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Flashcards in Substance Abuse Disorders Deck (30)
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1

what is substance use disorder?

-important social, occupational, recreational activities given up or reduced
-use in hazardous situations
-tolerance
-withdrawal
-use despite physical or psychological problems caused by use

2

What does severity depend on?

-the # of symptoms that they have

3

Specifiers for early remission?

-no criteria for > 3months but < 12

4

Sustained remission

-no criteria for > 12 months (except craving)

5

Withdrawal

-substance specific syndrome problematic behavioral change due to stopping or reducing prolonged use
-no withdrawal: PCP; other hallucinogens; inhalants

6

What does DA get converted into?

-adrenaline!
-so, coke addicts will come in emaciated and complaining of being tired

7

Why do Native Americans have a higher alcoholism?

-they can burn through alcohol faster
-more efficient Alcohol dehydrogenase

8

Is AA good for treatment?

-no, it is a social experience
-there is no professional leading it

9

What does alcohol do with NT's in our brain?

-raises GABA
-so, we compensate by increasing Glutamate

10

Does alcohol withdrawal sometimes require hospitalization?

-yes
-Delerium tremens is the really bad one that is life-threatening

11

What is the score for CIWA that they need to indicate more severe withdrawal?

->10

12

Benzodiazpines

-GABA agonist.... cross tolerant with alcohol
-reduce risk of SZ; provide comfort/sedation

13

Anticonvuslants

-reduce risk of SZand may reduce kindling
-helpful for portracted withdrawal
-carbamazepine or valproic acid

14

Thiamine supplementation

-risk thiamine deficiency (wernicke-korsakoff)

15

What meds will we use for alcohol t?

-disulfiram
-naltrexone
-acamprosate

16

what kind of prevention is disulfiram doing?

-tertiary prevention

17

Why would someone on disulfiram have rashes?

-they spray perfume on their skin... it's that powerful

18

Do we ever use alprazolam for withdrawal?

-no!
-too short of a time of action

19

Which three benzos have no metabolites associated with them?

-oxazepam, lorazepam, and temazopam or something like that

20

Pinpoint pupils.... what do we think of ?

-opioid intoxitcation
-for withdrawal, their pupils go the other way

21

Meds for opiate use disorder

-methadone: opioid sub... no ceiling...
-naltrexone
-buprenorphine: ceiling effect

22

Neuroadaptation for amphetamines

-inhibit reuptake of DA, NE, SE.... greatest effect on DA
-all 3 of them have similar structures.... so we call them monamines sometimes

23

What enzyme metabolizes tobacco?

-CYP1A2

24

Neuroadaptation for tobacco?

-nAChR on DA neurons in VTA release DA in nAC

25

Meds for tobacco use

-bupropion
-varenicline

26

MDMA

-ectsasy
-enhanced empathy, personal insight, euphoria, increased energy
-tolerance develops really quickly

27

Neuroadaptation for MDMA

-affects 5HT, DA, NE, but predominantly 5HT2 receptor agonists

28

Psychosis from MDMA

-Hallucinations generally mild
-paranoia

29

PCP

-angel dust
-severe dissociative reactions, paranoid delusions, hallucinations, can become very agitated/violent with decreased awareness of pain
-cerebellar sx: ataxia, dyarthria, nystagmus*********** this one is important
-they will have superhuman strength**

30

Tx for PCP

-antipsychotic drugs or BZD if required
-low stimulation environment
-acidify urine if severe toxicity/coma