Jeena's Substance Use Trivia

Med/Subs induced psychosis

100

most common cause of organic paranoid symptoms

stimulant use

200

Benzo Abuse Disorder Pt just O.D.ed. What can you consider giving them as antidote, and what is something you need to be wary of when giving this antidote?

• flumazenil
  • competitive GABAa antagonist

• DO NOT treat benzodiazepine overdose with flumazenil
  • in general it is benign and the patient can "sleep off" the overdose
  • offer respiratory support if needed
  • flumazenil can precipitate seizures particularly if the patient is benzodiazepine dependent

300

what is the MDMA Ecstasy O.D. pt's presentation? (behaviorally and medically?)

presentation

• hyperthermia and social closeness
  • "club drug"
• hyponatremia
  • due to increased fluid intake or antidiuretic hormone (ADH) secretion

400

How to you treat methamphetamine O.D.

include the vitamin that promotes excretion of methamphetamines

treatment

• pharmacologic
  • antipsychotics (haloperidol)
  • benzodiazepines
  • vitamin C (promotes excretion)
  • antihypertensives
  • propranolol (BP + tachycardia control)

500

Medication induced psychosis: name 7 drugs 

Nsaids opioids salicyclates

amantadine, antimuscarinics

dopaminergic, selegeline

ACEi, B blockers , ca channel blockers, clonidine

anabolic steroids 

cortiosteroids

cephalosporins, dapsone, streptomycin TMPSMX metronidazole, ioniozide

h2 agonists, PPIS

antivirals

baclofan, antihistamines, barbiturates, pseudoephedrine, EPO, dextropehrophan, sildenafil 

Pharmacology/Neuro Pathyways

100

most well studied medication in geriatrics for addiction

 Naltrexone is the most well-studied medication

200

Acamprostate MOA 

acamprostate: NMDA and GABA receptor modulator

300

Disulfiram: MOA, and what body system does it strain

increasing acetaldehyde levels

cardiovascular

400

the effects of caffeine on which receptor results in increased dopaminergic activity 

adenosine receptor

500

Reward pathway neuroanatomy: dopaminergic neurons have cell bodies in ____ which project to the ____

Ventral tegmental area

Nucleus accumbens

Addiction

100

3 reasons geri population have more susceptibility to substances (from presentation)

• Liver’s ability to process things  is diminished 

• Blood-brain barrier permeability increases 

• Neuronal receptor sensitivity increases 

200

3 stages of the addiction cycle

preoccupation/ anticipation

binge/intoxication

withdrawal/negative affect

300

name at least 5 opioid state withdrawal features

craving

rhinorrhea, sneezing

lacrimation

muscle cramps

abdominal cramps

N/V

diarrhea

pupil dilation

piloerection/recureent chills

tachycardia/HTN

Yawning

restless sleep

400

Subst use in older adults is classified in what 4 tiers

 

1. Abstinence 

No drinking at all and no illicit drug use

2.Low risk use

Drinking within safety guidelines (7 standard drinks per week; no more than 2 at any one occasion)

Only appropriate/prescribed use of prescription/OTC medications 

No guidelines for low-risk use of illicit drugs

3.At-risk use

Drinking beyond safety guidelines or drinking while taking medications where alcohol is contraindicated

Off-label use of prescription/OTC medications

Any use of illicit drugs

4. Problem use 

Substance use that results in social, medical, or psychological consequences, regardless of quantity or frequency

Problem use may or may not meet criteria for substance abuse disorder

500

3 screening tools for addiction in geriatrics...mentioned in presentation

• CAGE-AID

• The Michigan Alcohol Screening Test- Geriatric Version

• The Alcohol Use Disorders Identification Test

Miscellaneous

100

In friends: who was Rachel supposed to marry in the first episode

Barry 

200

who was the culprit behind Micheal Scott's foul smelling carpet

todd packer

300

Name one of Tom Haverford's business ideas

Rent a Swag

Toms Bistro

snakehole lounge 

Know ya boo

H2HO

Toddler cologne

disco dairy

400

what is hermione grangers Patronus

• Otter

500

Name 4 stranger things characters . Full name required

• Joyce Byers.
• Jim Hopper.
• Mike Wheeler.
• Eleven.
• Dustin Henderson.
• Lucas Sinclair.
• Nancy Wheeler.
• Jonathan Byers.