
  1. WHO classified ETOH as a Group 1 carcinogen. Organs most effected: oral cavities, pharynx, esophagus, laryns, stomach, liver, breast/ovary cancer.
    - works as a co-carcinogenic by enhancing the carcinogenic effects of other chemicals and by stimulating tumour growth.
    - acetaldehyde interferes with DNA replicatin and repair of DNA.
    inacitivate the tumourr suppressor gene BRCA1 and increase estrogen responsiveness.
22
Q

What affects the Effectiveness of alcohol dependence treatement?

A
  1. individual motivation
  2. age of onset of abuse
  3. duration and extent of abuse
  4. compliance with tx
  5. successful tx of co-morbud factors.
23
Q

What is the most common form of alcohol therapy?

A

Psychoscocial approach- AA
based on the spiritual belief in a higher power, built on a 12 step approach used psychosocial teachniques such as rewards, social support nextworks and role models.

24
Q

How are moderation programs such as moderation management different from AA?

A

they do not madate complete abstinence byt allow low-risk drinking.
some success, but abstinence represents the most stable form of remission for most recovering alcoholics.

25
Q

What are some medications that can be used in the tx of alcohol-dependence?

A
  1. disulfiram- prevents elimination of acetaldehydes. leading to A.E when ETOH is consumed
  2. Naltrexone- competitive antagonist for opioid receptors, reduces the craving for alcohol.
  3. acamprosate- restores the normal balance between neuronla excitation and inhibition that is altered by chornic alcohol use.
26
Q

What would an underwriter look for when u/w alcohol use hx?

A
  1. hx of depression/mood disorders
  2. sig personal or professional stressors
  3. hx of violence
  4. hx of another substance use disorder
  5. adverse MVR
  6. unstable employment record
  7. family hx of acohol abuse
  8. easy access to alcohol
  9. frequent falls or accident
  10. participation in high risk behaviours or avocations
  11. tobacco use
  12. physcical signs and sxs
27
Q

Which liver enzyme is primarily found in the liver?

A

ALT is found primarily in the liver, making it a more specific marker for liver injury, but AST is more sensitive marker for alcohol use; and AST/ALT ration greater than two is suspecious for liver disease.
GGT has been found to be elevated in association with steady ETOH use over time, but other factors can cause GGT elevations.

28
Q

What is the MCV and how is it useful in detecting ETOH use?

A

its the mean corpuscular volume (MCV) a measure of the size of RBA.
^ [ ] represents macrocytosis, or presence of RBCs. Seen with B12 and folate deficiencies.
there is a relationship between ETOH abuse and macrocytosis. Low levels are likely to be associate to alcohol-related abnormalities.

29
Q

How are Lipids affected by ETOH?

A

low/moderate alcohol use raises HDL. however excessive levels increase HDL to outside normal rance.
Trigs, are elevated d/t the fatty liver changes.
uric acid also can be increased.

30
Q

What are some common alcohol markers?

A
  1. CDT- ETOH interferes with teh addition of carbohydrate groups or stimulates their removal from transferrin.
  2. Acetaldehyde: when concentration levels are chornically elevated they cause elvated HAA concentrations.
31
Q

What are some good alcohol screening tools?

A
  1. CAGE questionnaire- simple screening test for alcohol abuse.
  2. Michigan Alcohol Screening TEst (MAST)- oldest and most accurate
  3. the alcohol use disorders identification test (AUDIt)- developped internationally.
32
Q

What are the 4 questions asked on the CAGE questionnaire?

A
  1. have you ever felt the need to cut down your drikning?
  2. have poeple annoyed you by cirticizing your drinking?
  3. have you ever felt guilty about drinking
  4. have you ever felt you needed a drink first thing in the morning to steady your nerves or to get rid of a hangover?
33
Q

What are the mortality implications of increased/chronic alcohol consumption?

A
  1. cirrhosis
  2. CV disorders
  3. cancers
  4. unintentional deaths via MVA, and high risk behaviours.
34
Q

What is the most commony used illicit drug with current users?

A

MArijinana,

35
Q

How does MArijuana affect the system

A
  1. enters the brain and lasts 1-3 hours.
  2. heavy use impaires ability to form memories, recal events, and shift attention
  3. disrupts coordination, and balance.
  4. high dose can create acute toxic psychosis
  5. long-term use increses risk of chronic lung diease and cancers of the head, neck and lungs.
36
Q

What are the short-term physiological effects of cocaine? And what are the most frequent complications of cocaine?

A

constricted blood evssels, dilated pupils, increased temperatures, heart rate, blood pressure.

  1. cardiovascular effects including arrhythmias and MI,
  2. respiratory effects, including respiratory failure.,
  3. neurological effects, including strokes, seizures, headaches.
  4. GI effect, including abdo pain and nausea.
37
Q

Define the mechanism of heroin?

A

absorbed quickly thorugh the blood-brain barrier where it is converted to morphine and rapidly binds to opioid receptors.
> can cause resp depression

38
Q

Define the mechanism of methamphetamine

A

man-made substance structurally similar to amphetamine and dopamine.

  • increases alertness, decreases appetitie and creases sensation of pleasure.
  • longer duration in the body compared to coccaine.
  • long term use creases sxs of anxiety, confussion, insomnia, mood disturbances, and violent behavirous. Also brain structure changes, in areas of motion and memory.
39
Q

Define the mechanism of MDMA

A

semi-synthetic stimulant and hallucigen that is used to improve mood and maintain energy.
- reduces mental abilities, memory and information-processing capabilities. These sxs can last up to a week and perhaps longer in regular uses.

40
Q

Define the mechanism of PCP (phencyclidime)

A
  1. dissociative anaesthetic.
  2. out-of body experience and sens of detachment from reality.
  3. effects are unpredictable
  4. can cause rapid, shallow breathing, HTN, tachycardia and elevated body temperatures.
41
Q

Define the mechanism of LSD (lysergic acid diethylamide)

A

semi-synthetic hallucinogenic drug derived from rye fungus and is the most potent mood and preception altering drug.

  • HTN, tachycardia, dizziness, dry mouthn, sweating, numbness and tremors.
  • emotion inbalanace
  • . hallucinations
  • develop high tolerance which also dissipates quickly after cessation of use.
  • Flash back concequence ( HPPD)
42
Q

How are substance use disorders treated?

A

successful tx is challanging d/t the changes that occured in the brain from chronic use.

  1. drug-rehabilitation.
  2. 12-step recovery programs such as NA and CA.
43
Q

Is there a relation between substance abuse and mental illness?

A

yes 6/10 people with substance use disorder have another form of mental illness, most commonly associated with:

  1. antisocial personality disorder
  2. schizophrenia
  3. bipolar disorder,
  4. major depressive disorder
  5. ADHD
  6. generalized anxiety disorer
  7. PTSD
44
Q

What is the mortality and morbidity among drug addits?

A

high d/t rates of suicide attempts, consequences of high-risk behavors, and unintentional deaths from OD. and injuries.

45
Q

What are factors that affect the treatment success for drug abusers?

A
  1. duration of use
  2. drugs used
  3. presence of polyp substance use
  4. co-morbid mental health disorder
  5. history of relapse
  6. number of years drug-free
46
Q

What are some u/w considerations when reviewing a history of drug use?

A
  1. drugs used
  2. hx of poly-substance abuse incl ETOH
  3. use of px Rx at risk of being abused
  4. hx of depression/other mood disorders
  5. suicidal ideations/ attempts.
  6. duration of abuse
  7. duration of abstinence
  8. hx and number of relapses
  9. type of tx and compliance
  10. presence of ongoing support
  11. hx of high risk behavior, accdients/falls or violent behavior
  12. Adverse MVR findings
  13. unstable employement records
  14. +ve findings on drug screens
47
Q

What are the most commonly used paid relieves?

A 
opioid compoused, which include:
1. hydrocodone
2. oxycodone
3. morphine
4. fentanyl
5. codeine
benzodiazepines which includes
1. dizepam
2. alprazolam
Px stimulants:
1. Dextroamphetamine 
2. methylphenidate
48
Q

What was caused of the increase incidence of px drug abuse?

A
  1. rising number of medicines being px for a variety of health problems
  2. ease of obtaining this rx online
  3. access by children and family members to the px medicines of others in the hosuehold.
49
Q

What is the most cmoon cause of mortality associated with teh nonmedical use of px drugs?

A
  1. unintentional injury
  2. suicide
  3. death from injury of undetermined intent.
  4. increases in poisoning mortality.
50
Q

What are the underwriting consideridarations in u/w px use?

A

its difficult to detect.

  1. records from px databases are useful for determining patterns.
  2. medical records- if all physicians are disclosed.

ALU 202 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions