Substance

Question 1

Signs of amphetamine intoxication

Answer 1

Dry mouth, hyperthermia, dilated pupils, tachypnoea, hypertension

Maybe chest pain & palpitations

Question 2

Cannabis affects cognition and learning T/F

Answer 2

T

Question 3

Amphetamines- mechanism of action

Answer 3

Catecholamine release (mostly dopamine) at the presynaptic terminal

Question 4

Tics can be precipitated by stimulant use T/F

Answer 4

T

Question 5

Mechanism of action of cocaine

Answer 5

Dopamine reuptake inhibition-

competitive blockade of dopamine reuptake by the dopamine transporter

Question 6

Paranoid delusions can accompany amphetamine intoxication T/F

Answer 6

T

Question 7

Antipsychotic use in alcohol withdrawal yes or no

Answer 7

No bcs it lowers the seizure threshold

Question 8

What is the definition of early remission from stimulant use disorder?

Answer 8

After full criteria for stimulant use disorder were previously met, none of the criteria for stimulant use disorder have been met for at least 3 months but
for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the stimulant,” may be met).

Question 9

Definition of sustained remission from stimulant use disorder

Answer 9

After full criteria for stimulant use disorder were previously met, none of the criteria for stimulant use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the stimulant,” may be met).

Question 10

What is the contemplative stage in substance misuse?

Answer 10

Contemplation (“getting ready”) – People are beginning to recognize that their behaviour is problematic, and start to look at the pros and cons of their continued actions

Question 11

What is the substance most commonly used in adolescents?

Answer 11

Alcohol

Question 12

Higher or lower doses of methadone maintenance for better treatment retention and decreased illicit drug use?

Answer 12

Higher

Question 13

Does pharmacological treatment of ADHD reduce future substance misuse?

Answer 13

Stimulant use prevents reduces future substance use

- at least in youth stimulants reduce SUD by 50% (Faraone meta analysis 2003) to close to levels of general pop

Question 14

What is the difference between naloxone and naltrexone?

Answer 14

They are both opioid antagonists. Naloxone is short acting and naltrexone is long acting and approved for treating opioid dependence as a result

Question 15

Suspect intoxication with which drug in a patient with vertical nystagmus?

Answer 15

PCP

Question 16

Naltrexone cannot be used w significant liver disease T/F

Answer 16

T

Question 17

Monitoring with naltrexone

Answer 17

LFTs quarterly

Question 18

Naltrexone and pregnancy

Answer 18

Contraindicated

Question 19

Acamprosate in pregnancy

Answer 19

Contraindicated

Question 20

Acamprosate and liver dysfunction

Answer 20

No

Question 21

Acamprosate and carrying on drinking

Answer 21

No you need to be abstinent 5 days

Question 22

Disulfiram and drinking

Answer 22

No

Question 23

Disulfiram and pregnancy

Answer 23

Contraindicated

Question 24

What is a standard drink of alcohol?

Answer 24

13.6gr of pure alcohol. 12oz beer, 5oz wine, one shot of spirits

Question 25

Low risk drinking guidelines Canada

Answer 25

Men max 15/ week (max 3 day) women 10/week (max 2 day)

Question 26

When do seizures and hallucinations start in ETOH withdrawal

Answer 26

8-24 hours

Question 27

Naltrexone can be used with ongoing drinking T/F

Answer 27

T

Question 28

Acamprosate is TID dosing T/F

Answer 28

T

Question 29

Acamprosate a problem in renal impairment T/F

Answer 29

T

Question 30

Disulfiram no psych sfx T/F

Answer 30

F, mood swings & psychosis

Question 31

Which is the only non substance addiction disorder in DSM

Answer 31

Gambling

Question 32

Action of Acamprosate

Answer 32

GABA agonist & glutamate antagonist

Question 33

Action of naltrexone

Answer 33

Blocks mu opioid receptor

Question 34

The first line treatments of alcohol use disorder

Answer 34

1. Naltrexone | 2. Acamprosate

Question 35

Naltrexone can cause potentially fatal hepatitis T/F

Answer 35

T

Question 36

Disulfiram interferes with dopamine metabolism T/F

Answer 36

T

Question 37

Methadone reduces risk of death in opioid addiction T/F

Answer 37

T

Question 38

Methadone has a short duration of action T/F

Answer 38

F

Question 39

Methadone is assoc a a high risk of overdose early in treatment T/F

Answer 39

T

Question 40

What is suboxone?

Answer 40

Buprenorphine + naloxone

Question 41

Suboxone safer than methadone T/F

Answer 41

T overdose much less frequent

Question 42

What are the approved pharmacological treatments for cannabis use disorder?

Answer 42

There aren’t any

Question 43

Prevalence gambling disorder

Answer 43

1% (London)

Question 44

Canadian Coalition for Seniors Mental Health: Low risk drinking guidelines for senior adults

Answer 44

Women: max 1 drink/day, 5/week. Men: max 1-2/day and 7/week

Question 45

Prevalence of alcohol use in schizophrenia

Answer 45

40% K&S

Question 46

Opioid withdrawal can present with delirium T/F

Answer 46

F

Question 47

Benzo withdrawal is potentially lethal T/F

Answer 47

T

Question 48

The most commonly abused substance in adolescence

Answer 48

Alcohol

Question 49

What is the half life of alcohol

Answer 49

4-5 hours

Question 50

What is type II alcoholism

Answer 50

It affects only the sons of alcoholic fathers & starts in adolescence

Question 51

Clonidine is ised in opioid withdrawal T/F

Answer 51

T

Question 52

Treatment for cocaine detox

Answer 52

No pharmacological agents. Symptoms are minor, its just craving. Treatment is relapse prevention

Question 53

NT involved in opioid withdrawal symptoms

Answer 53

Noradrenergic

Question 54

Hyperphagia is associated with no cocaine craving in cocaine use disorder T/F

Answer 54

T

Question 55

Risk factors for developing DTs

Answer 55

Risk factors for developing delirium tremens (DTs) include the following:  Prior ethanol withdrawal seizures  History of DTs  Concurrent illness  Daily heavy and prolonged ethanol consumption  Greater number of days since last drink  Severe withdrawal symptoms at presentation  Prior detoxification  Intense craving for alcohol 

Question 56

Amantadine may be an effective treatment for cocaine-dependent patients with severe cocaine withdrawal symptoms T/F

Answer 56

T

Question 57

How long do cocaine metabolites stay in the urine

Answer 57

96hours

Question 58

Cannabis effects on cognition last how long

Answer 58

Up to 48 hours but prob a lot less 5-12 hours

Question 59

Hyperreflexia is seen in which withdrawal states?

Answer 59

BDZ & alcohol

Question 60

Addictive drugs activate which dopaminergic pathways?

Answer 60

Mesocortical and mesolimbic

Question 61

A low dose of a substance can reactivate addiction via the D3 pathway T/F

Answer 61

T

Question 62

Stress can reactivate addiction via increased amygdala activity (increased NE and CRF release) T/F

Answer 62

T

Question 63

How is early remission defined in DSM V?

Answer 63

At least 3/12 but less than 12/12

Question 64

What is the longest acting opioid antagonist and how long does it last?

Answer 64

Naltrexone 72 hours

Question 65

Mechanism of action of Disulfiram

Answer 65

Inhibits acetaldehyde dehydrogenase

Question 66

Define mild, moderate & severe alcohol use disorder as per DSM V

Answer 66

mild AUDs – defined as the presence of 2-3 criteria moderate AUDs – defined as the presence of 4-5 criteria severe AUDs – defined as the presence of 6 or more criteria

Question 67

DSM V criteria for alcohol use disorder (including the time frame and how many criteria are required)

Answer 67

DSM-5 Alcohol Use Disorder Criteria According to the DSM-5, alcohol use disorder is “a problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following [criteria], occurring within a 12-month period.” 1. Alcohol is often taken in larger amounts or over a longer period than was intended. 2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use. 3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects. 4. Craving, or a strong desire or urge to use alcohol. 5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home. 6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol. 7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use. 8. Recurrent alcohol use in situations in which it is physically hazardous. 9. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol. 10. Tolerance, as defined by either of the following: a need for markedly increased amounts of alcohol to achieve intoxication or desired effect, or a markedly diminished effect with continued use of the same amount of alcohol. 11. Withdrawal, as manifested by either of the following: the characteristic withdrawal syndrome for alcohol, or alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid alcohol withdrawal symptoms.

Question 68

When do alcohol withdrawal symptoms typically begin?

Answer 68

4-12 hours after stopping/ reducing intake

Question 69

How does alcohol contribute to the development of heart disease? (2)

Answer 69

1. Low grade hypertension | 2. Marked increase in triglycerides and LDL cholesterol

Question 70

According to DSM V the large majority of individuals who develop AUDs do so by which age?

Answer 70

Late thirties

Question 71

How much does the risk of AUD increase by in children of parents with AUDs?

Answer 71

3-4X

Question 72

One year prevalence AUD in adolescents and adults

Answer 72

4.6% adolescents and 8.5% adults according to London course

Question 73

The mental disorder with the largest substance use concurrent prevalence

Answer 73

ASPD 84% (London)

Question 74

First line treatments for AUD

Answer 74

1. Naltrexone | 2. Acamprosate

Question 75

Which psychosocial treatment best for AUD?

Answer 75

According to Project Match (1988-98): MET = CBT = Twelve step

Question 76

Naltrexone does what to people with AUD in terms of drinking habits?

Answer 76

Reduces heavy drinking

Question 77

Naltrexone contraindications in AUD (3)

Answer 77

1. Liver dysfunction 2. Opioid use 3. Pregnancy

Question 78

Duration of action naltrexone

Answer 78

24-72 hours

Question 79

Route of metabolism acamprosate

Answer 79

Renal

Question 80

Number of days abstinent for alcohol for acamprosate

Answer 80

5

Question 81

Effect of acamprosate

Answer 81

Maintains abstinence

Question 82

Best pharmacological AUD therapy for a liver patient

Answer 82

Acamprosate

Question 83

Abstinent for how long before starting disulfiram?

Answer 83

Two days

Question 84

The Cochrane review 2020 said which psychosocial treatment is best for AUD in terms of abstinence?

Answer 84

12-step (42% at 12/12 cf 35% on CBT at 12/12)

Question 85

Methadone reduces criminal behaviour T/F

Answer 85

T

Question 86

Naltrexone is used in gambling disorder T/F

Answer 86

T but not much of an evidence base

Question 87

Two NRTs together are better than one T/F

Answer 87

T