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21 Cards in this Set
- Front
- Back
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what do all addictive drugs (besides LSD) affect?
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- the mesocroticolimbic dopamine reward threshold
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what do you see with stimulant intoxication?
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- two or more of: (all related to autonomic hyperarousal)
- tachycardia, bradycardia - pupillary dilation - elevated or lowered BP - perspiration or chills - nausea or voming - weight loss - psychomotor agitation or retardation - muscular weakness, resp depression, chest pain - confusion, seizures,, coma |
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what happens with stimulant withdrawal?
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- dysphoric mood and two of the following:
- fatigue - vivid, unpleasant dreams - insomnia or hypersomnia - increased appetite - psychomotor retardation |
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how do you treat nicotine addiction?
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- 1st line: nicotine replacement therapy + buproprion (wellbutrin)
- 2nd line: clonidine and nortryptiline (TCA) |
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what do you see with sedative, hypnotic and anxiolytic intoxication?
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- one or more:
- slurred speech - incoordination - unsteady gait - nystagmus - impairment in attention or memory - stupor or coma |
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what do see with sedative, hypnotic and anxiolytic withdrawal?
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- dysphoric moood and two:
- autonomic hyperactivity - increased hand tremor - insomnia - nausea, vomiting - transient visual, tactile, or auditory hallucinations - psychomotor agitation - anxiety - grand mal seizures - withdrawal (esp barbs) can be dangerous |
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what do you need to specify with stimulants, hypnotics, opiates, etc?
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- if withdrawal is with or without perceptual disturbances
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how do you manage sedative, hypnotic and anxiolytic withdrawal?
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- give tolerance test (use pentobarbital or diazepam) before tapering the drugs
- withdraw using phenobarbitol or diazepam in dwindling amounts |
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what do you see with opioid intoxication?
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- pupillary constriction and one:
- drowsiness or coma - slurred speech - impairment of attention or memory |
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what do you see with opioid withdrawal?
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- three or more:
- dysphoric mood - nausea/vomiting - muscle aches - lacrimation or rhinorrhea - papillary dilation, piloerection, or sweating - diarrhea - yawning - fever - insomnia |
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how do you treat opioid addiction?
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- treat with methadone (long-acting opioid so less likely for addiction)
- naltrexone: longacting opioid antagonist or clonidine (suppresses autonomic symptoms) |
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what do you get with hallucinogen intoxication?
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- papillary dilation
- tachycardia - sweating - palpitations - blurring of vision - tremors - incoordination |
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what do you get with arylcyclohexylamine intoxication? (PCP)
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- nystagmus
- hypertension/tach - numbness or diminished response to pain - ataxia - dysarthria - muscle regidity - seizures or coma - hyperacusis |
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how do you manage eating disorders?
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- anorexia: fluoxetine or clomipramine
- bulemia: fluxetine Bupropiron is contraindicated b/c it lowers the seizure threshold |
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what is first line treatment for agitation in dementia?
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Antipsychotics have been the standard first-line treatment for acute agitation in dementia, although also carry a more recent warning due to sporadic sudden deaths associated with use of antipsychotics in elderly patients with dementia. Tacrine is a cholinesterase inhibitor, trazodone an antidepressant, and lorazepam a benzodiazepine, all of which may be used in the management of agitation in some patients with dementia but as second-line approaches.
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tacrine
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cholinesterase inhibitor
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trazodone
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antidepressant
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lorazepam
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benzodiazepine
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risperidal
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anti-psychotic
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what is Dialectical behavior therapy?
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DBT was developed specifically for emotional dysregulation and related problems (including self-mutilation and suicidality) related to borderline personality disorder. The efficacy of DBT has been established in controlled trials. Nevertheless, the other psychotherapies listed have been applied successfully to problems related to personality disorders.
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what should you give after a traumatic event?
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propranalol: beta blocker suggest that it may interfere with the sympathetically mediated enhancement of traumatic memories that is thought to occur immediately following trauma (and perhaps upon subsequent reexperiencing events).
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