Psychoactive Drug Intoxication and Withdrawal
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Questions and Answers

What is the prototypic effect of opioid receptor activation?

  • Enhanced cognitive function
  • Hyped energy levels
  • Miosis (pinpoint pupils) (correct)
  • Increased gastrointestinal activity

What is a common treatment for opioid overdose?

  • Naloxone (correct)
  • Amphetamines
  • Methadone
  • Buprenorphine

Which of the following symptoms is associated with stimulant use?

  • Slurred speech
  • Euphoria (correct)
  • Lethargy
  • Drowsiness

What is a characteristic withdrawal symptom of caffeine?

<p>Headache (A)</p> Signup and view all the answers

What is the mechanism of action for methamphetamine?

<p>Induces reversal of monoamine transporters (A)</p> Signup and view all the answers

Inhalants primarily enhance which signaling pathway?

<p>GABA signaling (A)</p> Signup and view all the answers

What is a common psychological effect experienced during the 'post-use crash' from stimulants?

<p>Severe anxiety (D)</p> Signup and view all the answers

Which symptom is NOT typically associated with opioid intoxication?

<p>Cardiac arrest (C)</p> Signup and view all the answers

What is the primary effect of alcohol intoxication on the body?

<p>Mood elevation and sedation (D)</p> Signup and view all the answers

Which of the following symptoms is NOT associated with alcohol withdrawal?

<p>Emotional lability (B)</p> Signup and view all the answers

What treatment is indicated for severe alcohol withdrawal symptoms?

<p>Long-acting benzodiazepines (C)</p> Signup and view all the answers

Which receptor is primarily affected by barbiturates?

<p>GABA-A receptors (C)</p> Signup and view all the answers

Identify a danger associated with barbiturate use.

<p>Life-threatening cardiovascular collapse (C)</p> Signup and view all the answers

What is a common symptom of alcohol intoxication?

<p>Slurred speech (D)</p> Signup and view all the answers

Which effect is caused by the adaptation to alcohol consumption?

<p>Unregulated excess excitation via glutamate receptors (C)</p> Signup and view all the answers

What is a symptom of benzodiazepine withdrawal?

<p>Sleep disturbance (B)</p> Signup and view all the answers

Which symptoms are commonly associated with cocaine use?

<p>Impaired judgment and hallucinations (C)</p> Signup and view all the answers

Which receptor does lysergic acid diethylamide (LSD) primarily act on?

<p>5-HT2A receptor (B)</p> Signup and view all the answers

What is a major risk associated with chronic cocaine use?

<p>Perforated nasal septum (B)</p> Signup and view all the answers

Which of the following symptoms is NOT typically associated with nicotine withdrawal?

<p>Severe hallucinations (C)</p> Signup and view all the answers

MDMA is known to induce which of the following effects?

<p>Bruxism and hyperactivity (B)</p> Signup and view all the answers

What is the primary treatment for managing cocaine overdose?

<p>Benzodiazepines (A)</p> Signup and view all the answers

Which condition is a possible effect of cannabis use?

<p>Hallucinations and irritability (B)</p> Signup and view all the answers

What type of receptor is targeted by cannabinoids?

<p>CB1 receptor (D)</p> Signup and view all the answers

What is a complication associated with alcohol use disorder?

<p>Hepatitis (A)</p> Signup and view all the answers

Which of the following medications is contraindicated in renal failure?

<p>Acamprosate (B)</p> Signup and view all the answers

Wernicke-Korsakoff syndrome is primarily caused by a deficiency of which vitamin?

<p>Vitamin B1 (B)</p> Signup and view all the answers

What is the primary treatment for Wernicke encephalopathy?

<p>Intravenous Vitamin B1 (B)</p> Signup and view all the answers

Which type of therapy focuses on enhancing intrinsic motivation to change?

<p>Motivational Interviewing (A)</p> Signup and view all the answers

What is a goal of cognitive behavioral therapy?

<p>Change maladaptive thought processes (D)</p> Signup and view all the answers

Which symptom is associated with Korsakoff syndrome?

<p>Confabulation (C)</p> Signup and view all the answers

Which therapeutic approach is specifically designed for borderline personality disorder?

<p>Dialectical Behavioral Therapy (A)</p> Signup and view all the answers

Which type of antipsychotics is primarily effective in treating both positive and negative symptoms of schizophrenia?

<p>Atypical antipsychotics (D)</p> Signup and view all the answers

What is a significant side effect associated with the use of clozapine?

<p>Agranulocytosis (B)</p> Signup and view all the answers

Which class of antipsychotics block serotonin 5-HT2 receptors in addition to dopamine D2 receptors?

<p>Atypical antipsychotics (C)</p> Signup and view all the answers

What condition may be treated with typical antipsychotics?

<p>Tourette syndrome (D)</p> Signup and view all the answers

Which of the following is NOT a common adverse effect of antipsychotics?

<p>Euphoria (B)</p> Signup and view all the answers

Which of the following treatments is most appropriate for akathisia resulting from antipsychotic use?

<p>Benzodiazepines (B)</p> Signup and view all the answers

What is the primary mechanism of action for aripiprazole among antipsychotics?

<p>Dopamine D2 partial agonist (A)</p> Signup and view all the answers

Which adverse effect is linked to the long-term use of typical antipsychotics?

<p>Galactorrhea (A)</p> Signup and view all the answers

What is a significant adverse effect associated with lithium use?

<p>Tremor (D)</p> Signup and view all the answers

Which statement best describes the mechanism of buspirone?

<p>Partial 5-HT1A receptor agonist (A)</p> Signup and view all the answers

What clinical use is primarily indicated for lithium?

<p>Mood stabilization in bipolar disorder (C)</p> Signup and view all the answers

Which of the following can contribute to lithium toxicity?

<p>Use of diuretics (B)</p> Signup and view all the answers

Which statement accurately reflects the onset of buspirone's therapeutic effects?

<p>Begins to take effect after 1-2 weeks (D)</p> Signup and view all the answers

Which class of antidepressants primarily inhibits the reuptake of norepinephrine (NE)?

<p>SNRIs (A), TCAs (B), Bupropion (C)</p> Signup and view all the answers

Which of the following receptors is associated with autoregulation of norepinephrine release?

<p>α2 adrenergic receptor (D)</p> Signup and view all the answers

What is the primary action of selective serotonin reuptake inhibitors (SSRIs)?

<p>Inhibit 5-HT reuptake (C)</p> Signup and view all the answers

Which of these antidepressants is directly involved in the antagonism of the 5-HT receptor?

<p>Mirtazapine (A), Trazodone (C)</p> Signup and view all the answers

Which mechanism is commonly employed by mixed reuptake inhibitors in antidepressant therapies?

<p>Blocking norepinephrine and serotonin reuptake (A)</p> Signup and view all the answers

Flashcards

Alcohol Intoxication Mechanism

Alcohol activates GABA-A receptors and inhibits glutamate receptors, causing mood elevation, sedation, and behavioral disinhibition.

Alcohol Withdrawal Symptoms

Withdrawal causes anxiety, tremors, seizures, insomnia, and disinhibition.

Alcohol Withdrawal Seizures

Severe withdrawal can lead to life-threatening seizures.

Barbiturates Intoxication

Barbiturates, like alcohol, affect GABA-A receptors; marked respiratory depression.

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Barbiturate Withdrawal

Can lead to delirium tremens and potentially fatal cardiovascular collapse.

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Benzodiazepines Intoxication

Benzodiazepines are similar to barbiturates, targeting GABA-A receptors but with higher safety margins.

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Benzodiazepine Withdrawal Symptoms

Withdrawal can include seizures and sleep disturbance.

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Treatment for Intoxication

Supportive care, including fluids, antiemetics, and potentially longer-acting benzodiazepines are used to stabilize the individual.

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Opioids Mechanism

Opioids activate opioid receptors, causing effects like miosis (pinpoint pupils), GI motility changes, respiratory depression, and CNS depression.

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Opioid Intoxication Symptoms

Mydriasis, diarrhea, unusual symptoms, rhinorrhea, yawning, nausea, sweating, piloerection, lacrimation, and gag reflex impairment.

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Opioid Overdose Treatment

Naloxone is used to reverse the effects of an opioid overdose.

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Stimulants Mechanism

Stimulants induce reversal of monoamine transporters (VMAT, DAT, SERT, NET), increasing neurotransmitter release.

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Stimulant Intoxication Symptoms

Mood elevation, appetite suppression, psychomotor agitation, insomnia, and cardiac arrhythmias.

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Caffeine Mechanism

Caffeine blocks adenosine receptors, leading to stimulation and related effects.

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Caffeine Intoxication Symptoms

Palpitations, agitation, tremors, insomnia.

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Inhalants Mechanism

Inhalants enhance GABA signaling, causing disinhibition and related effects.

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Cocaine's Action

Cocaine blocks the reuptake of dopamine, serotonin, and norepinephrine in the brain, leading to increased levels of these neurotransmitters.

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Cocaine's Effects

Cocaine causes euphoria, increased alertness, decreased fatigue, and a sense of well-being, along with potential side effects like anxiety, paranoia, and hallucinations.

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Cocaine's Long-Term Effects

Chronic cocaine use can lead to addiction, insomnia, depression, and even heart problems.

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Nicotine's Action

Nicotine stimulates nicotinic acetylcholine receptors in the brain, leading to a release of dopamine and other neurotransmitters.

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Nicotine's Effects

Nicotine causes increased alertness, focus, and a sense of relaxation, along with potential side effects like anxiety, irritability, and insomnia.

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LSD (Lysergic Acid Diethylamide) Action

LSD is a potent agonist at the 5-HT2A serotonin receptor in the brain, leading to altered perceptions and altered states of consciousness.

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LSD's Effects

LSD causes hallucinations, altered perceptions of time and space, and altered mood, along with potential side effects like anxiety, paranoia, and psychosis.

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MDMA (Ecstasy) Action

MDMA induces the release of serotonin, dopamine, and norepinephrine, and blocks their reuptake in the brain.

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Alcohol Use Disorder

A chronic, relapsing brain disease characterized by an inability to control alcohol use despite negative consequences. Diagnosed using criteria for substance use disorder.

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Wernicke-Korsakoff Syndrome

A neurological disorder caused by thiamine deficiency, often associated with chronic alcoholism. Characterized by confusion, eye movement problems, and gait disturbances. Can progress to irreversible memory loss and personality changes.

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Naltrexone for Alcohol Use Disorder

A medication used to reduce alcohol cravings. It works by blocking opioid receptors in the brain, which are involved in the rewarding effects of alcohol.

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Acamprosate for Alcohol Use Disorder

A medication that helps maintain abstinence from alcohol by reducing cravings and withdrawal symptoms. It is thought to modify neurotransmitter activity in the brain.

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Disulfiram for Alcohol Use Disorder

A medication that causes unpleasant side effects (nausea, vomiting, flushing) when alcohol is consumed. It works by inhibiting the breakdown of acetaldehyde, a toxic byproduct of alcohol metabolism.

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Behavioral Therapy for Substance Use Disorder

A type of therapy that teaches patients to identify and change maladaptive behaviors or reactions to stimuli that trigger substance use (e.g., systematic desensitization for phobias).

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Cognitive Behavioral Therapy (CBT) for Substance Use Disorder

A type of therapy that helps patients recognize distorted thoughts, develop coping skills, and challenge maladaptive coping behaviors, leading to greater emotional control.

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Dialectical Behavioral Therapy (DBT) for Substance Use Disorder

A type of therapy developed for borderline personality disorder but can be used in other conditions, including substance use disorder. DBT teaches skills for emotional regulation, distress tolerance, and interpersonal effectiveness.

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Typical Antipsychotics

First-generation antipsychotics like haloperidol and chlorpromazine. They primarily block dopamine D2 receptors, treating positive symptoms of schizophrenia.

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Atypical Antipsychotics

Second-generation antipsychotics like clozapine and risperidone. They block both dopamine D2 and serotonin 5-HT2 receptors, treating both positive and negative symptoms of schizophrenia.

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Neuroleptic Malignant Syndrome

A serious adverse effect of antipsychotics characterized by high fever, muscle rigidity, altered mental status, and autonomic instability.

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Extrapyramidal Symptoms (EPS)

Movement disorders caused by antipsychotics, including acute dystonia, akathisia, parkinsonism, and tardive dyskinesia.

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Acute Dystonia

A type of EPS characterized by muscle spasms, stiffness, and involuntary eye movements (oculogyric crisis). Occurs within hours to days of starting antipsychotics.

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Akathisia

A type of EPS characterized by restlessness, inability to sit still, and pacing. Occurs within days to months of starting antipsychotics.

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Tardive Dyskinesia

A type of EPS characterized by involuntary movements, especially in the face and mouth (chorea). It develops months to years after starting antipsychotics and can be permanent.

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Clozapine

An atypical antipsychotic used for treatment-resistant psychosis and those with persistent suicidality. Known for its risk of agranulocytosis (low white blood cell count).

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Antihistaminic, Anti-!-adrenergic, Antimuscarinic (Anti-HAM)

Common side effects of typical antipsychotics: sedation, orthostatic hypotension, and dry mouth/constipation.

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Lithium's Mechanism

Lithium affects neurotransmission by influencing both excitatory and inhibitory pathways. It also interacts with second messenger systems, like G proteins.

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Lithium's Clinical Use

Lithium is a mood stabilizer used in bipolar disorder. It treats acute manic episodes and helps prevent relapses.

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Lithium: Adverse Effects

Lithium can cause tremors, thyroid problems (hypothyroidism or hyperthyroidism), mild hypercalcemia, increased urination (nephrogenic diabetes insipidus), birth defects (Ebstein anomaly), and narrow therapeutic window requiring careful monitoring.

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Buspirone: Mechanism

Buspirone acts as a partial agonist of the 5-HT1A receptor.

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Buspirone: Clinical Use

Buspirone is used for generalized anxiety disorder. Unlike other anxiolytics, it doesn't cause sedation, addiction, or tolerance.

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What are the main neurotransmitters targeted by antidepressants?

Antidepressants primarily target norepinephrine (NE) and serotonin (5-HT) pathways in the brain.

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What are the main ways antidepressants work?

Antidepressants can work by inhibiting monoamine oxidase (MAO), blocking reuptake of NE and 5-HT, or by affecting receptors for these neurotransmitters.

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What is an autoreceptor?

An autoreceptor is a receptor located on the presynaptic neuron that responds to the neurotransmitter it releases. It can regulate further release of that neurotransmitter.

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What is the role of alpha-2 adrenergic receptors in antidepressant mechanisms?

Alpha-2 adrenergic receptors, when activated, can inhibit the release of norepinephrine (NE). Some antidepressants, like mirtazapine, work by blocking these autoreceptors, leading to increased NE activity.

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What are examples of antidepressant categories?

Some major antidepressant categories include tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and others like bupropion and trazodone.

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Study Notes

Psychoactive Drug Intoxication and Withdrawal

  • Depressants:

    • Mechanism: GABA-A receptor positive allosteric modulator, inhibiting glutamate-induced excitation of NMDA receptors. Alcohol also causes emotional lability, slurred speech, ataxia, coma, and blackouts.
    • Intoxication: Mood elevation, reduced anxiety, sedation, behavioral disinhibition, respiratory depression.
    • Withdrawal: Anxiety, tremor, seizures, insomnia. Adaptation to chronic use causes elevated glutamate receptors, leading to symptoms from unregulated excitation.
    • Alcohol Specific: Alcoholic hallucinosis (typically visual), withdrawal seizures, tremors, insomnia, diaphoresis, agitation, GI upset, delirium tremens.
    • Barbiturates: Low safety margin, significant respiratory depression. Symptoms include ataxia, minor respiratory depression. Treatment includes symptom management and potentially flumazenil.
    • Benzodiazepines: Greater safety margin, with ataxia and minor respiratory depression as common effects. Treatment is with flumazenil (benzodiazepine receptor antagonist).

  • Opioids:

    • Mechanism: Opioid receptor modulator. Activation of u receptors causes miosis, GI motility and CNS depression, and euphoria.
    • Intoxication: Miosis (pinpoint pupils), GI motility, respiratory, and CNS depression, euphoria, and reduced gag reflex.
    • Withdrawal: Mydriasis, diarrhea, flu-like symptoms, rhinorrhea, yawning, nausea, sweating, piloerection, lacrimation.

  • Inhalants:

    • Mechanism: Enhanced GABA signaling, leading to disinhibition, euphoria, and a range of other symptoms.
    • Intoxication: Euphoria, slurred speech, ataxia, disorientation, drowsiness, periorifical rash.
    • Withdrawal: Irritability, dysphoria, sleep disturbance, headache.

  • Stimulants:

    • Mechanism: Reversal of monoamine transporters, increasing neurotransmitter release.
    • Intoxication: Mood elevation, appetite suppression, psychomotor agitation, insomnia, cardiac arrhythmias, increased heart rate, anxiety, euphoria, grandiosity, mydriasis, prolonged wakefulness, and hyperalertness.
    • Amphetamines: Skin excoriations, severe effects including cardiac arrest and seizures, are possible. Treatment includes benzodiazepines.
    • Withdrawal: "crash" including depression, lethargy, increased appetite, sleep disturbance, and vivid nightmares.

Other Psychoactive Drugs

  • Caffeine: Intoxication includes palpitation, agitation, tremor, and insomnia; withdrawal includes headache, difficulty concentrating, and flu-like symptoms.

  • Cocaine: Blocks dopamine, serotonin, and norepinephrine reuptake (DAT, SERT, NET), causing impaired judgment, mydriasis, diaphoresis, hallucinations, and paranoia. Withdrawal includes restlessness, severe depression, sleep disturbances.

  • Nicotine: Stimulates central nicotinic acetylcholine receptors. Intoxication includes restlessness, while withdrawal includes irritability, anxiety, and reduced concentration.

  • Hallucinogens (LSD):

    • Mechanism: 5-HT2A receptor agonist.
    • Effects: Perceptual distortion, anxiety, paranoia, psychosis, flashbacks.

  • Cannabis/Cannabinoids: CB1 receptor agonist, resulting in symptoms such as euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgment, social withdrawal, elevated appetite, and dry mouth.

  • MDMA (Ecstasy): Induces reversal of monoamine transporter, increasing neurotransmitter release, causing euphoria, hallucinations, disinhibition, hyperactivity, increased thirst, teeth grinding, distorted perceptions, mydriasis, and other life-threatening effects such as hypertension, tachycardia, hyperthermia, hyponatremia.

  • Phencyclidine: NMDA receptor antagonist. Effects include violence, nystagmus, impulsivity, psychomotor agitation, tachycardia, hypertension, analgesia, psychosis, and delirium.

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Related Documents

Psychoactive Drug Intoxication & Withdrawal PDF
Therapies PDF
Antipsychotics PDF
Lithium PDF - Psychiatry Pharmacology

Description

This quiz explores the mechanisms, symptoms, and treatment options related to intoxication and withdrawal from psychoactive depressants. It delves into the effects of alcohol, barbiturates, and benzodiazepines, including their risks and withdrawal symptoms. Test your knowledge on the physiological reactions and management strategies involved.

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