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28 Cards in this Set
- Front
- Back
what are the 4 principles of behavioral theory of addiction
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Positive reinforcing effects
Adverse effects Discriminate substance of abuse from other substances Substance seeking behavior is associated with cues that become connected with the experience |
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what makes up brain reward circuitry
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LC, VTA, NA
Locus ceruleus- largest group of adrenergic neurons Catecholamine (particularly dopamine) Ventral tegmental area are particularly important Nucleus accumbens |
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Dependence is defined as
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3 sx in 12 mo
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: inapp. Sexual or aggressive behavior, mood lability, impaired judgment & one or more of the following
Slurred speech Incoordination Unsteady gait Nystagmus Impairment in attention or memory Stupor or coma this is Intoxication or Withdrawal? of what? |
ETOH
intoxication |
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what 3 drugs can kill you in withdrawal
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booze benzos barbs
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2 or more of the following occurring a several hours or few days
Autonomic hyperactivity (sweating or pulse rate >100) Hand tremor Insomnia Nausea or vomiting Hallucinations (a/v/t) Psychomotor agitation Anxiety Grand mal seizure this is Intoxication or Withdrawal? of what? |
ETOH
withdrawal |
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tx for alcohol withdrawal
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Benzos
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etoh dependence tx
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Disulfiram (Antabuse): inhibits aldehyde dehydrogenase causing a build-up of aldehyde causing flushing, sweating, nausea, and tachycardia
Naltrexone: opioid receptor blocker reduced craving and reward response Acamprosate (Campral): affects glutamate and GABA neurotransmitter systems |
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why do many meth addicts go through depression when getting clean
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Methamphetamine appears to have a neurotoxic effect, damaging brain cells that contain dopamine and serotonin
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Increased wakefulness
Increased physical activity Decreased appetite Increased respiration Hyperthermia Euphoria. signs of pts on... |
Methamphetamine
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pupillary dilation=
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meth intox
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Tachy/bradycardia
Pupillary dilation hi BP Perspiration/chills nausea/vomiting Wt. loss Psychomotor agitation/retardation Muscular weakness, respiratory depression, chest pain Confusion, seizures, dyskinesias, dystonias, coma intox or withdrawal? what drug |
intox
meth |
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Fatigue
Vivid, unpleasant dreams Insomnia/hypersomnia Increased appetite Psychomotor agitation or retardation Peak within 2-4 days and resolve in a week w/ most serious symptom being depression. intox or withdrawal? what drug |
withdrawal
meth |
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tx for ppl getting off meth
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Buproprion (Wellbutrin) produces feelings of well-being as they cope with the dysphoria
inhibit DA/NE reuptake |
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how do you get euphoria w/ cocaine
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strong DA reuptake inhibition in brain
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CT scan of brain, huge intaparenchymal bleed=
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cocaine
vasoconstriction |
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euphoria, apathy, dysphoria, psy. Agitation/retardation
Pupillary constriction and one or more of the following Drowsiness or coma Slurred speech Impairment in attention or memory intox or withdrawal? what drug? |
intox
opioid |
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: cessation of use and three or more
Dysphoric mood Nausea/vomiting Muscle aches Lacrimation/rhinorrhea Pupillary dilation, piloerection, sweating Diarrhea Yawning Fever insomnia intox or withdrawal? what drug? |
withdrawal
opiod |
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*******
Alcohol and all drugs of this class (sedative/hypnotic/anxiolytic) are cross tolerant and their effects are additive. |
this is a test question
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major sign of barbituate withdrawal?
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seizures
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describe the INTOXICATION s/s of CANNABIS SATIVA
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Intoxication: 2 or more w/
1. impaired motor coordination 2. euphoria 3. anxiety 4. slowed time 5. impaired judgment 6. social withdrawal the person will also have: - conjunctiva injection - increased appetite - Dry mouth - tachycardia |
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what are the WITHDRAWAL s/s of CANNABIS SATIVA
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none.
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2 or more of the following:
Tachy/bradycardia Pupillary dilation inc or dec BP Perspiration/chills Nausea/vomiting Evidence of wt. loss Psychomotor agitation/retardation Muscular weakness, respiratory depression, chest pain, arrhythmias Confusion, seizures,"", dyskinesias, dystonias, coma these are ______ (intox or withdrawal) s/s of what? |
intoxication
cocaine |
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dysphoria and 2 or more:
- Fatigue - Vivid, unpleasant dreams - insomnia or hypersomnia - Increased appetite - Psychomotor agitation or retardation these describe the WITHDRAWAL s/s of what? |
cocaine
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flip to read the Tx for cocaine
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The goal of treatment is abstinence from a drug that is powerfully reinforcing and induces craving.
Inpatient settings include individual, group, and family psychotherapy Rx: If psychotic use an atypical antipsychotic and diazepam can help the agitation and hyperactivity. TREAT DEPRESSION -Buproprion (Wellbutrin) produces feelings of well-being as they cope with the dysphoria |
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INTOX s/s for benzo's/barb's/hypnotics
(aka sedative, hypnotic, or anxiolytic related disorders) |
Intoxication: inapp. Sexual or aggressive behavior, mood lability, impaired judgment & one or more of the following:
1. Slurred speech 2. Incoordination 3. Unsteady gait 4. Nystagmus 5. Impairment in attention or memory 6. Stupor or coma |
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WITHDRAWAL s/s for barbs/benzo's/hypnotic's
(aka sedative, hypnotic, or anxiolytic related disorders) |
2 or more of the following occurring a several hours or few days:
1. Autonomic hyperactivity (sweating or pulse rate >100) 2. Hand tremor 3. Insomnia 4. Nausea or vomiting 5. Hallucinations (a/v/t) 6. Psychomotor agitation 7. Anxiety 8. Grand mal seizures |
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flip to read another slide about Tx of WITHDRAWAL for benzo's and barb's
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withdrawal syndromes can be life-threatening (barbs) or result in serious medical complications (grand mal seizures).
Benzo’s- 2-3 days after cessation but with diazepam can be 5-6 days. Barb’s: Most in the first 3 days of abstinence and can result in seizures, delirium, cardiovascular collapse, and death. --Seizures always precede delirium --Delrium is indistinguishable to DT’s and seen more commonly with barb’s than benzo’s |