Substance Abuse

Question 1

Depressants

Answer 1

Benzodiazepines
Barbiturates
Marijuana

Question 2

Opioids

Answer 2

Narcotics
Abuse and psychological dependency
Promote relaxation and euphoria

Question 3

Methadone

Answer 3

Used to treat opioid dependence
Goal is to reduce the patient’s dosage gradually so that eventually the patient can live permanently drug free
Relapse rates are often high, so the drug can be abused

Question 4

Heroin

Answer 4

Causes a brief rush followed by a few hours of a relaxed, contented state
Large doses can stop respirations
Methadone used to treat dependence

Question 5

Opioid Adverse Effects

Answer 5

Diuresis, miosis, convulsions, nausea, vomiting, respiratory depression, hypotension, constipation, sweating

Question 6

Opioid Drug Withdrawal

Answer 6

Peak Period: 1-3 days
Duration: 5-7 days
Signs: drug seeking, diaphoresis, lacrimation, diarrhea, elevated blood pressure
Symptoms: desire for drug, muscle cramps, anxiety, nausea, vomiting, malaise

Question 7

Opioid Drug Withdrawal Treatment

Answer 7

Block opioid receptors so that use of opioid drugs does not produce euphoria
Naltrexone, vivitrol, naloxone

Question 8

Stimulants Adverse Effects

Answer 8

Restlessness, syncope, tremor, irritability, insomnia, euphoria, confusion, anxiety, headache, chilliness, cardiac dysrhythmias, circulatory collapse, cerebral hemorrhage

Question 9

Stimulant Withdrawal

Answer 9

Peak Period: 1-3 days
Duration: 5-7 days
Signs: social withdrawal, psychomotor retardation, hypersomnia, hyperphagia
Symptoms: depression, suicidal thoughts, paranoid delusions
No specific pharmacologic treatments

Question 10

Depressants Adverse Effects

Answer 10

Drowsiness, sedation, blurred vision, headaches, nausea, vomiting, constipation, loss of coordination

Question 11

Depressants Withdrawal

Answer 11

Peak Period: 2-4 days or 4-7 days
Duration: 4-7 days or 7-12 days
Signs: Increased psychomotor activity, agitation, hyperthermia, diaphoresis, delirium, convulsions, elevated BP and pulse rate
Symptoms: anxiety, depression, incoherent thoughts, euphoria, hostility
Treatment involves tapering of the drug over a course of 7-10 or 10-14 days
Most dangerous in terms of withdrawal

Question 12

Alcohol (Ethanol)

Answer 12

Causes CNS depression by dissolving in lipid membranes in CNS
Respiratory stimulation or depression, vasodilation, increased sweating, diuretic effects

Question 13

Effects of Chronic Alcohol Ingestion

Answer 13

Nutritional and vitamin B deficiencies (Wernicke's encephalopathy, Korsokoff's psychosis, polyneuritis, nicotinic acid deficiency encephalopathy)
Seizures
Hepatitis
Cardiomyopathy
FAS

Question 14

Ethanol Withdrawal Signs and Symptoms

Answer 14

Elevated blood pressure, pulse rate, temperature
Insomnia
Tremors
Agitation

Classified as mild, moderate, and severe

Question 15

Ethanol Withdrawal Treatment

Answer 15

Benzodiazepines are the treatment of choice

CHLORODIAZEPOXIDE (Korsokoff’s psychosis)

Question 16

Treatment for Alcoholism

Answer 16

Disulfiram (Antabuse)
Tablet, taken orally
Causes patient to become extremely ill if they drink alcohol after taking the tablet

Question 17

Nicotine Effects

Answer 17

Releases epinephrine, which creates physiologic stress rather than relaxation
Tolerance develops
CNS and respiratory stimulation followed by CNS depression
Increased heart rate and BP
Increased bowel activity

Question 18

Nicotine Withdrawal

Answer 18

Manifested by cigarette craving (irritability, restlessness, decreased heart rate and BP)
Cardiac symptoms resolve in 3-4 weeks, but craving may last months or years

Question 19

Nicotine Withdrawal Treatment

Answer 19

Treatments provide nicotine without the carcinogens in tobacco
Nicotine transdermal system (patch), nicotine polacrilex (gum), inhalers, nasal spray