Psych Substance/drugs - Ms3

Front 1

what does Methylphenidate treat?

(3)

Back 1

1. ADHD

2. narcolepsy

3. psychomotor retardation

Front 2

DOC for alcohol withdrawal =

Back 2

Chlordiazepoxide (benzo)

Front 3

SE’s of Methylphenidate:

(4)

Back 3

1. irritability

2.Dec. appetite

3. Wt loss

4. Insomnia

Front 4

substance abuse =

Back 4

role/obligation failure, social impairment, legal probs, or dangerous use **w/in 12 mths**

Front 5

Dependence = at least 3 of:

Back 5

Tolerance

Withdrawal

Effects usually opposite of intoxication Recurrent legal probsPersistent desire to cut downMultiple unsuccessful efforts to cut down Significant time spent in getting/using/recovering fromDec. social/occupational activities due to use Continued use despite negative physical or psychological probs (e.g. declining liver function)

Front 6

Heroin Intoxication symps

Back 6

Drowzee is cognitively depressed anyway; now he’s intoxicated, he can’t breathe, and he’s got pinpoint pupils as he tries to strain

Front 7

Tx for opioid OD =

Back 7

naloxone or naltrexone (alc too) – opioid antagonists

- will cause withdrawal in opioid-dependent pt

Front 8

Heroin Withdrawal (NOT life-threatening)

(4)

Back 8

Mydriasis
Rhinorrhea
Muscle and joint aches
Cramping, nausea, diarrhea

- opposite of Drowzee; symps are out of proportion to exam

Front 9

Tx for opioid WD =

(3 categories)

Back 9

clonidine for HTN, **NSAIDs for pain**
Buprenorphine or methadone if severe

Front 10

Meperidine (opioid) does NOT

Back 10

constrict pupils: “Demerol dilates”
~~SER synd

Front 11

Cocaine – a stimulant; blocks Dopa reuptake at the cleft. Intoxication =>

(7)

Back 11

1. Euphoria
2. Anxiety, agitation, anorexia (wt loss)
3. Tactile and VH
4. BP either way
5. HR either way
6. Mydriasis
7. respiratory depression

Front 12

cocaine OD:

(5)

Back 12

Arrhythmias
MI
Sez’s
Stroke
Formication

Front 13

cocaine Withdrawal = crash:

(4)

Back 13

Hypersomnolence

Miosis
hyperphagia
Psychomotor

Front 14

Alcohol = potent CNS:

Back 14

depressant

Front 15

Alcohol to Acetaldehyde via

Back 15

alcohol-DH

Front 16

Alc Intoxication:

(6)

Back 16

1. Dec. fine motor skills

2. Impaired judgment and coordination

3. Ataxia + poor balance

4. Lethargy

5. Memory

(6. severe: respiratory depression)

Front 17

Alc WD Tx =

(1st and 2nd lines)

Back 17

1st = DCC long-acting benzo's vs LOT short

2nd = CBZ/V

Front 18

Alc WD signs/symps start 6-48 hours after last drink:

(4 symps)

Back 18

Tremor
Anxiety

then AI

Front 19

or alcoholic hallucinosis

Back 19

AH, but VSS

Front 20

DTs 2-4 days after last drink;

(4)

Back 20

Delirium
Sez’s
VH
Autonomic instability (tachy, fever, sweating)

Front 21

*medical* Tx alc w/d =

(3)

Back 21

thiamine (to cover probable deficiency) + folic acid + MV (banana bag)

Front 22

No thiamine before giving glucose =>

Back 22

Wernicke encephalopathy

(Korsakoff is chronic – anterograde, confabs)

- Confusion + ataxia + ophthalmoplegia

Front 23

to decrease craving for alc: (2)

Back 23

Naltrexone or topiramate

Front 24

Heavy drinking for men vs women =

Back 24

>4 per day / >14 per week for men
3 and 7 for women

Front 25

Alcohol can cause _____________

Back 25

macrocytosis (due to folate deficiency)

Front 26

Amphetamine Intoxication – same as cocaine:

Back 26

Euphoria
Anxiety, agitation, anorexia (wt loss)
Psychosis
BP either way
HR either way
Mydriasis
respiratory depression

Front 27

Amphetamine OD:

(5)

Back 27

Irritable
Mydriasis
Inc. libido
Hallucinations
Autonomic instability (tachy, sweating, HTN)
=> hyperthermia, dehydration, rhabdo

Front 28

Chronic amphetamine use ~~

Back 28

Meth mouth (acne, accelerated tooth decay)

Front 29

Ketamine = (mech)

Back 29

NMDA r’ antagonist / gen. anesthetic

Front 30

ketamine intoxication Symps:

(4)

Back 30

tachy, tappy
hallucinations
amnesia

Front 31

PCP (“angel dust”)

(5)

Back 31

Aggression

Psychosis

Rotary Nystagmus (pathognomonic)
ataxia

muscle rigidity

Front 32

PCP “w/d” =

Back 32

recurrence of intoxication symps due to release of PCP from adipose stores

Front 33

“bad trip” ~~

Back 33

marked anxiety, panic, and psychotic symps like paranoia

Front 34

Chronic LSD users may experience random ________________________________

Back 34

“flashbacks” throughout life

Front 35

THC medical uses:

(3)

Back 35

1. Nausea in chemo

2. Inc. appetite in AIDS

3. Dec. intraocular P and muscle spasms

Front 36

MJ Intoxication

Back 36

Euphoria
Anxiety
Impaired motor
Slowed time
Red eyes
Munchies
May induce psychosis
Chronic use
Respiratory problems like asthma, suppressed IS

Front 37

MJ Withdrawal:

(2)

Back 37

agitation, strange dreams

Front 38

Inhalants e.g. glue, paint thinners =>

(3)

Back 38

respiratory, CNS depression, arrhythmias

- quick rush

Front 39

smoking during preg =>

(2)

Back 39

SGA, PHTN of newborn

Front 40

*Varenicline and Bupropion* =

Back 40

partial agonists of nicotinic (cholinergic) r’s

Front 41

Lorazepam (Ativan) =

Back 41

Short-acting

Front 42

Diazepam =

Back 42

Long-acting (like chlordiazepoxide and clorazepam)

Front 43

zolpidem =

Back 43

sedative

Front 44

Dopa r' agonists for Parkinson's:

(2)

Back 44

1. Amantadine

2. Pramipexole

Front 45

3 meds for narcolepsy:

Back 45

1. Modafinil

2. Methylphenidate

3. Amphetamines

Front 46

cough syrup drug ingredient:

Back 46

dextromethorphan (opioid)

Front 47

barbs are for:

Back 47

epilepsy

Front 48

main SE of barbs =

Back 48

respiratory depression

Front 49

antidote for barbs =

Back 49

sodium bicarb

Front 50

which drug has the highest mortality rate in WD?

Back 50

barbs

- symps like alcohol

Front 51

what do benzo's do to the sez threshold?

Back 51

INCREASE it

Front 52

Fluvomxamine is an SSRI especially for:

Back 52

anxiety and OCD

Front 53

to calm a pt with delirium, give them:

Back 53

**ANTIPSYCHOTIC,**

not benzo

Front 54

depakote = divalproex sodium =

(2)

Back 54

mood stabilizer for mania,

AED for sez's

Front 55

3 SE's of depakote =

Back 55

GI

Sedation

Tremor

Front 56

TOC for acute panic attack until SSRI kicks in =

Back 56

Xanax (alprazolam)

- rapid onset, short half-life

(vs chlordiazepoxide)

Front 57

DOC for alcohol WD =

Back 57

chlordiazepoxide (benzo)

Front 58

only _________ is safe for treating opioid WD during preg.

Back 58

methadone

Front 59

Tx for REM Behavior Disorder =

Back 59

Clonazepam

Front 60

chronic amphetamine use ==>

(2)

Back 60

nosebleeds

acne

Front 61

loecus ceruleus =

Back 61

alarm/anxiety center

Front 62

which substance leads to mania?

Back 62

*cocaine*

Front 63

stimulants (as in tx of ADHD) can cause:

Back 63

*tics*

Front 64

anticholinergics exacerbate:

Back 64

Alz

- Alz ~~ *loss* of cholinergic neurons

Front 65

SSRI relationship to CYP450:

Back 65

SSRI's *inhibit* CYP450 => other drugs metabolized slower=> drug levels INCrease

Front 66

antiHIST effects =

(2)

Back 66

sedation and weight gain

Front 67

antiadrenergic effect =

Back 67

hypotension

Front 68

3 main SE's of Trazodone =

Back 68

sedation, priapism

Front 69

2 main SE's of Mirtazapine =

(a2 antagonist - antidepressant)

Back 69

wt gain, sedation

(opposite of methylphenidate)

- esp. good for thin elder with insomnia

Front 70

antidote for TCA OD =

Back 70

IV sodium bicarb

Front 71

SER Syndrome: first, stop the drug; then, try:

Back 71

CCB like nifedipine

Front 72

Loxapine =

Back 72

mid-potency 1st-gen antipsychotic

Front 73

antipsychotics lower:

Back 73

the seizure threshold

- low-potency more so than high

Front 74

on clozapine ==> __________ blood-draws

Back 74

weekly, for 6 mths

Front 75

clozapine is the only antipsychotic shown to:

Back 75

decrease the risk of suicide

Front 76

LOT of benzo's for alcohol WD or liver dz:

Back 76

Lorazepam, Oxazepam, Temazepam

Front 77

4 SE's of methypphenidate (a stimulant for ADHD, narcolepsy):

Back 77

1. insomnia

2. wt loss

3. dec. appetite

4. irritability

Front 78

stimulants are ___% successful in ADHD:

Back 78

70%

Front 79

Atomoxetine = nonstimulant for:

Back 79

ADHD