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IM 6 Test 2 > Substance Use Disorder > Flashcards

Substance Use Disorder Flashcards

(77 cards)

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1
Q

goals of substance use treatment X4

A

recognition of acute toxicity

facilitation of withdrawal

dx and tx of complications

education/counseling/therapy

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2
Q

CNS Depressants X3

A

alcohol
barbiturates
benzos

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3
Q

Opiates X9

A 
oxycodone
fentanyl
heorin
meperidine
morphine
codeine
methadone
hydromorphone
opium
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4
Q

CNS Stimulants X3

A

cocaine/crack
amphetamines
methamphetamines

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5
Q

Club drugs X4

A

ectasy
GBH
ketamine
rohypnol

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6
Q

Hallucinogens X2

A

PCP

LSD

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7
Q

abuse

A

habitual use of a substance which falls outside of medical necessity or societal acceptance

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8
Q

addiction

A

chronic, relapsing disease characterized by compulsive substance seeking behaviors

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9
Q

psychological risk factors

A 
low frustration levels
poor impulse control
lack of meaningful
relationships
childhood trauma
low self-esteem
propensity for risk taking behaviors
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10
Q

societal considerations

A

peer influences

family acceptance

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11
Q

gender influences on substance use

A

men at greater risk

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12
Q

genetic

A

member of family in which SUD prevalent

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13
Q

brain reward system

A

reinforcement of behaviors and production of memories/limbic system

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14
Q

neurobiology and neurotransmitters

A

substances of abuse affect neurotransmitters - varies by specific drug

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15
Q

genetic risk for substance disorder

A

increased risk associated with genetic links

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16
Q

Acute MOA of Alcohol

A

binding with GABA receptor and glutamate receptors - activates the reward circuit

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17
Q

how does alcohol act as a diuretic

A

inhibits the release of ADH

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18
Q

heavy or at risk alcohol use in men

A

> 4 drinks on one day or more than 14 in one week

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19
Q

heavy or at risk alcohol use in women

A

> 3 drinks on one day or more than 7 in one week

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20
Q

breast feeding moms and alcohol

A

bBAC of mom is the same as in breast mil

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21
Q

high BAL with few symptoms =

A

high tolerance

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22
Q

early signs of alcohol withdrawal

A

sweating
tremors
elevated BP

peaks within 24 to 48 hours

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23
Q

when does alcohol withdrawal go away

A

rapidly and dramatically disappears unless it progresses to delirum

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24
Q

when are grand mal seizures possible in alcohol withdrawal

A

7-48 hours after cessatoin

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25
withdrawal delirium
medical emergency d/t possible fatality ``` autonomic hyperactivity perceptual disturbances fluctuation LOC paranoid delusions fever ```
26
when does alcohol withdrawal delirium peak
2-3 days after cessation and reduction`
27
sedatives used in alcohol withdrawal
benzos diazepam chlordiazepoxide
28
meds used for seizure control in alcohol withdrawal
carbamazepine magnesium sulfate thiamine
29
alleviation of ANS symptoms in alcohol withdrawal
betablockers | clonidine
30
CIWA-AR
max of 67 | lower than 10 do not require treatment
31
wernicke's encephalopathy
d/t chronic alcohol use inflammatory henorrhagic degenerative condition of the brain caused by thamine deficiency from poor diet
32
how is wernicke's encephalopathy treated
thiamine
33
if untreated, wernicke's encephalopathy leads to
korsakoff's psychosis
34
korsakoff's psycosis
irreversible form of amnesia characterized by: short-term memory loss/long term memory gaps inability to learn
35
drugs used to maintain alcohol sobriety X4
naltrexone acamprosate disulfiram gabapentin
36
how does naltrexone stop alcoholism
blocks feel good results
37
how does acamprostate stop alcoholism
blocks s/s of withdrawal
38
how does disulfram stop alchoolism
makes you sick when drinking
39
benzo toxicity
``` severe confusion drowsiness lack of coordination/balance lighteheadedness muscle weakness fainting memory loss ```
40
what does a benzo OD usually occur with
usually occurs with cross use of alcohol opiates TCAs CNS depressants
41
benzo withdrawal
body pain, muscle tension, cramping, vomiting, sweating, seizures
42
benzo reversal agent
flumazenil
43
opioid intoxication
``` constricte dpupils decreased RR sedation hypotension intially euphoric - progresses to dysphoria ```
44
opioid toxicity
triad symptoms leads to death d/t shock, seizures, cardiac arrest
45
withdrawal opioids
yawning, insomnia, irritabilty, rhinorrhea, panic, increased BP and HR BONE PAIN
46
what are triad symptoms
pinpoint puils decreased RR coma
47
opioid toxicity treatement
AIRWAY oxygenation naloxone - short acting - multiple doses nalmefene - longer acting
48
why is heroin so addictive
high lipid solubility - crosses BBB easily to convert to active form (morphine)
49
how fast does heroin take place
IV 7-8 seconds | smoked/snorted - 10-15 minurwa
50
Oxycodone OD risk
if no tolerance has been developed - OD risk is higher
51
meperidine use
effective when taken orally no obvious signs of IV drug use
52
meperidine pupil response
less pupillary constriction than other opioids
53
meperidine effects on smooth muscle
minimal effects on smooth muscle less constipation and urinary retention
54
treatment for opioid sobriety X3 meds
methodone buprenorphine naltrexone
55
methodone interventions opioids
daily clinic visits | decreasing doses
56
buprenorphine maintenance opioids dose route
SL tabs or film used once daily
57
naltrexone is used for
maintenance after opioid detox
58
cocaine intoxication
``` euphoria dilated pupils elevated BP and HR grandiosity altered judgment ```
59
cocaine use in preganncy
``` preemie small head decreased BW LBW ADD/ADHD memory/language development ```
60
methamphetamine intoxication
delusions of increased strength and mental capacity littel need for sleep/food talkative
61
meth withdrawal
strong cravings, dysphoria, depression lasting for months
62
meth overdose
cerebral and systemic vasculitis
63
what does meth induced psychosis mimic
paranoid schizophrenia
64
meds for meth treatment
none FDA approved bupropion and modafinil used ibudilast is in clinical trials
65
matrix model meth tx
CBT/group therapy family edu drug testing non-drug related activities
66
Ecstasy intoxication
muscle cramping involuntary teeth clenching feelings of trust and love
67
ecstasy AE
hyperthermia memory impairment CV stimulation - HTN
68
ketamine intoxication
dreamlike state hallucinations sedation
69
ketamine long term effects
``` bladder pain/ulcers kidney problems stomach pain depression poor memory ```
70
bath salts intoxication
extreme agitation and violent behavior | increased HR and BP
71
X2 date rape drugs
GHB | flunitrazepam
72
LSD intoxication
pupil dilation | synesthesi
73
LSD OD
``` psychosis CVA Resp arrest sz HTN crisis ```
74
LSD tx
acidify urine to hasten excretion | diazepam/haloperidol
75
PCP intoxication
``` hallucinations bizzare behavior violence sz elevated vitals muscle rigidity ```
76
PCP toxicity
``` hallucinations HTN coma Seizures depressed respirations ```
77
X2 inhalents
nitrous oxide and ether

IM 6 Test 2 (5 decks)

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