Substance Use Disorders Flashcards Preview

Mo-Neuro 4 > Substance Use Disorders > Flashcards

Flashcards in Substance Use Disorders Deck (30):
1


Continued substance use despite _________ caused or exacerbated by the effects of the substance.

having persistent or recurrent social or interpersonal problems

2

Withdrawal, as manifested by experiencing the characteristic withdrawal syndrome or the substance is used to relieve or avoid ________________

withdrawal symptoms.

3

Tolerance, as defined by either of the following:

(a) A need for markedly increased amounts of substance to achieve intoxication or desired effect. (b) Markedly diminished effect with continued use of the same amount of the substance.

4

Substance use is continued despite____________ that is likely to have been caused or exacerbated by substance use.

knowledge of having a persistent or recurrent physical or psychological problem

5

8. Recurrent substance use in situations in which it is

physically hazardous.

6

Substance is often taken in larger amounts or over a longer period than was ________

intended

7

There is a ___________ to cut down or control substance use

persistent desire or unsuccessful efforts

8

A great deal of time is spent in activities necessary to?

obtain or use the substance or recover from its effects

Definition of substance use disorders (SUD).

9

_________ to use the substance.

Definition of substance use disorders (SUD).

Craving, or a strong desire or urge

10

Recurrent substance use resulting in a failure to fulfill : __________

major role obligations at work, school or home.

11

_________________ are given up or reduced because of substance use.

Important social, occupational, or recreational activities

12

Important to substance abuse disorders

Cortically regulated cognitive and emotional processes, which result in the overvaluing of drug reinforcers, the undervaluing of alternative reinforcers, and decifits in inhibitory control

13

AUDIT

screening for substance abuse

14

At-risk drinking

Men ≥ 5 standard drinks in a day or > 14 per week

Women ≥ 4 in a day or > 7 per week

This level of drinking are asc. with bad health outcomes

15

Alcohol withdrawal

Autonomic hyperactivity (e.g., sweating or pulse >100 bpm)
Increased hand tremor

Nausea or vomitting

Transient visual, tactile, or auditory hallucinations or illusions

Psychomotor agitation
Anxiety

Generalized tonic-clonic seizures.

* generally opposite of etoh use

rx: benzo

16

Opioid withdrawal

Dysphoric mood

Nausea/vomiting

Muscle aches

Lacrimation or rhinorrhea

Pupillary dilation, piloerection or sweating

Diarrhea

Yawning

Fever

Insomnia

17

Alcohol meds

Antabuse (disulfiram)

18

Going cold turkey

term comes from opioid withdrawal- goose bumps

19

Antabuse/disulfiram reaction

Flushing
Headache
Nausea
Dizziness
Tachycardia

20

meds can only help w/ 3 classes

etoh
opioids
nicotine

21

Antabuse Side effects/complications

Metallic taste
Headaches
Drowsiness or fatigue
Optic neuritis
Peripheral neuropathy
Hepatitis
Rash
A few cases of psychotic symptoms (i.e. metronidazole)

22

You should maybe do what test for antabuse?

Liver enzyme

23

Reasons to not do anabuse

Some Contraindications
Risk for MI
Risk for CVA
Cognitive dysfunction (can’t understand or remember what will happen if drinks)

Pregnancy category C/breast feeding safety unknown

24

Revia and Vivitrol (naltrexone)

Pure opioid antagonist
Blocks μ opioid receptors

25

Naltrexone Why might it work

μ agonists ↑ dopamine release in Nucleus Accumbens
μ agonists ↑drinking in rats

Opioid antagonists reduce alcohol consumption in rats

Alcohol dependent people may have low baseline beta-endorphin levels (stress response)

Alcohol consumption ↑endorphin in those with family history of alcoholism

Naltrexone blocks euphoria from alcohol

beware opiot or herion comorbid

26

Naltrexone

moderate effect size on etoh quitting

can be a depot injection aka vivatrol

27

Naltrexone Some side effects/complications:

Nausea (10%)
Headaches (7%)
Anxiety (2%)
Sedation (2%)
Hepatic failure (rare)

28

Naltrexone Interactions

↓Benefit from opioid analgesics
↓Benefit from some antidiarrheal
↓Benefit from opioid containing cough medicines

29

Campral (acamprosate)

Structurally resembles GABA
Enhances GABA transmission
Interferes with Glutamate transmission
Reduces CNS hyperexcitability

30

Some side effects/complications:
Campral (acamprosate)

Diarrhea (10-17%)
Anxiety (5-8%)
Depression (4-8%)
Insomnia (6-9%)
Suicidality (1.4% vs. 0.5%)