Substance Abuse and Overdose

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Questions and Answers

What is the primary mechanism of action of cocaine in producing euphoria?

Releasing dopamine from storage

Increasing the uptake of dopamine (correct)

Blocking the uptake of dopamine

Breaking down dopamine

What is a unique toxicity associated with ecstasy abuse?

Ventricular dysrhythmias

Hyperthermia (correct)

Cannabinoid hyperemesis syndrome

Hemorrhagic stroke

What is a common physical effect of marijuana abuse?

Constriction of airway

Bronchodilation

Reddening of conjunctiva (correct)

Orthostatic hypertension

What is a common psychological effect of methamphetamine abuse?

Delusions Signup and view all the answers

What is a cardiovascular effect of methamphetamine abuse?

Hypertension Signup and view all the answers

What is a potential long-term effect of marijuana abuse on the brain?

Reduction in size of hippocampus and amygdala Signup and view all the answers

What is the primary function of dopamine in the brain?

To influence how we interact with the world Signup and view all the answers

What is the role of norepinephrine in the brain?

To have an excitatory impact on mood and anxiety Signup and view all the answers

What is a rare effect of antidepressant medications?

All of the above Signup and view all the answers

What is the primary function of serotonin in the brain?

To serve as a chemical mediator in pain perception Signup and view all the answers

Why should MAOIs and SSRIs not be taken together?

Due to the risk of serotonin syndrome Signup and view all the answers

What is the role of GABA in the brain?

To reduce a nerve cell's ability to send and receive chemical messages Signup and view all the answers

What should be done when switching from one psychiatric medication to another?

Taper off the original medication, followed by a washout period Signup and view all the answers

What is the greatest risk for patients taking MAOIs?

Hypertensive crisis due to eating foods high in tyramine Signup and view all the answers

What is a classic adverse reaction associated with first-generation antipsychotic medications?

Prolonged QTc interval Signup and view all the answers

What is an important aspect of patient monitoring when prescribing clozapine?

Monitoring complete blood count (CBC) Signup and view all the answers

What conditions does Risperidone treat?

Manic episodes of bipolar disorder Signup and view all the answers

What does Lithium treat?

Mania and depressive episodes of bipolar illness Signup and view all the answers

What is a potential side effect of clozapine?

Sedation Signup and view all the answers

Are Risperidone and Lithium ever used in combination?

Yes, to control symptoms of mania Signup and view all the answers

What is a rare but serious side effect of clozapine?

Both A and B Signup and view all the answers

What is a sign of serotonin syndrome?

Headache, tachycardia, and hypertension Signup and view all the answers

What are the common signs and symptoms of drug withdrawal?

Dilated pupils, increased vital signs, physical fatigue, rhinorrhea, sleep disturbances Signup and view all the answers

What is the treatment for tremors caused by lithium?

Divided doses, sustained release doses, or a beta blocker Signup and view all the answers

What is the drug of choice for a pure manic episode?

Mood stabilizers, seven second-generation antipsychotics, and a benzodiazepine if needed Signup and view all the answers

What medication can worsen asthma symptoms?

Typical antipsychotics (clozapine) as well as anticholinergics (amitriptyline) and imipramine Signup and view all the answers

What health information should be monitored in patients receiving methylphenidate?

Release of norepinephrine and dopamine Signup and view all the answers

What is the treatment for lithium toxicity?

Hemodialysis if necessary Signup and view all the answers

What is the drug of choice for depression?

SSRI (Fluoxetine) Signup and view all the answers

What is the treatment for polyuria caused by lithium?

Amiloride, a potassium-sparing diuretic, and staying hydrated Signup and view all the answers

What is a common effect of cocaine abuse on appetite?

Decrease appetite Signup and view all the answers

What is a potential issue in patients with cardiac disorders who take cocaine?

Increased risk of heart problems Signup and view all the answers

What is a characteristic of substance abuse disorder?

Physical dependence is neither necessary nor sufficient for addiction to occur Signup and view all the answers

What is a medication that patients with alcohol abuse disorder should not take?

Antihypertensive drugs Signup and view all the answers

What is a potential long-term effect of alcohol abuse on the brain?

Enlargement of cerebral ventricles Signup and view all the answers

What is a physical manifestation of cocaine abuse?

Weight loss Signup and view all the answers

What is a laboratory test that should be monitored in a patient taking lithium?

Blood levels for toxicity Signup and view all the answers

What is a potential consequence of excessive use of cocaine?

Paranoid psychosis Signup and view all the answers

Study Notes

Substance Abuse and Psychiatric Medications

Cocaine abuse: euphoria through uptake of dopamine, toxicity includes agitation, dizziness, tremor, blurred vision, hyperpyrexia, convulsions, ventricular dysrhythmias, and hemorrhagic stroke, anxiety, paranoia, and hallucinations.
Ecstasy abuse: euphoria, psychedelic effects in low dose and amphetamine-like effects in high doses, toxicity includes neurotoxicity, seizures, excessive cardiac stimulation, and hyperthermia.
Marijuana abuse: euphoria, sedation, and hallucinations, increased sensitivity and humor, delusions, toxicity includes antimotivation syndrome, cannabinoid hyperemesis syndrome, increased HR, orthostatic hypotension, and reddening of conjunctiva, bronchodilation, but constriction of airway with chronic use, decreased sperm count, reduction in size of hippocampus and amygdala.
Methamphetamine abuse: increases norepinephrine and dopamine uptake, produces arousal and elevation of mood, euphoria, and talkativeness, increased physical strength and mental capacity, toxicity includes delusions, paranoia, hallucinations, psychosis, vasoconstriction, angina, hypertension, and weight loss.

Neurotransmitters in Psych

Dopamine: influences how we interact with the world, found in all areas of the brain, involved in psychosis, associated with schizophrenia, bipolar, and Alzheimer's.
Norepinephrine: excitatory impact, major role in mediating mood and anxiety, regulation of NE is generally used in treating mood and anxiety disorders, associated with major depression, bipolar, Alzheimer's, and anxiety.
Serotonin: influence temperature, sensory, sleep, and assertiveness areas of the brain, serves as chemical mediator in pain perceptions, normal and abnormal behaviors, moods and drives, regulation of food intake, and neuroendocrine functions, associated with major depression, bipolar, Alzheimer's, and anxiety.
GABA: chemical made in the brain, inhibitory NT that reduces a nerve cells' ability to send and receive chemical messages through CNS, linked with anxiety, autism, and Parkinson's, bipolar, and anxiety.
Acetylcholine: first NT, plays a major role in encoding memory and cognition, associated with Alzheimer's and bipolar.

Adverse Reactions and Management

Classic adverse reactions associated with first-generation antipsychotic medications include orthostatic hypertension, prolonged QTc interval, anticholinergic, weight gain, diabetes, sexual side effects, blood disorders, neuroleptic malignant syndrome, photosensitivity, and lowered seizure threshold.
Education for patients and families regarding possible side effects and patient monitoring when prescribing clozapine: blocks receptors for serotonin and dopamine, used for schizophrenia and reducing suicidal behavior when other drugs have failed, monitor CBC, cardiovascular exam, and blood glucose, adverse effects include sedation, weight gain, lowered BP, anticholinergic effects, new onset diabetes, dyslipidemia, and seizures.
Managing sexual dysfunction caused by antidepressant medications: reducing the dosage of the medication or switching to a high potency FGA may reduce adverse effects.
Why MAOIs and SSRIs should not be taken together: combining MAOIs and SSRIs leaves a patient vulnerable to serotonin syndrome, prevention includes tapering off the original antipsychotic, followed by a washout period, and then starting a slow and tapered dose of the second medication.
Patient education for MAOI: the greatest risk is hypertensive crisis due to eating foods high in tyramine, which leads to a buildup of tyramine in the body, causing massive vasoconstriction and intense stimulation of the heart.
Conditions treated by Risperidone: BPD manic episodes.
Conditions treated by Lithium: mania and depressive episodes of bipolar illness, Lithium can be combined with Risperidone to control symptoms during an acute manic episode.
Signs and symptoms of serotonin syndrome: mental status changes, autonomic instability, neuromuscular problems, and GI disturbances.
Signs and symptoms of drug withdrawal: dilated pupils, increased vital signs, physical fatigue, rhinorrhea, sleep disturbances, N/V, cramping, diarrhea, anxiety, irritability, and depression.

Psychiatric Medications and Conditions

Conditions that may develop as a result of taking lithium and their treatments: tremors, polyuria, goiter and hypothyroidism, and lithium toxicity.
Drug of choice for different types of mania: pure manic episode (Euphoria mania), hypomanic episode, major depressive episode, and mixed episode.
Drug of choice for depression: SSRI (e.g., Fluoxetine), atypical antipsychotic, or a mood stabilizer/antipsychotic plus an antidepressant.
Drug of choice for panic attacks: SSRI (e.g., Prozac) or SNRI (e.g., venlafaxine), benzodiazepines (e.g., Xanax, Valium, and Ativan) are also a first-choice treatment for anxiety disorders.
Psychiatric medications that potentiate asthma: typical antipsychotics (e.g., clozapine), anticholinergics (e.g., amitriptyline), and imipramine.
Health information to be monitored in patients receiving methylphenidate: considered an amphetamine, releases norepinephrine and dopamine, increases wakefulness, alertness, mood, stimulates respiration, decreases appetite, increases heart rate, and has high potential for tolerance as well as abuse, can cause insomnia and restlessness, weight loss, and increased HR and BP, which can cause issues in patients with previous cardiac disorders.

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Description

This quiz covers the effects of overdose on substances like cocaine and ecstasy, including symptoms of toxicity, euphoria, and psychological effects.