Jewell: Substance Abuse

Front 1

brain altering chemical

Back 1

Substance

Front 2

Seemingly ignores the concept of substance abuse

Back 2

Addiction

Front 3

Psychological dependence and craving

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Habituation

Front 4

use of a drug that deviates from normal social patterns

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Abuse

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applies to drugs prescribed by physicians

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Misuse

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Reversible syndrome that affects memory, orientation, mood, judgment, behavior, functioning

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Intoxication

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Substance specific syndrome due to discontinuation of a substance

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Withdrawal

Front 8

repeated administration a given dose has decreased effect or increased dose is needed to achieve same effect

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Tolerance

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Ability of one drug to be substituted by another (i.e. benzos and barbiturates

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Cross-tolerance

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Neurochemical or neurophysiologic changes in the body from a substance

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Neuroadaptation

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Family members affected by or influencing the behavior of the abuser.

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Codependence

Front 12

Protecting or supporting the family member possibly due to social pressures.

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CODEPENDENCE

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protecting or supporting the family member possibly due to social pressures

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CODEPENDENCE
(fail to see addiction as dz, thinks it's voluntary and willful, cares for EtOH and rugs more than family, resists modification)

Front 14

Family members, like substance-abuser, often behave as if there is no problem at all.

Back 14

DENIAL
-Self protecting (they may be responsible), unwilling to accept help.

Front 15

What are the reward centers in the brain?

Back 15

Ventral Tegmental area and Nucleus accumbens.
-Collectively called brain reward circuitary

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TOLERANCE is a) a need for markedly ________amounts of the substance to achieve intoxication or desired effect; b) markedly diminished ________with continued use of the same amount of the substance.

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INCREASED

EFFECT

Front 17

Withdrawal, as manifested by either of the following: a) the ______________withdrawal syndrome for the substance; b) the ____________(or closely related) substance is taken to relieve or avoid withdrawal symptoms

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characteristics
same

Front 18

A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more of the following, occurring within a 12-month period:

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Substance Abuse
(failure to meet oblications @ work, home, school, performance, absences...)

Front 19

Intoxication of Withdrawal of EtOH? inapp. Sexual or aggressive behavior, mood lability, impaired judgment, slurred speech, incoordination, nystagmus

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Intoxication

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Intox or W/D? Sweating, pulse reat > 100, hand tremor, insomnia, NV, hallucination, grand mal seizures.

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W/D of alcohol.

Front 21

What is the central feature occuring about a week after cessation of EtOH?

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Delirium tremens (HTN, tachy, diaphoresis, fever, anxiety)

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Treatment for Delirum tremens?

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1. DOC is benzos
2. Carbamazepine
3. Clonidine?

Must treat b/c DT's carry mortality rate of 20%!

Front 23

Alcohol Dependence Tx that inhibits aldehyde dehydrogenase causing a build-up of aldehyde causing flushing, sweating, nausea, and tachycardia

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Disulfiram

Front 24

Alcohol Dependence Tx that is an opioid receptor blocker reduced craving and reward response.

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Naltrexone

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Alcohol Dependence Tx that affects glutamate and GABA neurotransmitter systems

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Acamprosate

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Alcohol Dependence Tx that is 24 hours a day, Associate with a sober peer group, Learn that it s possible to participate in social functions w/o drinking
Given a model of recovery by observing successful sober members of the group

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Alcoholics Anonymous:

Front 27

How does methamphetamines act?

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1. release of high dopamine
2. damages brain cells that contain D2, and 5HT
3. causes reduced levels of dopamine, results in parkinson-like symptoms

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Intox or W/D of amphetatmies?
Tachy/brady, PUPILLARY DILATION, sweat, chills, weight loss...

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Intox

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intox or w/d of amphetamines?
-dysphoric mood, fatigue
-vivid unpleasant dreams
-inceased appetite

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w/d

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Treatment of amphetamine addiction?

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1. Inpatient setting
2. if psychotic use atypicals and diazepam
3. treat DEPRESSION with buproprion.

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D9-tetrahydrocannabinol (D9-THC)

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Cannabis sativa

Front 32

Why doesn't marjiana produce cardiac or respiratory effects?

Back 32

No receptors in brain stem.
High concentration of receptors in BG, hippo, and cerebellum.

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No symptoms. Intox or w/d of marijana?

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W/d

Front 34

:2 or more w/ impaired motor coordination, euphoria, anxiety, slowed time, impaired judgment, social withdrawal, conjunctiva injection, increased appetite
Dry mouth, tachycardia

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Intox of marjiana

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An alkaloid derived from the shrub Erythroxylon coca indigenous to South America

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Cocaine

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How does cocaine work?

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Cocaine Blocks the Removal of Dopamine From the Synapse of Neurons in the Nucleus Accumbens. These Neurons Originate From the Ventral Tegmental Area

Front 37

tachy, brady, PUPILLARY DILATION,

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intoxication with cocaine

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Adverse effects of cocaine on cerebral vascular system?

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INTRAPRENCHYMAL bleed, hemorrhagic infarction by vasoconstriction!

Front 39

Affects of cocaine on heart?

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-MI's, arrhythmias
-cardiomyopathies
-cardio-embolic

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What is the treatment for cocaine withdrawal?

Back 40

-atypical + diazepam
-treat depression with buproprion.

Front 41

Euphora, apathy, dysphonia, pupillary CONSTRICTION, drowsiness

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Opioid Intox

Front 42

dysphoria, NV, MUSCLE ACHES, lacrimation, pulliary DILATION, diarrhea, fever, insomnia

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withdrawal of opiods!

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_____________and all drugs of this class (sedatives, hypnotics, anxiolytics) are cross tolerant and their effects are additive.

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Alcohol

Front 44

: inapp. Sexual or aggressive behavior, mood lability, impaired judgment, slurred speech, incoordination

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intoxication of EtOH and barbs!

Front 45

How do barb's work?

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Upon binding, it increased the affinity of the receptor for its endogenous neurotransmitter, GABA, and to increase the flow of Cl- ions into the neuron. The influx of the negatively charged ions is inhibitory and HYPERPOLARIZE the neuron relative to its extracellular space.

Front 46

Treatment of withdrawal symptoms of barbs?

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-can be life threatening!!
-benzo's to treat
-death usually occurs w/in first three days of abstience with seizures, delirum (indistinguishable from DT's)

Front 47

Barb Overdose Treatment?

Back 47

1. gastric lavage, AC
2. Flumazenil
3. Carbamazepine