W15_03 substance abuse 2 Flashcards Preview

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Flashcards in W15_03 substance abuse 2 Deck (23):
1

what are the 2 major neurotransmitter systems affected in alcohol?

GABA - cns inhibition;
glutamate - CNS excitation

2

what are 2 main acute (6-24h) alcohol withdrawal symptoms?

tremor;
diaphoresis

3

note: hallucinations (mostly visual) and seizures (grand mal) can occur after alcohol withdrawal too

8-24 hours, 24-48 hours respectively

4

when do delirium tremens occur in alcohol withdrawal?

72-92 hours after last drink;
tachycardia, tremor, diaphoresis, fever, disorientation, global confusion, hallucinations, psychomotor agitation;
mortality up to 30-40%

5

what's the medical treatment of choice for those in alcohol detox?

benzodiazepines

6

what are the 5 stages of treatment?

identification;
intervention;
detoxification;
rehab;
prevention of relapse

7

recall the CAGE questionnaire

feel the need to cut down?
Annoyed by criticism on drinking?
Guilty?
Eye openers in the morning?

8

what's the binge drinking question?

in the past year, how many occassions have you have 5+ drinks (men) or 4+ drinks (women) in one day?

9

what are the limits for "too much" drinking?

women: 10/week;
men: 15/week

10

what is naltrexone?

opioid antagonist for alcohol withdrawal

11

what is acamprosate?

enhances GABA system and modulates glutamate to relieve sub-acute withdrawal of alcohol

12

what's disulfiram?

inhibits acetaldehyde dehydrogenase, so any alcohol causes hangover effects quickly

13

which receptors do opiods act on?

endorphin (mu) receptors

14

name some opioid drugs

heroin;
morphine;
codeine;
oxycodone;
hydromorphone;
fentanyl

15

note: common pain conditions usually don't need opiates, so try to find others

ok

16

what are symptoms of opioid withdrawal?

flu-like symptoms;
myalgia, chills, vomiting

17

note: methadone can relieve withdrawal symptoms without inducing sedation or euphoria

ok

18

how does buprenorphine work?

partial agonist that displaces other opioids - ceiling effect so can't overdose

19

note: cannabis is discussed

ok

20

how does cocaine work?

blocks presynaptic uptake of dopamine, norepinephrine, epinephrine

21

what's GHB?

metabolite of GABA;
sedative

22

how does MDMA work?

stimulates release of serotonin

23

what are some psychotherapies for substance use?

motivational interviewing;
cognitive behavioural therapy;
12-step facilitation/AA/NA;
contingency management;
family therapy

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