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CMN 554- Unit 3 Review Test.-Major neurotransmitters involved in developing substance
abuse/dependence: opioid, catecholamine (particularly
dopamine), GABA -Dopaminergic neurons in the ventral tegmental area project to the cortical and limbic regions, especially the nucleus accumbens.-This pathway probably involved in sensation of reward -May be major mediator of the effects of substances (amphetamine & cocaine) -Locus ceruleus mediates effects of opiates and the opioids -These pathways collectively called the brain-reward circuitry
Question 1: What is the reward pathway involved in substance
abuse?
CORRECT ANSWER : Dopaminergic neurons in the ventral
tegmental area project to the cortical and limbic regions, especially the nucleus accumbens.
In some Asian persons, the decreased function of alcohol- metabolizing enzymes can also lead to easy intoxication and toxic symptoms.
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Question 2: How is alcohol metabolized differently in the Asian
population?
CORRECT ANSWER : In some Asian persons, the decreased
function of alcohol-metabolizing enzymes can also lead to easy intoxication and toxic symptoms.
-has an adverse effect on sleep architecture.-decrease in rapid eye movement sleep (REM or dream sleep) -decrease in deep sleep (stage 4) -more sleep fragmentation, with more and longer episodes of awakening. Therefore, the idea that drinking alcohol helps persons fall asleep is a myth.
Question 3: How does alcohol use affect sleep?
CORRECT ANSWER : has an adverse effect on sleep
architecture; decrease in rapid eye movement sleep (REM or dream sleep); decrease in deep sleep (stage 4); more sleep fragmentation, with more and longer episodes of awakening.
-Best quick screen for alcoholism remains the tried-and-true CAGE questionnaire -A positive response to two or more of the items implies a 95% chance of alcohol abuse or dependence
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-Study suggests that the way interviewers transition to the CAGE questions profoundly affects the questionnaire's sensitivity
Question 4: What is the CAGE assessment?
CORRECT ANSWER : Best quick screen for alcoholism
remains the tried-and-true CAGE questionnaire; a positive response to two or more of the items implies a 95% chance of alcohol abuse or dependence.
Question 5: What does CAGE stand for?
CORRECT ANSWER : Cut down: "Have you felt you should
cut down on your drinking?" Annoyed: "Have people annoyed
you by getting on your case about your drinking?" Guilty:
"Have you ever felt bad or guilty about your drinking?" Eye-
opener: "Have you ever needed to take a drink first thing in the
morning to steady your nerves or get rid of a hangover?"
Question 6: What are the medications used for the treatment of
alcohol dependence?
CORRECT ANSWER : Antabuse, Naltrexone (Revia),
acamrosate (Campral)
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Disulfirarm (Antabuse) Which medication does the below describe?
-Action : inhibits alcohol metabolism by irreversibly inhibiting
acetaldehyde dehydrogenase -Response is proportional to the dose and amount of alcohol ingested and can occur in 10- 20mts -Daily dosage range 125- 500 mg.Duration of action up to 14 days,due to slow restoration rate -Adverse effect: :Depression,disorientation,neurological toxicity, elevated liver function test,encephalopathy,Hepatitis, optic neuritis,peripheral neuropathy,psychotic reactions,
-Side effects :Metallic aftertaste, dermatitis
-Contraindications: Use of alcohol or alcohol containing
precautions, metronidazole, CAD, MI,Psychosis, hypersensitivity -Warn the patient should not consume alcohol in the diet ,none of this med for at least 12 hours after drinking and alcohol reaction can occur up to 2 weeks -Monitor liver function tests periodically