1
Traditionally the treatment of choice for heroin abusers in pregnant women
methadone
Patient presents to ED with general fatigue, hypersomnolence, and depression. Commonly will see this in a patient withdrawing from...
Cocaine
The best treatment option for an alcoholic who wants to stop but has cirrhosis of the liver
Acamprosate
What enzyme is typically INDUCED by cigarette smoke? What specific part?
CYP1A2, Polyaromatic hydrocarbons
Affects in particular Clozapine, Olanzapine
18 y/o patient presents with HTN, tacycardia, and vertical nystagmus. Unable to verbally re-direct requiring multiple security guards to hold down. What drug?
PCP
This substance is most likely associated with leading to developing Bipolar disorder and/or schizophrenia
Cannabis
Multiple staff members working for a dentist are increasingly concerned due to him staying excessively late at office. His dexterity in treating patients is worsening. He's complaining of weakening of the limbs and loss of balance. What substance is the dentist possibly abusing?
Inhalant (NITROUS OXIDE)
What type of psychotherapy is used to help patients stop becoming ambivalent about their drug use/have them change-try to quit?
Motivational interviewing
carbohydrate deficient transferrin
50 y/o alcoholic is presenting confused with oculomotor disturbance, dysarthria, and ataxia. What do you give first?
IV Thiamine
What is the purpose of Al-Anon?
It's a support group for family members/friends of substance users
What is the best evidence that alcoholism is hereditary?
Synesthesia
Sedative that has a Phenobarbital challenge test to determine the right amount of phenobarbital needed to detox from this substance.
Hint: Keeps GABA channel OPEN LONGER
Barbiturate
Which benzodiazepine options are safest for those in alcoholics with liver disease?
OTL (oxazepam, temazepam, lorazepam)
Enzyme that is lacking in Asians when drinking causing the "Asian glow"
Aldehyde dehydrogenase
Most likely substance (known for highest DA surge/release) that results in tachycardia, dilated pupils, significant mood lability and psychosis
Amphetamines
The difference between stimulant amphetamine vs cocaine
Amphetamine: presynaptic DA release
Cocaine: postsynaptic DA reuptake blockade
This medication is used in benzodiazepine overdose
Flumazenil
Difference between Buprenorphine versus Methadone versus Naltrexone
Buprenorphine = partial mu opioid agonist
Methadone = full mu opioid agonist
Naltrexone = mu opioid antagonist
23 y/o comes to the ER after a party. He's dehydrated with dilated pupils, HTN, and has elevated CPK. Notable bruxism. What substance did he take?
MDMA/Ecstasy
Rohypnol (Fluinitrazepam = benzo, roofie)
GHB gamma-hydroxy-butyrate (cleaning product solvent ex. nail polish, super glue remover)
This medication is used to help treat an alcoholic who recently drank antifreeze (ethylene glycol)
Fomepizole (also may need hemodialysis)
Key physical changes seen in an anabolic steroid abusing male and female bodybuilders
ACNE
Men: gynecomastia, testicular atrophy
Women: Shrinking breasts, clitoral hypertrophy
Mechanism of action of varenicline/Chantix involving the DA reward pathway