SUD

Question 1

mu agonist

Answer 1

opioids (heroin)

Question 2

GABAa channel opening duration increased

Answer 2

barbiturates

Question 3

GABAa channel opening frequency increased

Answer 3

benzodiazepines

Question 4

injection drug users at risk for (5)

Answer 4

right-sided endocarditis (Tricuspid valve)
abscesses
hepatitis
HIV
hemorrhoids

Question 5

for heroin use, look for

Answer 5

track marks (needle injections)

Question 6

opioid withdrawal is ___ fatal

Answer 6

NOT

- it is just unpleasant

Question 7

opioid withdrawal can cause what pulmonary dysfunction?

Answer 7

pulmonary edema

Question 8

Presents with: anxiety, insomnia, anorexia, sweating, dilated pupils, piloerection, fever, rhinorrhea, N/V/D

Answer 8

Opioid Withdrawal

Question 9

treatment of Opioid withdrawal (3)

Answer 9

Clonidine (α2 agonist)

Subaxone (Buprenorphine + Naloxone)

Methadone

Question 10

Subaxone (buprenorphine + naloxone) can precipitate opioid withdrawal if

Answer 10

given too soon (partial mu agonist) after intoxication
or
injected while using opioids

Question 11

naloxone is not active when taken orally, so withdrawal symptoms occur only if

Answer 11

injected

Question 12

Treatment of Barbiturate withdrawal

Answer 12

Long-acting benzodiazepines with taper
or
Long-acting barbiturates (phenobarbital)

Question 13

DO NOT treat benzodiazepine overdose in chronic Benzodiazepine users with ____
because it can cause seizures.

Answer 13

Flumazenil

*use for patients who do not have a chronic history of using benzos due to no GABA/Glutamate inbalance.

Question 14

DO NOT restrain patients overdosed on stimulants because it may result in

Answer 14

rhabdomyolysis ?????

Question 15

MDMA overdose treatment is

Answer 15

supportive for symptoms

Question 16

Pregnant women using cocaine can lead to

Answer 16

Placental Infarction (Abruption)

*vasospasm of placental vessels

Question 17

contraindicated in MI secondary to cocaine due to HTN crisis (unopposed alpha)

Answer 17

beta-blockers

Question 18

Treatment of cocaine overdose

Answer 18

Benzos

Question 19

2 treatments for smoking cessation

Answer 19

Bupropion

Varenicline (partial nicotine receptor agonism)

Question 20

PCP overdose treatment

Answer 20

Benzos

antipsychotic (2nd line)

Question 21

Intoxication presents with short lived slurred speech, disorientation, blurred vision, and possibly coma

Answer 21

Inhalant

Teenagers/ poor people

Question 22

Alcohol Withdrawal treated with

Answer 22

Thiamine, Folate, Multivitamin, Dextrose, IV Fluids

Lorazepam or Diazepam (PRN)

Question 23

alcohol is a depressant that INCREASES ________ opening.

Answer 23

GABAa channel opening

Question 24

long term use of alcohol leads to down regulation of ____ and up regulation of

Answer 24

GABA channels (inhibitory)

NMDA-Glutamate receptors (excitatory)

Question 25

Alcoholic Hallucinosis seen within ____ hours of last drink

Answer 25

12-24 Presents with AVH or Tactile Hallucinations no autonomic instability (as opposed to DT).

Question 26

Alcohol Withdrawal Tonic-Clonic Seizures seen within ____ hours of last drink

Answer 26

48 hours | 2 days

Question 27

Delrium Tremens seen within ____ hours of last drink

Answer 27

48- 96 (2-4 days) Autonomic instability + AVT Hallucinations Disorientation Agitation

Question 28

Minor Alcoholic withdrawal seen within ____ hours of last drink

Answer 28

6 Trembling, Irritability, Anxiety Headache, Tachycardia, Insomnia

Question 29

How to tell the difference between Alcoholic Hallucinosis and DT?

Answer 29

DTs usually present 2 days after last drink and with autonomic instability. AHs happens within 1 day of withdrawal and NO autonomic instability

Question 30

disulfiram - inhibits

Answer 30

acetaldehyde dehydrogenase (aversive conditioning) 2nd line treatment for AuD & only if pt is abstinent already

Question 31

List the 6 stages of quitting SuD

Answer 31

1. Pre-contemplation (denial) 2. Contemplation (accepting) 3. Preparation/Determination (ready to change) 4. Action/ Willpower (actively changing) 5. Maintenance 6. Relapse

Question 32

most addictive drugs act on the ____ reward pathway

Answer 32

dopamine mesolimbic

Question 33

LONG acting opioid COMPETITIVE antagonist

Answer 33

Naltrexone Naloxone has same MOA, but SHORT acting

Question 34

weak partial mu AGONIST

Answer 34

Buprenorphine Subaxone = (Buprenorphine + Naloxone)