Substance misuse

Question 1

Types of dependence (4)

Answer 1

Physical dependence
Psychological dependence
Habituation
Addiction

Question 2

Commonly misused substance (7)

Answer 2

Opioids, Stimulants, Depressants, Alcohol, Methamphetamines, Nicotine, Methylenedioxymethamphetamine (ecstasy, molly)

Question 3

What is methadone

Answer 3

Is a replacement drug used to treat opioid dependence. To use as a replacement for the opioid they are addicted to and it weens them off it. Long acting.

Question 4

How is heroin taken

Answer 4

Injected, sniffed, smoked

Question 5

How does heroin make you feel

Answer 5

Causes a brief rush followed by a few hours of relaced content state but large doses can stop respirations

Question 6

CNS adverse effects of opioids

Answer 6

Drowsiness
Diuresis
Miosis (pupil constriction)
Convulsions
Nausea, vomiting
Respiratory depression

Question 7

Non-CNS adverse effects of opioids

Answer 7

Hypotension
Constipation
Decreased urinary retention
Flushing of the face, neck, and upper thorax
Sweating, urticaria, and pruritus

Question 8

Signs and symptoms of Withdrawal (opioids)

Answer 8

Signs: drug seeking, Sweating, mydraiasis, Rhinorrhea, lacrimation, vomiting, diarrhea, insomnia, elevated blood pressure (BP) and pulse
Symptoms: muscle cramps, arthralgia, anxiety, nausea, malaise

Question 9

Treatment of withdrawal of opioid

Answer 9

• Naltrexone Hydrochloride (an opioid antagonist)
• methylnaltrexone bromide (injectable form of ^^)
• Naloxone to reverse an overdose

Question 10

Types of stimulants

Answer 10

Amphetamines
Cocaine
Methamphetamine
methylenedioxymethamphetamine

Question 11

What are methamphetamines

Answer 11

• Stronger than amphetamines
  Found in pill, powder(injected or snorted), crystalized

Question 12

What is Methylenedioxymethamphetamine

Answer 12

• AKA ecstasy
• Often homemade ad taken as a pill
• More calming effects than other amphetamine

Question 13

What is cocaine

Answer 13

• From the leaves of the coca plant
• Snorted or injected intravenously
• Highly addictive—physical and psychological dependence
• Comes in powdered and crystalized (smoked)

Question 14

Stimulants adverse effects (CNS)

Answer 14

(like the body is too stimulated)
Restlessness, Syncope (fainting), Tremor, Hyperactive reflexes, Talkativeness, Irritability, Insomnia, Fever, Euphoria, Confusion, Aggression, Increased libido,, Anxiety, Delirium, Paranoid hallucinations, Suicidal or homicidal tendencies

Question 15

Stimulants adverse effects (Cardiovascular)

Answer 15

(Heart is too stimulated)
- Headache, Chilliness, Pallor or flushing, Palpitations, Tachycardia, Cardiac dysrhythmias, Anginal pain, Hypertension or hypotension, Circulatory collapse

Question 16

Stimulants adverse effects (GI)

Answer 16

Dry mouth
Metallic taste
Anorexia
Nausea
Vomiting
Diarrhea
Abdominal cramps
and fatal hyperthermia

Question 17

What does stimulant overdose look like

Answer 17

Convulsions, Coma and cerebral hemorrhage during intoxication or withdrawal

Question 18

How long is the withdrawal (stimulants)

Answer 18

Peak:1-3 days
Duration: 5-7 days

Question 19

Signs and symptoms of stimulant withdrawal

Answer 19

(opposite of stimulation)
Signs: Social withdrawal, psychomotor retardation, hypersomnia, hyperphagia
Symptoms:Depression, suicidal thoughts and behaviour, paranoid delusions

Question 20

Pharmacological treatment of stimulant withdrawl

Answer 20

There are no specific pharmacological treatments

Question 21

Types of depressants

Answer 21

• Benzodiazepines
• Barbiturates
• Marihuana
• Flunitrazepam (roofies) (not legal in canada)

Question 22

What do Benzodiazepines and barbiturates do

Answer 22

• Increase the action of gamma-aminobutyric acid (GABA) which inhibits nerve transmission in the CNS

Question 23

treatment of benzodiazepine overdose.

Answer 23

flumazenil

Question 24

Difference between Benzodiazepines and Barbiturates

Answer 24

• Benzodiazepines: Induce sleep to sedate and to prevent seizures(more used than barbiturates as a replacement)
• barbiturates: sedatives and anticonvulsants and to induce anaesthesia

Question 25

Adverse effects of depressants

Answer 25

CNS: Drowsiness, sedation, loss of coordination, dizziness, blurred vision, headaches, and paradoxical reactions GI:Nausea, vomiting, constipation, dry mouth, and abdominal cramping - Itchiness and skin rash

Question 26

Marihuana Adverse effects

Answer 26

Amotivational syndrome (kills the motivation of the user)

Question 27

How long is withdrawal of Depressants

Answer 27

Peak period 2 to 4 days for short-acting drugs 4 to 7 days for long-acting drugs Duration 4 to 7 days for short-acting drugs 7 to 12 days for long-acting drugs

Question 28

signs and symptoms of withdrawal of Depressants

Answer 28

(body trying to become stimulated again after being depressed for so long) - Signs:Increased psychomotor activity; agitation; muscular weakness; hyperthermia; diaphoresis; delirium; convulsions; elevated BP, pulse rate, and temperature; others - Symptoms: Anxiety, depression, euphoria, incoherent thoughts, hostility, grandiosity, disorientation, hallucinations, suicidal thoughts

Question 29

How long does treatment take for depressants withdrawal

Answer 29

Takes 7-10 days or 10-14 days of tapering the drug

Question 30

Alcohol AKA...

Answer 30

Ethanol

Question 31

How is alcohol and CNS depressant

Answer 31

Causes CNS depression by dissolving in lipid membranes in the CNS

Question 32

Systemic uses for ethanol

Answer 32

Systemic uses of ethanol: treatment of methyl alcohol and ethylene glycol intoxication (e.g., from drinking automotive antifreeze solution)

Question 33

Effects of chronic ethanol ingestion

Answer 33

- Nutritional and vitamin deficiencies (Vit B- thiamine vit B1) - Seizures - Alcoholic hepatitis leading to cirrhosis - Cardiomyopathy - Fetal alcohol spectrum disorder (FASD)

Question 34

Fetal alcohol spectrum disorder (FASD) is charcterized by...

Answer 34

- Craniofacial abnormalities - CNS dysfunction - Prenatal and postnatal growth retardation

Question 35

Signs and symptoms of ethanol withdrawal

Answer 35

Elevated blood pressure, pulse rate, and temperature Insomnia Tremors Agitation

Question 36

delirium tremens

Answer 36

from severe alcohol withdrawal hyperthermia, hypertension, agitation

Question 37

Ethanol: withdrawal treatment

Answer 37

Benzodiazepines are the treatment of choice (diazepam

Question 38

What does nicotine do

Answer 38

- Releases epinephrine, which creates physiological stress rather than relaxation

Question 39

Drug effects of nicotine

Answer 39

- Stimulation of autonomic ganglia leading to more persistent depression from autonomic ganglia - Respiration is increased then lead to depression - Increases, HR, BP and bowel activity

Question 40

What does nicotine withdrawal look like

Answer 40

- Irritability, restlessness, decreased heart rate and BP

Question 41

How long does nicotine symptoms resolve

Answer 41

Takes 3-4 weeks but cravings may take months to years to disappear

Question 42

Types of nicotine treatment

Answer 42

- Those with Nicotine trying to ween it off ( Transdermal patch, nicotine gum, inhalers and nasal spray) - Bupropion Hydrochloride Zyban: stops smoking without nicotine Varenicline tartrate: Stimulates the nicotine receptors. CI in pregnancy

Question 43

What are the most dangerous substances in terms of withdrawal

Answer 43

CNS depressants (barbiturates, benzodiazepines, and alcohol)

Question 44

chewing nicotine gum will give an immediate release of nicotine T or F

Answer 44

true