Flashcards in Substance Abuse Disorders Deck (30)
what is substance use disorder?
-important social, occupational, recreational activities given up or reduced
-use in hazardous situations
-use despite physical or psychological problems caused by use
What does severity depend on?
-the # of symptoms that they have
Specifiers for early remission?
-no criteria for > 3months but < 12
-no criteria for > 12 months (except craving)
-substance specific syndrome problematic behavioral change due to stopping or reducing prolonged use
-no withdrawal: PCP; other hallucinogens; inhalants
What does DA get converted into?
-so, coke addicts will come in emaciated and complaining of being tired
Why do Native Americans have a higher alcoholism?
-they can burn through alcohol faster
-more efficient Alcohol dehydrogenase
Is AA good for treatment?
-no, it is a social experience
-there is no professional leading it
What does alcohol do with NT's in our brain?
-so, we compensate by increasing Glutamate
Does alcohol withdrawal sometimes require hospitalization?
-Delerium tremens is the really bad one that is life-threatening
What is the score for CIWA that they need to indicate more severe withdrawal?
-GABA agonist.... cross tolerant with alcohol
-reduce risk of SZ; provide comfort/sedation
-reduce risk of SZand may reduce kindling
-helpful for portracted withdrawal
-carbamazepine or valproic acid
-risk thiamine deficiency (wernicke-korsakoff)
What meds will we use for alcohol t?
what kind of prevention is disulfiram doing?
Why would someone on disulfiram have rashes?
-they spray perfume on their skin... it's that powerful
Do we ever use alprazolam for withdrawal?
-too short of a time of action
Which three benzos have no metabolites associated with them?
-oxazepam, lorazepam, and temazopam or something like that
Pinpoint pupils.... what do we think of ?
-for withdrawal, their pupils go the other way
Meds for opiate use disorder
-methadone: opioid sub... no ceiling...
-buprenorphine: ceiling effect
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
What enzyme metabolizes tobacco?
Neuroadaptation for tobacco?
-nAChR on DA neurons in VTA release DA in nAC
Meds for tobacco use
-enhanced empathy, personal insight, euphoria, increased energy
-tolerance develops really quickly
Neuroadaptation for MDMA
-affects 5HT, DA, NE, but predominantly 5HT2 receptor agonists
Psychosis from MDMA
-Hallucinations generally mild
-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**