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Psychiatry > Substance Use Disorder > Flashcards

Substance Use Disorder Flashcards

1
Q

drugs and alcohol stimulate what system & pathway?

A

dopamine system in the brain & mesolimbic pathway

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2
Q

what receptor is deficient in px with substnce use disorders?

A

DRD2

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3
Q

what brain structures are affected by substance use & its function?

A

mesolimbic = pearlure a receptio
mesocortical = judgement and decision making
hippocampus = learning & memory
prefrontal cortex = behavior control

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4
Q

what brain structures are affected by substance use & its function?

A

mesolimbic = pearlure a receptio
mesocortical = judgement and decision making
hippocampus = learning & memory
prefrontal cortex = behavior control

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5
Q

what are criteria of dubstance use disorder

A

impaired control
social impariment
recurent use
tolerance & wasti

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6
Q

what are the categories of criteria of SA?

A

mild = 2-3
moderate 4-5
severe 6+

timefram :1ye

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7
Q

what is the diff betw bing-drinking and heavy-used drinking?

A

Bing-dringing: 5 drinks in a short period of time
heavy

heavy-use drinking: 5 drinks in the same occassion >5x in a month

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8
Q

what is the alcohol content in beer, wine, and liquor?

A

12 oz glass of bear (355mL)
5ox glass of wine (148mL)
1.5ox of hard liquor 44mL

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9
Q

what are the neurochemical effects of alcohol to the brain?

A

pleasure = INC Serotonin & dopamine
Tension reduction = stimulation of GABA
cognitive slowing = Glutamate inhibition

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10
Q

what is the primary excitatory neurotransmitter of the brain?

A

Glutamate

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11
Q

if there is less GABA, what is its effect to GABA?

A

less Glutamate -> More of GABA

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12
Q

what are signs of alcohol intoxication?

A

slurred speech
incoordinatoin
nystagmus
impaired memory => in Ernicke-Korsakoff synd
Stupor
Coma

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13
Q

what are the Qs in CAGE questionnaire?

A

C: effotrs to CUT down?
A: Anger when being confronted with alcohol use
G: Guilt about alcohol consumption
E: Eye-opener

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14
Q

what is the scoring in CAGE questionnaire?

A
  • yes to 2 or more = HIGH likelihood for alcohol use disorder
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15
Q

what are signs & symptoms of alcohol withdrawal?

A

tremors
psychotic symptoms
seizures
deleirium tremens

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16
Q

out of all the s/sx of alcohol withdrawal, which one is the longest & shortest?

A

derium - longest
tremors - shortest

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17
Q

what are conditions predisposing to increased severity of withdrawal?

A

sustained alcohol use
malnutrition/physical illness
comorbid psychiatric conditions

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18
Q

when does delirium commonly begin in alcohol withdrawal?

A

after 5-15 yrs of heay drinking

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19
Q

when is delirium considered a medical emergency?

A

if it comes with seizures

20
Q

what are 3 alcohol-related disorders?

A

Wernicke’s Encephalopathy
Korsakoff syndrome
Wernicke’s Korsakoff syndrome

21
Q

what alcohol related disorder is a combination of Wernicke’s encephalopathy & Korsakoff syndrome?

A

Wernicke’s Korsakoff syndrome

22
Q

what alcohol-related disorder is an acute disorder characterized by ataxia, vestibular dysfunction, confusion and ocular motility abnormalities?

A

Wenicke’s encephalopathy

23
Q

What is the tx for Wernicke’s encephalopathy?

A

replacement of vitamin B (if not it can progress to Korsakoff syndrome)

24
Q

what alcohol-related diosrder manifests with impaired mental abilities & anterograde amnesia in an alert &responsive px?

A

Korsakoff syndrome

25
Q

what is the addiciting agent of tobacco?

A

nicotine

26
Q

what does nicotine do to the body?

A

stimualtes dopamine neurons & INC cerebral blood flow

27
Q

what is the common use for of Marijuana?

A

pain control

28
Q

what are addictive sedatives that relieve pain and induce sleep?

A

opiates

29
Q

what are the different derivatives of opiates?

A

opium
morphine
heroin
hydrocodone/oxycodone

30
Q

why are opiates highly addicitng?

A

INC pleasure

31
Q

how do Opiates affect the body?

A

stimulate neural receptors of the body’s own opioid system -> release of endorphins & enkephalins

32
Q

what are the diff stimulants that can lead to being abused?

A

amphetamines
cocaine

33
Q

what was the use of Amphetamines?

A

relieve stuffy noses, control appetite, treat mild depression

34
Q

what are the 2 mechanisms that flood the synapse?

A
  1. forcing vesicular release of NRE, dopamine & serotonin
  2. blocking the reuptake of NRE & dopamine
35
Q

what is aka “crystal meth, ice, or shabu”, a derivative of amphetamine?

A

methampetamine

36
Q

what can chronic use of Methamphetamine lead to?

A

brain damage

37
Q

what are psychological effects of Amphetamine?

A

Incerased alertness
INC sociability
euphoria
inc energy & self-confidence
Agitation, confusion & paranoia

38
Q

what are physiological effects of amphetamine?

A

heightened wakefulness
reduced appetite
incerased heart rate
hypertension
insmonia
headache

39
Q

What stimulant has been used as a mild stimulant bcos of its local anesthesthetic and vasoconstrictor action?

A

Cocain

40
Q

What is the MOA of Cocaine?

A

Blocks reuptake of dopamine in mesolimbic areas -> pleasurable states

41
Q

What are the effects of Cocaine?

A

INC sexual desire
Feelings of self-confideence
DEC fatigue

42
Q

Overdose of cocaine can lead ot?

A
  • Sympethetic nervou sytem activation
  • chills, insomnia
  • paranoia & tactile hallucinations - formicatoin
  • malignant HTN, MI, stroke
  • Formication = psychotic phenomenon
43
Q

What happens in formication?

A

Hallucinations in a tactile sense
- inteased of hearing voices, seeing things, feeling insects under the skin

44
Q

What hallucinogen produces a subjective expansion of consciousness & hallucinations?

A

LSD

45
Q

What is a synthetic hallucinogen that contains compounds of both the hallucinogen & amphetamine families?

A

Ectasy (MDA + MDMA)

46
Q

What psychiatric condition is MDMA used for?

A

PTSD

Psychiatry (5 decks)

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