Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Addiction boards > Random pearls from BEST > Flashcards

Random pearls from BEST Flashcards

(93 cards)

Start Studying
1
Q

Pharmacologic changes re MTD in pregnancy (4)

A

Increased gut transit time (increased absorption), 50% increase in blood volume (lower concentration), induction in CYP3A4 activity, Increase in accumulation in adipose (supposedly can be problematic in postpartum state)

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

“Seeking Safety”

A

evidence-based treatment approach for PTSD and SUD

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

Network therapy def

A

individual psychotherapy or family therapy in which an attempt is made to involve not only immediate family members but also other relatives, friends, and neighbors as sources of emotional support and possible vocational opportunity.

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

Screening tool for unhealthy substance use in adolescents

A

CRAFFT (ridden in Car, use Alone, Family/Friends concerned, gotten in Trouble)

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

Schedule 1 meds

A

no currently accepted medical use and high potential for abuse. Heroin, LSD, cannabis, MDMA, methaqualone, peyote

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Schedule 2 meds

A

High potential for abuse, can only be prescribed in triplicate. Cocaine, methamphetamine, opioids, meperidine, dexadrine, adderall, ritalin

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

Schedule 3 meds

A

can be prescribed by phone. Moderate-to-low potential for dependence. APAP w codeine, ketamine, anabolic steroids, testosterone

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

Schedule 4 meds

A

can be prescribed by phone. “Low” potential for abuse. Benzos, ambien, tramadol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Schedule 5 meds

A

can be prescribed by phone . Limited quantities of certain opioids like robitussin with codeine, lomotil, lyrica

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

Limbic system (hippocampus and amygdala) role in addiction

A

memory and emotional context (triggers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Orbito-frontal cortex role in addiction

A

reward processing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Nucleus accumbens role in addiction

A

dopaminergic / pleasure from drugs and behaviors

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

Insula role in addiction

A

integrating and giving meaning to sensations such as hot/cold as well as cravings

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

Pseudowithdrawal def

A

intensification of symptoms when wd is imminent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Rebound def

A

intensification of pre-treatment symptoms after discontinuation. Distinguish from “recurrence” by whether symptoms merely returned vs intensified

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Sensitization def

A

opposite of tolerance (increased effect with repeat doses)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

“stacking” in anabolic steroids

A

using multiple types simultaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

“pyramid” in anabolic steroids

A

increasing dose, then tapering prior to competition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Effects of anabolic steroids

A

increase muscle strength, but not bone mass, aerobic capacity, injury time. Can increase irritability.
In women, masculinization, weight gain, irr periods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Toxicity of anabolic steroids

A

PO administration associated with LFT abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

anabolic steroid withdrawal illness script

A

Looks like depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Gambling disorder risk and meds

A

DSM-5 recognized, about 50% of risk attributable to genetic influences. Meds with evidence: naltrexone, lithium, paroxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

rate of SUD in Eds

A

50% of patients with eating disorder have SUDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Gene with variants that modulate naltrexone efficacy for AUD

A

OPRM1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Kratom pharmacology
mitragynine. Antagonist at kappa opioid receptor, agonist vs partial agonist at mu receptor.
26
Salvia pharmacology and effects
salvinorin A. kappa opioid agonist→ hallucinosis and dissociation, not reliably euphoria
27
methanol poisoning illness script
vision loss, hyperventilation, abd pain, parksinonian features, AGMA, increased ICP. Can occur with huffing. Tx: fomepizole.
28
Stages of changes and their associated pitfalls for patients
Pre-contemplative → resistance Contemplation → demoralization Action → dropout Maintenance → relapse
29
mechanism of LSD and psilocybin
serotonin 5HT-2A agonists
30
Features of therapeutic community
Structured daily regimen Assigned role models Use of peer community as healing agent ("community-as-method")
31
Active metabolites of heroin
6-MAM morphine 3-MAM
32
risk of SUD attributable to genetic factors
40-60% (supposedly) Outweighs parental substance use in adoption studies
33
Principles of twelve-step facilitation
Abstinence (goal) Acceptance (of one's loss of control over substance consumption) Spirituality ("power greater than oneself") Pragmatism (collaborative approach to do whatever is needed to avoid first drink)
34
Role of recovery coach
Encourage healthy structures and rituals. Best utilized as part of comprehensive treatment plan
35
Unique toxicity of meperidine
Decreased seizure threshold d/t normeperidine accumulation
36
PNPLA3 and MBOAT7
genes associated with incr risk of alcohol-related liver disease
37
GABRA2
gene likely associated with severity of AWS and daily alcohol use
38
CYP2A6
Metabolizes nicotine to cotinine. Reduced activity associated with reduced smoking risk due to increased adverse effects
39
GABA agonists
benzo - GABA-A etoh - gaba-a GHB - gaba-b baclofen - gaba-b
40
benzo overdose mortality
remarkably low -- lethal dose not established for most benzos Problem is combination w other drugs
41
prevalence of tobacco use in OUD
75-90%
42
convergent therapy
combination of multiple modalities (eg meds and CBT)
43
cause drug testing
done when there is suspicion of use (distinguish from random)
44
CYP 2D6
hydrocodone --> hydromorphone AND Codeine --> morphine slow metabolizers achieve very low levels, fast metabolizers can have rapid high levels
45
Harrison act and controlled substances act
Harrison 1914 - codified illegal vs legal and taxable CSA - governs medical use
46
D4R gene
dopamine R. variants associated w lower dop tone --> incr risk of smoking and relapse
47
conditional confidentiality
generally afforded to adolescents 14-18
48
relative dopamine release of diff drugs
meth >> cocaine > heroin/nicotine > sex/food
49
MTD and NAS
higher doses not associated w incr risk for NAS
50
Fidelity ethical principle
Being truthful/faithful to duties as a medical professional. Includes CME and maintenance of competence
51
1976 Court case establishing that correctional authorities must reasonably assess and treat incarcerated people?
Estelle v Gamble
52
dopamine transporter A9 allele
associated with more severe AWS and DTs risk!
53
primary vs secondary vs tertiary prevention
primary - preventing incidence secondary - identifying and intervening as early as possible (includes screening) Tertiary - preventing complications by active treatment quaternary - avoiding harm through overmedicalization
54
URICA
University of RI Change Assessment - measures motivation to change across range of behaviors
55
CRI
Coping Response inventory - measures coping skills
56
InDUC
Inventory of drug use consequences -- measures adverse effects from drug use
56
RAATE
Recovery Attitude and treatment evaluator -- measures resistance to change
57
MAST-G
Michigan Alcoholism Screening Test - Geri -- older adult alcoholism screening instrument. 24-item scale, superior to other screening tests
58
Hyperalgesia vs allodynia
hyperalgesia - increased pain from painful stimulus allodynia - pain from non-painful stimulus
59
DrInc vs AUDIT
DrInC - Drinker inventory of consequences : assesses adverse impacts in domains of physical, social, impulsive, interpersonal, and intrapersonal AUDIT: assesses drinking patterns and failed efforts to control
60
Khat and bath salts
Cathinone - stimulant alkaloid derived from khat. MAO reuptake inhibitor Bath salts - synthetic analogues
61
healthy drinking limits
men under 65 - 4 per sitting / 14 per week women under 65 - 3 per sitting / 7 per week over 65 - 2 per sitting / 7 per week Above this is "heavy use" (per NIDAA)
62
Webb vs US
interpreted Harrison Act to declare that physicians maintaining patients with addiction on usual dose of prescribed opioid is not "good faith" and therefore indictable. DATA-2000 was then necessary to allow physicians to prescribe schedule III-V opioids with FDA indication for OUD (currently describes only bup since methadone is schedule II)
63
FRAMES
Brief intervention outline: Feedback Responsibility Advice Menu of strategies Empathy Self-Efficacy
64
CDT
Carbohydrate deficient transferrin -- biomarker for HEAVY alcohol use
65
Categorical levels of substance use (low risk, unhealthy, etc)
low risk - complete absence or use at very low risk for adverse events Unhealthy: both hazardous and harmful Hazardous: risky use that has not yet developed adverse effects Harmful: +adverse effects
66
disulfiram toxicity/contraindication
psychosis - can precipitate! Hepatic metabolism, not appropriate with impairment
67
phencyclidine false positive
venlafaxine
68
varenicline and alcohol
can increase toxic effects (drunkeness, blackouts). patients should be cautioned
69
Smoking cessation in pregnancy/lactation
NRT - less data, most trials stopped early for adverse pregnancy effects. Risk/benefit Bupropion - generally safe, including lactation. probably first line Varenicline - limited data, probably safe
70
Fentanyl patch --> increased drug delivery
fever/increase in skin temp
71
pharmacokinetics vs dynamics
PK - time course of concentration following administration (what body does to drug) PD - drug effects relative to concentration (what drug does to body)
72
cocaine MOA
NE reuptake inhibitor
73
MA MOA
inhibits DA reuptake, promotes release
74
cocaethylene effects
incr cardiotoxicity, hepatotoxicity, seizures
75
e-cigarette solvent
propylene glycol
76
MDMA mechanism
releaser and/or reuptake inhibitor of presynaptic monamines (5HT, DA ,NE
77
dextromethorphan mechanism
at high doses, nonselective 5HT reuptake inhibitor, NMDAR antagonist (like ketamine) --> dissociative hallucinogen
78
phencyclidine mechanism
NMDAR antagonist, also has anticholinergic properties
79
Stark Law
prohibits physicians from referring Medicare patients for health services with which the physician (or family) have financial relationship
80
toluene illness script
paint thinner, extreme intoxication and AMS
81
low-acuity patient presenting for first episode of care requesting inpatient tx
should be referred for outpatient tx first.
82
evaluation for depression in AUD
should be done on admission to detox/treatment, even though many sx resolve with abstinence
83
standard drinks
1.5 oz liquor, 5 oz wine, 12 oz beer (standard mass-consumption beverages, not high ABV)
84
why is lorazepam preferred in cirrhosis?
undergoes gluconuridation to inactive metabolites (other bzd have active metabolites)
85
e-cigs regulation and outcomes
ENDS (electronic nicotine delivery systems) FDA regulated since 2016 helpful in harm reduction. At 52 weeks, 18% of people stop cigs (compared to 9% for NRT)-- many ppl become dual-users. huge variability in nicotine levels and has harmful pregnancy outcomes. heavy metals present in both ENDS and cigarettes. No approved meds for vaping use disorder
86
adolescent ENDS use
3X risk of cigarette smoking
87
top-line outcome for methadone and bup
50% relative risk reduction for death by overdose
88
smoking effects on life expectancy
on average, smokers die 10 yrs early. smoking leads to premature death in at least 50% of long-term smokers
89
factors increasing risk of overdose in LTOT
- OME >90 - long-acting opioids - history of overdose - OUD - MDD
90
SSPs + MOUD impact on infectious risk
decr HIV and HCV by ~67%
91
CV effects of ecigs
improved endothelial function and vascular stiffness, no hard outcomes
92
Medial OFC
"stinking thinking" i.e. aberrant motivation/reward thinking

Addiction boards (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions