Ksubstans

Front 1

Motivational Interviewing 3 goals?

Back 1

1/ Understand Pt and for Pt to feel Understood
2/ Understand stage of change
3/ Move to next stage

Front 2

MI stages?

Back 2

precontemplation
contemplation
preparation
action
maintenance
relapse prevention

Front 3

Name FDA approved drugs for Nicotine Dependence and Mechanism of Action

Back 3

1. Buproprion: Dopamine and Norepinephrine Reuptake Inhibitor; enhance the firing of serotonergic neurons, via activation of downstream norepinephrine flow; noncompetitive α3β4 nicotinic ANTAGONIST (a type of anticholinergic which inhibits the action at nicotinic acetylcholine receptors)

2. Nicotine Replacement Therapy : NRT delivers nicotine to the smoker's brain in a much slower way than cigarettes do. The main problem with this nicotine delivery is that it makes one feel overly constipated

3. Varenicline: nicotinic receptor PARTIAL AGONIST.

Front 4

Name FDA approved drugs for Alcohol Dependence and Mechanism of Action

Back 4

1. Acamprosate:brain stabilizer
Alcohol inhibits activity of biochemical receptors called N-methyl-D-aspartate receptors, or NMDARs, so that chronic alcohol consumption leads to the overproduction of these receptors. Thus, sudden alcohol abstinence causes these excessive numbers of NMDARs to be more active than normal and to produce the symptoms of delirium tremens and excitotoxic neuronal death.[9] Withdrawal from alcohol induces a surge in release of excitatory neurotransmitters like glutamate, which activates NMDARs.[10]

Acamprosate reduces this glutamate surge.[11]

The drug also protects cultured cells in excitotoxicity induced by ethanol withdrawal.[12] and by glutamate exposure combined with ethanol withdrawal
2. Disulfiram/Antabuse

Under normal metabolism, alcohol is broken down in the liver by the enzyme alcohol dehydrogenase to acetaldehyde, which is then converted by the enzyme acetaldehyde dehydrogenase to the harmless acetic acid. Disulfiram blocks this reaction at the intermediate stage by blocking the enzyme acetaldehyde dehydrogenase.
3. Naltrexon (ReVia, Vivitrol)
opioid receptor antagonist

Front 5

Name FDA approved drugs for Opiod Dependence and Mechanism of Action

Back 5

1. Buprenorphine: semi-synthetic opiate with partial agonist and antagonist actions
2. Methadone: long half life synthetic opiate
3. Naltrexone: opioid receptor antagonist

Front 6

Name FDA approved drugs for Stimulant Dependence and Mechanism of Action

Back 6

None
Supportive Tx

Front 7

Substance Dependence Criteria DSM

Back 7

A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by THREE (or more) of the following, occurring at any time in the same 12-month period:

(1) tolerance, as defined by either of the following:
(a) a need for markedly increased amounts of the substance to achieve intoxication or desired effect
(b) markedly diminished effect with continued use of the same amount of the substance

(2) withdrawal, as manifested by either of the following:
(a) the characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets for Withdrawal from the specific substances)
(b) the same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms

(3) the substance is often taken in larger amounts or over a longer period than was intended
(4) there is a persistent desire or unsuccessful efforts to cut down or control substance use
(5) a great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or recover from its effects
(6) important social, occupational, or recreational activities are given up or reduced because of substance use
(7) the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption)

Specify if:

With Physiological Dependence: evidence of tolerance or withdrawal (i.e., either Item 1 or 2 is present)

Without Physiological Dependence: no evidence of tolerance or withdrawal (i.e., neither Item 1 nor 2 is present)

Course specifiers (see text for definitions):

Early Full Remission

Early Partial Remission

Sustained Full Remission

Sustained Partial Remission

On Agonist Therapy

In a Controlled Environment

Front 8

Substance Dependence Mnemonic

Back 8

ADDICTeD
Activities given up or reduced (6)
Dependence, physical tolerance (1)
Dependence, physical: withdrawal (2)
Internal consequences (physical or psychological) (7)
Can't cut down or control use (4)
Time-consuming (5)
Duration or amount of use is greater than intended (3)

Front 9

Substance Abuse criteria?

Back 9

A. 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:
(1) recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household)
(2) recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
(3) recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)
(4) continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)

B. The symptoms have never met the criteria for Substance Dependence for this class of substance.

Front 10

Substance Abuse mnemonic?

Back 10

WILD
Work, school, or home obligation failures (1)
Interpersonal and social consequences (4)
Legal problems (3)
Dangerous use (2)

Front 11

Dependence Mnemonic

Back 11

WAIT CCCC
Withdrawal
Activities Decreased
Intended duration/use less than than actual
Tolerance
Can't control/CutDown
Consuming of time, trying to get it
Consequences, but still use
Craving use

Front 12

Substance Abuse Mnemonic?

Back 12

1 WILD
Work or other obligations let down
Interpersonal Consequence
Legal Problems
Dangerous Use