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42 Cards in this Set
- Front
- Back
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Cause of Wernicke-Korsakoff |
Thiamine deficiency
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Triad of Wernicke's
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Eye movement abnormalities
Ataxia Mental confusion |
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What is the AST:ALT ratio you are looking for in an alcoholic?
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Greater than 2
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Differential diagnosis of ETOH intoxication (6):
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Diabetic hypoglycemia |
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Signs of alcohol withdrawal:
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Tremor
Cardiovascular (tachy, HTN) GI Sx Psychomotor agitation Anxiety Grand Mal seizures |
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What is the definition of delirium tremens?
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Life threatening condition marked by perceptual disturbances, confusion, disorientation, agitation, autonomic hyper-arousal, and mild fever.
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What percentage of patients that are hospitalized with alcohol dependence go into Dts?
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5.00%
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MoA of acamprosate (Campral)
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Glutamate receptor modulator used for the maintenance of ETOH abstinence
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What is the most important thing to know about prescribing Acamprosate, Naltrexone, and Disulfiam?
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They are only used in maintenance therapy, never for withdrawal.
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What percentage of EtOH patients going through abstinence will relapse within the first six months?
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50.00%
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what percentage of the general population is prescribed benzos in any year?
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15.00%
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Symptoms of severe sedative hypnotic withdrawal:
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Tremors, weakness, vomiting, sweating, hyperreflexia, nausea, orthostatic hypotension
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Which tends to produce more withdrawal when it comes to benzos, short acting ones, or long acting ones?
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Short acting ones
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Percentage of folks in the USA who abuse heroin?
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0.10%
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What does the patient who takes heroin experience when they shoot up?
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Initial rush, followd by a sense of well-being.
Psychomotor retardation, drowsiness, inactivity, and impaired concentration ensue |
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How long does it take for withdrawal to develop in a heroin abuser?
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Within 10 hours of last dose.
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Signs of opioid withdrawal:
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Piloerection
Sweating Tachycardia Yawning N/V Hot and cold flashes Anxiety |
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What is the best way to get a patient addicted to opiates off of them?
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Methadone
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What is buprenorphine (Buprenex)?
When is it used? |
Partial mu receptor agonist and kappa receptor antagonist.
Often used for opioid dependence. Available in IM or tablet form. |
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When do you use clonidine for supstance abuse?
What limits its usage? |
Used for acute withdrawal syndromes.
It's use is limited by sedation and hypotension. |
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How is methamphetamine ingested?
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Either snorted or smoke
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Two antidepressants good for treating depression in a crack addict?
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Desipramine and buproprion
Both work on catecholamines |
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Signs of cocaine withdrawal
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Fatigue, depression, HA, sweating, cramps, hunger
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How long after cessation of crack do symptoms develop?
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2-4 days
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Chemical name for Ecstasy
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2,4-methylenedioxy-N-methylamphetamine
AKA MDMA |
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Which club drug is associated with unsafe sexual practices?
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Ecstasy. Causes euphoria and increases one's desire for intimacy
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Are there any effects of long term MDMA usage?
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Can lead to long-lasting reduction in serotonin transmission
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What occupation is associated with gamma-hydroxybutyrate (GHB)?
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Bodybuilders
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How can GHB cause death?
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Overdose: Leads to respiratory depression.
Also, medical mgmt is needed for withdrawal |
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Which sedative hypnotic is used for drugging others for the purpose of sexual assault?
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Rohypnol
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What are the long term sequele of LSD?
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Psychosis or hallucinogen persisting perception disorder
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Which drug should immediately come to mind when you see vertical nystagmus?
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PCP (Angel dust)
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Mechanism of action of PCP?
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Inhibits catecholamine uptake
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Symptoms of PCP withdrawal:
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Depression, anxiety, hypersolemnence.
*Flashbacks* |
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Differential diagnosis for PCP intoxication:
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Acute psychosis
Schizophrenia |
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What is the strategy for a bad trip with PCP?
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Leave pt alone in a dark room.
Avoid restraints |
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Treatment for PCP overdose?
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Acidify urine with ammonium chloride
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what is the key feature of LSD hallucination?
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Sensorium is intact.
(Patient is alert and oriented) |
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Mechanism of action of LSD:
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Stimulation of 5HT2 receptors
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Is it okay to talk a patient with LSD intoxication down?
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Yes
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DDX of LSD intoxication
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PCP, marijuana
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what does LSD stand for?
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Lysergic Acid Diethylamide
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