Substance Use Disorders Flashcards Preview

EOR Exam - Behavioral Medicine > Substance Use Disorders > Flashcards

Flashcards in Substance Use Disorders Deck (42)
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1

What are the three most commonly abused drugs?

Alcohol, nicotine, caffiene

2

Give a general definition of substance use disorder.

Inappropriate use of a substance with 2 or more maladaptive behaviors that result in impairment.

3

Describe the maladaptive behaviors associated with substance use disorder.

Use to prevent/avoid difficult circumstances, anxiety, anger, withdrawal, self-harm, continued use despite awareness of adverse effects, cravings, etc.

4

Define tolerance and withdrawal.

Tol: Decreased affect over time with same amount of substance.
With: Symptoms related to sudden cessation of substance use.

5

What S/S are associated with chronic AUD?

acne, rosacea, palmar erythema, hepatomegaly, dupuytren contracture, testicular atrophy, gynecomastia

6

What is dupuytren contracture?

An abnormal thickening of the skin in the palm of your hand at the base of your fingers which can cause one or more fingers to curl over time.

7

What serum lab changes are associated with AUD?

elevated --> GGT (early), AST, ALT, LDH, MCV
decreased --> BUN, LDL, red cell volume

8

Describe the progression of severe alcohol withdrawal over a 4 day period.

12-24h: irritable, diaphoretic, tachycardia, insomnia, tremor, autonomic hyperreactivity
24-48h: seizure risk
48-96h: DTs, disorientation, agitation, hyperthermia

9

What are S/S of delirium tremens?

Fever, tachycardia, HTN, anxiety, irritability, tremors, decreased seizure threshold, AVH.

10

What is the treatment for DTs?

Emergent: BZDs, anti-psychotics
Supplement PRN: glucose, thiamine, fluids

11

What is the treatment for AUD?

Non-pharm: education, coping skills, family therapy, psychotherapy, AA
Pharm: disulfiram (antabuse), naltrexone

12

What is the concern with use of disulfiram?

Any intake of alcohol while on the medication causes severe nausea and illness.

13

What is the MOA of cannabis products?

Delta-9-Tetrahydrocannabinol (THC) is a partial agonist at cannabinoid 1 & 2 receptors. C-1 receptors are found in the brain's dopamine reward system.

14

What determines the potency of a cannabis product?

Ratio of THC to cannabidiol in the substance. Cannabidiol inhibits the effects of THC.

15

What are the S/S associated with cannabis intoxication?

disconnected speech, recent memory impairment, emotional lability, confusion, tachycardia, decreased body temp, depersonalization.

16

Define emotionally labile.

Emotions easy to arouse and that tend to alter quickly and spontaneously --> emotionally unstable

17

Define depersonzalization.

The feeling of observing oneself from outside the body.

18

Describe adverse effects from cannabis use disorder.

Panic, psychosis, depression (rare), amotivational syndrome. Psychosis is more common at higher potency (eastern cultures)

19

Describe withdrawal syndrome associated with cannabis use disorder.

Medication typically not required. S/S include malaise, irritability, insomnia, diaphoresis, night sweats, GI disturbance. Anxiolytics may be used to manage S/S.

20

How long after use is THC detectable in urine?

1 month

21

List some examples of hallucinogenic substances.

Psilocybin, mescaline (peyote), LSD, PCP

22

What is the classic presentation of PCP intoxication?

Violent or bizarre behavior, horizontal and vertical nystagmus, disorientation, auditory hallucinations.

23

What is the first line treatment for severe PCP intoxication?

BZDs

24

What medications should be avoided in management of hallucinogenic intoxication?

Anti-psychotics --> adverse Ach reaction from hallucinogenic + antipsychotic

25

T/F: Addiction risk is high with abuse of inhalants.

False: addiction is possible but unlikely

26

What is the cardinal S/S associated with inhalation of a solvent and what is it caused by?

Erythematous rash around the mouth --> contact dermatitis.

27

What are the long term effects of inhalant use?

Damage to kidney, liver, nerve fibers, and brain cells.

28

What are the S/S of opioid intoxication?

Respiratory depression, CNS depression, miosis

29

What are the S/S of opioid withdrawal?

Severe discomfort but not life threatening --> tachypnea, tachycardia, HTN, N/V/D, mydriasis, lacrimation.

30

What is used in treatment of opioid withdrawal?

Clonidine

31

What medications are used for ongoing maintenance in the management of opioid use disorder?

Methadone, naltrexone, buprenorphine, suboxone (buprenorphine + naloxone)

32

What medication is used in the management of opioid overdose?

Naloxone

33

What are the S/S BZD intoxication and overdose?

Intox: mimic alcohol intoxication
OD: coma, respiratory depression, hypotension

34

What is used in the management of BZD overdose?

Flumazenil if no risk of seizure
Gastric lavage if within 12 hours since ingestion, alkalinize urine, respiratory and vasopressor support.

35

What are the S/S of BZD withdrawal and what is the risk?

Risk of seizures and death.
S/S: agitation, anxiety, anorexia, N/V, tachycardia, hypotension, hypereflexia, tremor, seizures, delirium.

36

What is the treatment of BZD overdose?

Long acting BZD with slow taper --> may take several weeks

37

What are the S/S of acute stimulant intoxication?

agitation, impaired judgement, euphoria, HTN, psychosis, tachycardia, mydriasis, hallucinations.

38

What are the S/S of stimulant withdrawal?

fatigue, depression, HA, dysphoria, diaphoresis, muscle cramps, hunger.

39

What is the management of stimulant intoxication/overdose?

BZDs, anti-psychotics

40

What medications should NOT be used to treat stimulant intoxication/overdose and why?

BBs --> unopposed alpha stimulation can lead to cardiovascular collapse.

41

List and describe the medications used for smoking cessation.

NRT: gum, patch, lozenge --> avoids cravings and prevents withdrawal.
Bupropion: blocks reuptake of DA and norepi --> dec seizure threshold, C/I in seizure history.
Varenciline (Chantix): partial agonist to nicotine receptors --> inc risk of SI and cardiovascular events

42

What circumstances are known to decrease the success of smoking cessation programs.

Concomitant AUD or other SUD, family history of smoking.