Stimulants and Substance Use Ex 4

Question 1

stimulants mostly act by increasing what?

Answer 1

the activity of CNS neurons

Question 2

main stimulant drugs are?

Answer 2

amphetamine, methylphenidate, methylxanthine

Question 3

Amphetamine and methylphenidate MOA

Answer 3

release of norepinephrine and dopamine

Question 4

therapeutic effects of Amphetamine and methylphenidate

Answer 4

increased alertness
increased initiative
reduced fatigue
elevated mood

Question 5

Amphetamine and methylphenidate pharmacokinetics

Answer 5

available PO
short and long duration forms

Question 6

Amphetamine and methylphenidate adverse effects

Answer 6

excess CNS stimulation (Insomnia)
reduced appetite (weight loss)
vasoconstriction (HTN)
cardiac excitation (angina)
psychosis (excessive use)
overdose can cause seizures/coma

Question 7

Methylxanthine (caffeine) MOA

Answer 7

blockade of adenosine receptors appears responsible for most effects

Question 8

methylxanthine therapeutic effects

Answer 8

decreased drowsiness
decreased fatigue
increased intellectual exertion
headache relief
mild diuretic

Question 9

less desirable effects of methylxanthine

Answer 9

nervousness
insomnia
convulsion (extreme doses)

Question 10

substance use disorders relevance to nursing

Answer 10

abuse is common
causes significant health problems
affects nursing care for other diseases

Question 11

knowledge of drug abuse enables nurses to

Answer 11

recognize abuse and toxicity
participate in treatment and withdrawal
educate pts who are struggling with addiction and recovery

Question 12

what leads to drug abuse

Answer 12

acceptable use vs abuse is socially and culturally defined
exists on a spectrum from occasional use to compulsive use

Question 13

what else leads to drug abuse

Answer 13

physiological vs psychological dependence
social factors
availability
individual vulnerability

Question 14

substance use disorder definition has no connection with?

Answer 14

physical dependence

Question 15

goal of substance use disorder tmt

Answer 15

complete cessation

Question 16

addiction definition

Answer 16

chronic relapsing illness characterized by continued use of specific psychoactive substance despite physical, psych, or social harm

Question 17

define tolerance

Answer 17

smaller response from same dose

Question 18

cross tolerance

Answer 18

tolerance to one drug confers tolerance to another

Question 19

psychologic dependence

Answer 19

an intense subjective need for a psychoactive drug

Question 20

cross - dependence

Answer 20

one drug supports dependence on another drug

Question 21

controlled substances act of 1970

Answer 21

federal leg that categorized potentially addictive substances into 5 categories
to prescribe controlled drugs, prescribers need DEA licenses

Question 22

Alcohol two main CNS effects

Answer 22

GABA receptor activation
glutamate inhibition
—-> widespread CNS depression

Question 23

What happens when you drink alcohol

Answer 23

reflexes diminished, impaired consciousness
depressant effect is dose dependent
high doses = state of general anesthesia

Question 24

alcohol pharmacokinetics

Answer 24

metabolised quickly
primarily hepatic
constant rate of metabolism

Question 25

adverse effects of alcohol

Answer 25

cardiovascular - cutaneous vasodilation elevation of BP respiratory depression liver damage erosive gastristis diureses pancreatitis sexual function cancer teratogen

Question 26

alcohol interactions

Answer 26

other CNS depressants NSAIDS acetaminophen disulfiram

Question 27

withdrawal syndrome of alcohol

Answer 27

Gi distress, SNS over activation, hallucinations, tonic-clonic seizures, disorientation, delirium,

Question 28

what drugs facilitate withdrawel

Answer 28

benzodiazepines (diazepam, aplrazolam) beta blockers clonidine (off label use) antiepileptics

Question 29

what drug can you used to maintain abstinence from alcohol

Answer 29

disulfiram

Question 30

disulfiram (antabuse) only used for what

Answer 30

ETOH treatment

Question 31

disulfiram (antabuse) MOA

Answer 31

irreversibly inibits aldehyde dehydrogenase causing acetaldehyde accumulation from ETOH ingestion

Question 32

ETOH + disulfiram = ?

Answer 32

acetaldehyde syndrome

Question 33

acetaldehyde syndrome

Answer 33

vomiting, flushing, headache, sweating, blurred vision, hypotension can be life threatening`

Question 34

Nicotine MOA

Answer 34

at low doses, activates nicotine receptors in the reward center which stimulate dopamine release

Question 35

adverse effects of nictoine

Answer 35

cardiovascular stimulation, nausea, appetite suppression, fetal harm long term increased risk of CVD, cancer, COPD

Question 36

trmt of nicotine addiction

Answer 36

gum/lozenges patches nasal spray inhaler > e cigs not FDA approved for smoking cessation

Question 37

What is bupropion SR

Answer 37

Zyban/ Wellbutrin - an atypical antidepressant

Question 38

Bupropion MOA

Answer 38

blocks uptake NE and DA reduces cravings for nicotine and eases withdrawel symptoms

Question 39

side effects of bupropion

Answer 39

dry mouth, insomnia, decreased appetite > drug started before quit date, take 7-12 weeks

Question 40

what is Vaenicline

Answer 40

Chantixx

Question 41

MOA of Varenicline (Chantix)

Answer 41

partial nicotinic receptor agonist, so it prevents most of the nicotine from binding most effective aid for smoking cessation - reduced cravings and intensity of symptoms

Question 42

adverse effects of Varenicline (Chantix)

Answer 42

nausea and psychologic changes

Question 43

Cocaine MOA

Answer 43

prevents dopamine reuptake in the CNS neurons, which increases its levels in the brain

Question 44

two forms of cocaine

Answer 44

Cocaine HCL and Cocaine base

Question 45

what is Cocaine HCL

Answer 45

white powder usually diluted, taken intranasally

Question 46

what is cocaine base

Answer 46

"crack" smoked, very fast absorption in lungs

Question 47

adverse effects of cocaine

Answer 47

angina pectoris/ MI from coronary vasospasm nasal mucosa atrophy and septum perforation

Question 48

Methamphetamine (Meth) MOA

Answer 48

increases levels of norepinephrine and dopamine in the CNA

Question 49

Meth causes?

Answer 49

arousal, improved mood, euphoria, decreased pain perception, decreased appetite and ned for sleep can be snorted, injected, or smoked

Question 50

adverse effects of meth

Answer 50

psychosis cardiac stimulation and vasoconstriction

Question 51

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