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60 Cards in this Set

  • Front
  • Back
Most common sex and age of illegal substance abuse
Males 18-25
Most important feel good neurotransmitter
Dopamine
Dopamine is synthesized where? Released toward?
DA is synthesized in neurons of mesolimbic dopaminergic tract in the ventral tegmentum.

Projects through the medial forebrain bundle

When stimulated, releases DA toward the Nucleus Accumbens and frontal cortex
Most addicting substance
Opioids
NT associated specifically with maintenance of addictive behavior
Glutamate
Agent that blocks glutamate activity and reduces drug cravings
acamprosate
Barbituate withdrawal can cause:
seizures and cardiovascular collapse
Stimulant withdrawal sx
headache
What is MICA?
Mentally ill, Chemically Addicted
3 Sedatives
Alcohol
Benzos
Barbituates
Effects of Sedative Use
Mood elevation
Dec Anxiety
Sedation
Behavioral Disinhibition
Respiratory Depression (barbs)
Effects of sedative withdrawal
Mood depression
Inc Anxiety
Insomnia
Delirium
Seizure
Cardiovascular collapse
2 Opioids
heroin
methodone
Effects of opioid use
mood elevation
dec anxiety
sedation
analgesia
resp. depression
constipation
pupil constriction
Opioid withdrawal sx
Mood depression
Inc anxiety
Autonomic instability
Flu like sx
Piloerection
Yawning
Stomach Cramps
Diarrhea
Pupil Dilation
4 Stimulants
Amphetamines
Cocaine
Caffeine
Nicotine
Stimulant effects
Mood elevation
Insomnia
Dec appetite
Inc cardiovascular, neurological, and GI activity
Psychotic sx
Pupil Dilation
hallucinations
stimulant withdrawal sx
Mood depression
Lethargy
Inc appetite
Dec CV, Neuro, GI activity
Fatigue
HA
6 Hallucinogens
Marijuana
Hashish
LSD
PCP
Psilocybin
Mescaline
Effects of hallucinogen use
Mood elevation
Altered perception
CV sx
Hyperthermia/sweating
Tremor
Nystagmus (PCP)
hallucinogen withdrawal sx
few, if any withdrawal sx
Sedative tx?
Hospitalization
Substitution of long-acting barbituate (phenobarbitol) or benzo (chlordiazepoxide) in decreasing doses
IV diazepam (valium) or lorazepam (ativan) or phenobarbital if seizures occur

Alcohol: thiamine, nutrition, AA, disulfram
Opioid Tx
Hospitalization
Naloxone (Narcan) for OD
Clonidine to stabilize autonomics during withdrawal
Substitution of long-acting opioid (methadone) in dec doses.

Methadone and LAMM
Naloxone, naltrexone, buprenorphine
Stimulant tx
Benzos to dec agitation
Antipsychotics
Smoking cessation drug
Bupropion (zyban)
hallucinogen tx
Benzos for agitation
Antipsychotics
Most abused substance in the world
Alcohol
child with facial abnormalities, reduced height/weight, mental retardation
FAS
Sedative with higher safety margin than barbituates
Benzos
First observed on 3rd day of withdrawal in patients who have been drinking heavily for at least 5 years
Delirium Tremens
Is DT's lifethreatening?
Yes. 20%
DT tx
Fluids for dehydration
Benzos (chlordiazepoxide, diazepam, lorazepam)
MOA of disulfram
blocks EtOH breakdown--> acetaldehyde accumulation. EtOH ingestion causes intense nausea, HA, flushing
Opium grown where?
Afghanistan, Pakistan, Myanmar, Columbia, Mexico
Opioid overdose clinical triad
Coma
Respiratory Depression
Miosis (pinpoint pupils)
MCC of opioid death
Respiratory Arrest
Opioid OD tx
establish airway
mech. ventilation
naloxone
naltrexone
Are methadone and LAMM addictive? Advantages?
Yes.
Legal
Oral
longer duration of action
less euphoria/drowsiness
methadone mechanism
dec withdrawal sx and cravings
naloxone mechanism
occupies opioid receptors and blocks euphoric action.
Buprenorphine mechanism
similar to both methadone and naloxone. At high doses, it antagonizes its own receptors, dec OD.
Stimulant MOA
inc availability of DA in synapse
Amphetamine MOA
stimuates release of DA
cocaine MOA
blocks reuptake of DA
Caffeine amounts in:
brewed coffee
instant coffee
tea
cola
non-rx stimulants
diet agents
Americans/day
brewed coffee 125mg/cup
instant coffee 75mg
tea 65mg
cola 45mg
non-rx stimulants 150mg
diet agents 150mg
Americans/day 200mg
Are smokers more likely to be depressed?
Yes
% of american that smoke
25%
Legitimate uses for amphetamines
ADHD, narcolepsy, depression, obesity
What is a speedball
Ecstasy + cocaine
Common psychotic sx of cocaine use
bugs crawling on skin
Most commonly used illegal psychoactive substance
Maijuana
Marijuana can be legally used in some states for:
glaucoma
cancer related N/V
Common sx of chronic pot use
amotivational syndrome (dec desire to work, apathy)
LSD MOA
inc availability of 5HT
PCP MOA
binds to NMDA receptors (glutamate)
Sx of pcp use
violent behavior
hyperthermia
nystagmus
quantity of pcp causing OD
20mg (coma, death)
Pupil constriction occurs with
Opioid Use
Stimulant withdrawal
Pupil dilation seen with:
Stimulants
LSD
Opioid withdrawal
Sedative withdrawal
Psychotic sx see with:
Stimulants
EtOH
Hallucinogens
Sedative withdrawal