Substancea buse 2 Flashcards
(151 cards)
1
Q
What are the “5 C’s” of addiction?
A
Chronicity
Impaired control over drug use
Compulsive use
Continued use despite harm
Craving
2
Q
Ability of a second drug of the same class (similar MOA) to maintain the dependence of an original drug
A
Cross-dependence
3
Q
Pharmacological treatment is always necessary for withdrawal from these two types of substances, since it can be life threatening
A
Alcohol and depressants
4
Q
Subjective need or compulsion to use the drug in order to maintain a feeling of well being
May be present even in the absence of physical dependence
A
Psychological dependence
5
Q
This intoxication sign is common to most drugs with the sole exception of nicotine
A
Euphoria
6
Q
Euphoria is common to most drugs with the sole exception of this
A
Nicotine
7
Q
All used substances appear to activate the same reward pathway with this as the final common neurotransmitter
A
Dopamine
8
Q
Increased response to repeated and intermittent administration of the drug
A
Sensitization
9
Q
These three enzymes metabolize alcohol
A
Alcohol and aldehyde dehydrogenase
Catalase
Alcohol oxidase (CYP)
10
Q
This enzyme converts alcohol to aldehyde
A
Alcohol dehydrogenase
11
Q
Is alcohol dehydrogenase zero or first oder?
A
Zero order
12
Q
This enzyme is the primary route for alcohol metabolism
A
Alcohol dehydrogenase
13
Q
Is alcohol dehydrogenase inducible?
A
No
14
Q
Are alcohol oxidase and catalase zero or first oder?
A
First
15
Q
Are alcohol oxidase and catalase induced?
A
Yes (by ethanol and other drugs)
16
Q
This enzyme converts acetaldehyde to acetic acid
A
Aldehyde dehydrogenase
17
Q
This enzyme is the point of “disulfiram-like” inhibition
A
Aldehyde dehydrogenase
18
Q
Is ethanol withdrawal serious?
A
Yes - potentially lethal
19
Q
1-2 days after start of withdrawal from ethanol, these appear and increase in intensity, may be life threatening
A
Convulsions
20
Q
Early signs (within one day) of withdrawal from this substance include vivid dreams, insomnia, tachycardia, and hypertension
A
Ethanol
21
Q
Visual hallucinations may occur anytime after the start of withdrawal from this substance
A
Alcohol
22
Q
This symptom of ethanol withdrawal may occur anytime after the start of withdrawal
A
Visual hallucinations
23
Q
1-2 days after start of withdrawal from this substance, convulsions appear and increase in intensity, may be life threatening
A
Ethanol
24
Q
About 3 days after start of withdrawal from this substance, delirium tremens appear
A
Ethanol
25
About 3 days after start of withdrawal from ethanol, this symptom appears
Can include tremors, delirium, confusion, and sympathetic overdrive leading to cardiovascular instability and death
Delirium tremens
26
Delirium tremens is associated with withdrawal from this substance
Ethanol
27
Uncomplicated withdrawal from alcohol is treated with this
Benzodiazepines
28
Alcohol related seizures (complicated withdrawal) is a medical emergency and is treated also with this drug, but in an intensive care setting
Benzodiazepines
29
Seizures generally present after this much time of alcohol withdrawal
At the end of the first day
30
Delirium tremens usually occurs this much time after cessation of alcohol
48-72 hours
31
This symptom of alcohol withdrawal is a medial emergency, and involves autonomic hyperactivity, disorientation, visual or tactile hallucinations
Fluctuate from lethargic to agitated
Delirium tremens
32
This drug for alcohol craving reduction is administered oral or by extended-release injection
Naltrexone
33
This drug for alcohol craving reduction is a competitive mu-opiate receptor antagonist that reduces drug cravings
Naltrexone
34
Naltrexone is a competitive antagonist of this receptor
Mu-opiate receptor
35
Is naltrexone an agonist or antagonist of the mu-opiate receptor?
Antagonist
36
This drug for alcohol craving reduction appears weak at preventing a lapse, but better at preventing a lapse from becoming a relapse
Naltrexone
37
This drug for alcohol craving reduction is a GABAergic agonist that modulates alcohol cravings
Acamprosate
38
This drug for alcohol craving reduction appears good at preventing a lapse
Acamprosate
39
Is Naltrexone or Acamprosate better at preventing a lapse of alcohol use?
Acamprosate
(naltrexone is better at preventing a lapse from becoming a relapse)
40
Acamprosate is an agonist of this
GABA
41
Is acamprosate an agonist or antagonist of GABA?
Agonist
42
This drug is used as aversive therapy for ethanol
Disulfiram
43
Disulfiram inhibits this enzyme
Aldehyde dehydrogenase
44
This drug is reserved for the motivated ethanol abstinent patient that fears relapse
Disulfiram
45
Use of disulfiram results in the buildup of this compound, which makes the user sick after alcohol
Acetaldehyde
46
Do cross tolerance and cross dependence occur with depressants?
Yes
47
Does tolerance to depressants develop slowly or rapidly?
Slowly
48
Tolerance of depressants to this symptom is slow to develop and has a ceiling
Respiratory depression
49
Tolerance to respiratory depression is slow to develop and has a ceiling with these substances
Depressants
50
Does alcohol or benzoes have a shorter half life?
Alcohol
(so symptom of abstinence syndrome develop earlier)
51
Is withdrawal from depressants serious?
Yes - potentially life threatening
(regardless of half life)
52
Withdrawal from this type of depressant has the highest mortality rate
Barbiturate
53
How is depressant withdrawal treated?
1. establish a stabilizing dose of the drug
2. begin a slow taper process
54
Pinpoint pupils, respiratory depression, and constipation are signs of intoxication with this type of substance
Opioid
55
Is withdrawal from opioids serious?
Rarely life threatening
Hypertension, racing heart, and loss of electrolytes (vomiting and diarrhea) may be complications
56
Withdrawal from this type of substance is rarely life-threatening but hypertension, racing heart and loss of electrolytes (vomiting and diarrhea) may be complicating factors
Opioids
57
If decision is made to relieve symptoms of opioid withdrawal with opiate replacement, either of these 2 drugs are recommended
Methadone
Buprenorphine
58
Methadone and Buprenorphine are recommended to relieve symptoms of withdrawal from this type of substance
Opioids
59
This drug can be used to treat the hypersympathetic activity of opioid withdrawal
Clonidine
60
Clonidine can be used to treat the hypersympathetic activity of withdrawal from this type of substance
Opioids
61
Clonidine can be used to treat this activity that occurs with opioid withdrawal
Hypersympathetic
62
Buprenorphine-Naloxone combinations are used for this
Opioid dependence maintenance
63
Combinations of these two drugs are used for opioid dependence maintenance
Buprenorphine-Naloxone
64
This drug is used for aversive therapy from opiates
Naltrexone
65
This drug blocks opiate activity, preventing any desirable effects of opiates
Requires an abstaining opiate user motivated to stay opiate-free but fears relapse
Naltrexone
66
Naltrexone is used as aversive therapy from this type of substance
Opiates
67
D-isomer of opiate normally used as antitussive
Dextromethorphan
68
Dextromethorphan is used to treat this
Cough
Is antitussive
69
This drug is the antidote to Dextromethorphan
(especially higher dose effects)
Naloxone
70
Intoxication with this antitussive is achieved by large oral doses
High dose: Hyperexcitability, lethargy, ataxia, slurred speech, diaphoresis, hypertension, nystagmus, mydriasis
Higher dose: Dissociative anesthetic-like sensations
Dextromethorphan
71
This is a partial nicotine agonist
Has been noted to increase the risk of seizures, and risk is increased when combined with bupropion
Varenicline
72
Varenicline is a partial agonist to this
Nicotine
73
Varenicline has an increased risk of this, and the risk is increased when combined with bupropion
Seizures
74
Varenicline increases the risk of seizures, and this risk is increased when combined with this drug
Bupropion
75
Bupropion decreases drug craving, drug reward, and withdrawal symptoms of this type of substance
Nicotine
76
This is the most widely consumed behaviorally active substance
Caffeine
77
Peripheral actions of caffeine includes inhibition of this type of enzyme
PDEs
(results in sustained levels of cAMP and cGMP)
78
Central actions of caffeine involve antagonism of these two compounds
Adenosine and GABA-inhibitory action
79
Does caffeine dilate or constrict coronary vessels?
Dilates
80
Does caffeine dilate or constrict cerebral vessels?
Constricts
81
Does caffeine relax or stimulate smooth muscle?
Relax
82
Does caffeine relax or stimulate skeletal muscle?
Stimulate
83
In coronary insufficiency, what effect does caffeine have on cardiac function?
Cardiac depressant
(is usually a cardiac stimulant)
84
In coronary insufficiency, what effect does caffeine have on coronary vessels?
Constricts
(usually dilates)
85
Caffeine actions in a patient with this condition may be reversed of what is normal
(cardiac depressant, coronary vessel constrictor)
Coronary insufficiency
86
What is the half-life of cocaine?
1 hour
87
What is the half-life of amphetamine?
12 hours
88
cocaine is this type of substance
Stimulant
89
Amphetamine is this type of substance
Stimulant
90
This pattern of misuse of stimulants is an intense pleasure as drug is administered
Rush
91
This pattern of misuse of stimulants is periods of intense drug use, also called binge
Run
92
This pattern of misuse of stimulants is the end of a run, characterized by prolonged sleep, depression, hunger and weakness
Crash
93
Rush, run, and crash are patterns of misuse of this type of substance
Stimulants
94
Withdrawal from this type of substance begins shortly after last dose with increased drug cravings, intense dysphoria, depression, anxiety and agitation
Stimulants
95
Within a day or so of withdrawal from this type of substance, hypersomnia, increased appetite, and cravings vary in intensity
Stimulants
96
Within a day or so of withdrawal from stimulants, does insomnia or hypersomnia occur?
Hypersomnia
97
Within a day or so of withdrawal from stimulants, is appetite increased or decreased?
Increased
98
In withdrawal from this type of substance, patients without depression or suicidal tendencies can be treated outpatient
Stimulants
99
Cocaine is metabolized to this compound in the presence of alcohol
Cocaethylene
(a longer acting psychoactive compound; has a higher risk of death)
100
Cocaine is metabolized to cocaethylene in the presence of this
Alcohol
101
This is metabolized to cocaethylene in the presence of ethanol
Cocaine
102
This stimulant produces profoundly positive feelings (empathy, relief of anxiety, extreme relaxation) at recreational doses
Ecstasy
103
This type of cannabinoid receptor is found in CNS; mediates the rewarding properties of cannabinoids
CB1
104
This type of cannabinoid receptor is prominent in the immune system
CB2
105
These are homologs of marijuana produced in the brain
Endocannabinoids
106
Marijuana is derived from this
Cannabis sativa
107
This active ingredient of Cannabis stimulates appetite and reduces nausea
9-Tetrahydrocannabinol (THC)
108
This active ingredient of Cannabis is used for reducing pain and inflammation, and controlling epileptic seizures
Non-psychoactive
Cannabidiol
109
Is 9-Tetrahydrocannabinol (THC) or Cannabidiol a psychoactive component of Cannabis?
THC
110
What effect does cannabis have on heart rate and BP?
Mild increase
111
In heavy users of this substance, amotivational syndrome of apathy, dullness, impaired judgement, decreased concentration and memory, loss of interest in personal hygiene, and a general reduction of goal-directed behavior may occur
Cannabis
112
A hyperesmesis syndrome may occur in current, heavy users of this substance
Abdominal pain, epigastric or periumbilical
Recurrent episodes of severe nausea and intractable vomiting
Resolution of symptoms with cessation
Cannabis
113
Do hallucinogens change mood and thought patterns?
Generally yes
114
Do hallucinogens cause constricted or dilated pupils?
Dilated
115
Cross-over sensory patterns (hear sights, smell sounds, etc) may occur with higher doses of this type of substance
Hallucinogen
116
Powerful hallucinatory drugs (such as LSD) can trigger this
Most typically observed in recurrent users or have underlying personality disorders
Flashbacks
117
Are hallucinogens considered addictive?
No
118
Phencyclidine (PCP) is this type of substance
Hallucinogen
119
Phencyclidine (PCP) is a dissociative anesthetic chemically related in action to this compound
Ketamine
120
This is a dissociative anesthetic chemically related in action to ketamine
Phencyclidine (PCP)
121
This drug provides feelings of detachment from environment and self
Often used as a spike for another drug
Phencyclidine (PCP)
122
Chronic effects of this drug include flashbacks, persistent speech problems, social withdrawal and isolation, toxic psychosis
Phencyclidine (PCP)
123
Rash/irritation around mouth and nose, Red, glassy, watery eyes, Excitability and unpredictable behavior and Odor on clothes, skin and breath are signs of use of this type of substance
Inhalants
124
Chronic use outcomes of this type of substance include cardiac arrhythmias, liver and kidney damage, cancer, and gateway use to other drugs of misuse
Inhalants
125
In general approach to substance use disorder, is pharmacological treatments or psychosocial therapy primary?
Psychosocial therapy
(Pharmacological treatments are secondary to psychosocial therapy)
126
What are the five stages of change in substance use disorder?
Precontemplation
Contemplation
Preparation
Action
Maintenance
127
A person with no intent to change and sees positive aspects of behavior rather than negative, may be in this stage of change
Precontemplation
128
A person who is willing to consider changing, and is mostly ambivalent and becomes quickly resistant or defensive, may be in this stage of change
Contemplation
129
This drug is the first-line for alcohol withdrawal prevention
Benzos
130
This drug reduces alcohol cravings but should not be used in patients taking opioids
Naltrexone
131
Naltrexone reduces alcohol cravings, but should not be used in patients taking these drugs
Opioids
132
This drug for alcohol use disorder is safe in liver disease but avoided in renal failure
Acamprosate
133
Acamprosate is avoided in patients with this organ failure
renal
134
This drug is short acting and given for opioid overdose
Naloxone
135
This drug is given in controlled settings for opioid use disorder, and is a long-acting full opioid agonist
Methadone
136
This drug is a partial opioid agonist with a ceiling effect (less respiratory depression)
Buprenorphine
137
Is methadone a partial or full opioid agonist?
Full
(prevents withdrawal; long half life)
138
Is Buprenorphine a partial or full opioid agonist?
Partial
(reduces cravings)
139
Is Buprenorphine a partial or full opioid agonist?
Partial
140
Suboxone is a combination of these two drugs, and is discourages misuse of opioids
Blocks euphoric effects if injected
Buprenorphine + Naloxone
141
This drug used for opioid withdrawal has adverse effects of respiratory depression and QT prolongation
Methadone
142
What is the first line treatment for stimulant use disorder?
Supportive therapy
*No FDA approved medications
143
Agitation in stimulant use disorder should be managed with this drug
Benzos
144
This type of drug should be avoided in acute cocaine intoxication due to unopposed alpha-adrenergic vasoconstriction
Beta blockers
145
What is the first line treatment for cannabis use disorder?
Supportive therapy
*No FDA approved medications
146
In treatment of withdrawal from this type of substance, gradual taper is key
Benzodiazepine
147
Benzodiazepine withdrawal is similar to withdrawal from this substance
Alcohol
148
Opioid overdose should be treated with this drug
Naloxone
149
Opioid maintenance therapy should involve either of these 2 drugs
Methadone
Buprenorphine
150
Is withdrawal from stimulants life threatening?
No
(treat with CBT)
151
Are there FDA-approved treatments for stimulant, cannabis, or benzodiazepine use disorders?
No
