Unit 7

When is pharmacotherapy indicated for patients with anxiety?

When the anxiety becomes severe enough to significantly interfere with ADLs

What is the most commonly abused substance in the healthcare field?

alcohol, secondary to prescription drugs

Hallucinogens cause an _____ state of thought and perception similar to that found in _____.

altered dreams

What are the three classes of drugs used to treat anxiety that are CNS depressants?

antidepressants benzodiazepines barbiturates

The primary indication for benzodiazepines is _____. Thus they are called _____.

anxiety anxiolytic

How long should you take methylphenidate (Concerta, Metadate, Ritalin) before going to sleep?

at least six hours prior to sleep to avoid insomnia

What can happen to the liver upon chronic alcohol abuse?

cirrhosis

CNS depressants act by _____ the activity of the CNS. They cause people to feel _____ or relaxed. T/F: Most CNS depressants are controlled substances d/t their high abuse potential.

decreasing sedated True

CNS stimulants _____ the activity if the CNS.

increase

The organ most affected by chronic alcohol abuse is the _____.

liver

Antidepressants have an ability to enhance _____ by altering the levels of _____ and _____ neurotransmitters in the brain.

mood norepinephrine serotonin

Opioids are prescribed for severe _____, persistent _____, and _____.

pain cough diarrhea

What may happen if you take alcohol while also taking Disulfiram?

patient becomes violently ill within 5 to 10 minutes, with headache, shortness of breath, nausea, vomiting, and other unpleasant symptoms

Substance dependence is classified as _____ or _____ dependence.

physical psychological

Microorganisms become _____ to the effects of an antibiotic; they do not become _____. Patients become _____ to the effects of pain relievers; they do not become _____. Therefore, it is incorrect to say that patients are _____ to drug therapy.

resistant, tolerant tolerant, resistant immune

What is another word for tranquilizers?

sedatives

Tranquilizers (sedatives) are mainly prescribed for _____ disorders. The two primary classes of sedatives are _____ and _____.

sleep barbiturates and non-barbiturate sedative hypnotics

Nicotine is powerful and highly addictive because it is a CNS _____. It increases _____.

stimulant alertness

When taking MAOIs, you should avoid foods with what in them?

tyramine

When does tolerance occur?

when a higher and higher dose of the drug is needed to achieve the initial response

What is the common ending for benzodiazepines?

-am

Choose the correct definition for each type of dependence: 1. Physical 2. Psychological a. causes no apparent signs of physical discomfort after the agent is stopped. The person, however, will have an intense craving and will display an overwhelming desire to continue using the substance when if there are obvious negative economic, physical, or social consequences. This is often what is the cause of relapse b. an altered physical condition caused by the nervous system adapting to repeated use of a substance. Over time, the body's cells are tricked into believing that it is normal for the substance to continually be present. Uncomfortable symptoms, known as withdrawal syndrome, occur when the agent is stopped.

1. b 2. a

Match the following regions of the brain with their role in anxiety symptoms: 1. Cerebral Cortex 2. Diencephalon 3. Brain Stem a. Triggers unconscious responses to extreme stress (fight-or-flight response) b. Responsible for overall level of heightened alertness c. Responsible for emotional expression, learning, memory, anxious feelings, fear, dread, restlessness, and alertness

1. c 2. a 3. b

Match the following terms to their correct definition: 1. Addiction 2. Tolerance 3. Withdrawal 4. Abuse a. b. uncomfortable symptoms that occur when the agent is stopped or no longer available c. the progressive and chronic abuse of a substance, is an overwhelming desire that drives someone to use a drug repeatedly despite serious health and social consequences d. biological condition that occurs when the body adapts to a substance after it is repeatedly administered, administered. Over time, higher doses of the agent are needed to produce the initial affect.

1. c 2. d 3. b 4. a

When inhales, marijuana introduces _____ times more tar into the lungs than tobacco smoke.

4

What are the two most commonly used drugs>

Alcohol and nicotine

What are some variables that influence addiction in the following category: History of trauma, or physical or sexual abuse

Correlated to later substance abuse in represented groups (e.g. children, women, men)

What are some variables that influence addiction in the following category: Agent or Drug Factors

Cost, availability, dose, method of administration (e.g., oral, IV, inhalation), speed of onset or duration of effect, and length of drug use

What is the name for what happens when tolerance develops to one substance, and it often also occurs with use of closely related drugs.

Cross tolerance

What are some of the classifications that belong to abused and misused drugs?

Designer drugs Club drugs

What is disulfiram used for?

Disulfiram (Antabuse) may be given to discourage relapses. Disulfiram inhibits acetaldehyde dehydrogenase, the enzyme that metabolizes alcohol.

T/F: Someone who is trying to get 100% clean can still be on methadone.

False, they must be completely off of it

T/F: It is okay to combine CNS depressants (including alcohol).

False: Never combine CNS depressants (including alcohol) unless advised to do so by a healthcare provider.

What are some variables that influence addiction in the following category: User Factors

Genetic factors (e.g., metabolic enzymes, natural tolerance), tendency toward risk-taking behavior, prior experiences with drugs, disease that may require a scheduled drug

What is the drug used to treat withdrawal symptoms/opioid addiction?

Methadone

When does withdrawal occur?

Once an individual becomes physically dependent and the substance is stopped

T/F: Use of marijuana increases motor activity, increases coordination, and causes connected thoughts, paranoia, and euphoria. It increases thirst and craving for food, particularly chocolate and other sweets.

Partly false: it decreases motor activity, decreases coordination, and causes disconnected thought. The rest is true.

What is the hallmark symptom of marijuana use?

Red or bloodshot eyes caused by dilation of blood vessels

What are the three major bran regions responsible for anxiety and wakefulness?

Regions of the cerebral cortex, diencephalon, and brainstem

What kind of drug is the preferred DOC for anxiety?

SSRIs

Why must healthcare providers strive to remain free from impairment?

So that we can safely care for patients

What are some variables that influence addiction in the following category: Environmental factors

Social and community norms (behavior accepted within a community), role models, peer influences, educational opportunities, underprivileged population groups

Why is substance abuse by healthcare providers more common than we think?

Their jobs are very high stress. Difficulty sleeping is another issue. Social environments among medical professionals that promote self-reliance and independence.

What is the correlation between nicotine/cigarettes and birth control use?

They both increase the risk for blood clots, so when they are used together there is a greater risk of blood clots.

T/F: Tolerance should be thought of as a natural consequence of continued drug use and not be considered evidence of addiction or substance abuse.

True

T/F: You should avoid sources of caffeine such as chocolate, coffee, tea, and OTC drugs with caffeine if taking CNS stimulants.

True