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2024 NR546 WEEK 6 TEST EXAM WITH CORRECT ANSWERS
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2024 NR546 WEEK 6 TEST EXAM WITH CORRECT ANSWERS
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2024 NR546 WEEK 6 TEST EXAMWITH CORRECT ANSWERS
Addiction is often driven by the client's attempts to: - CORRECT-
ANSWERSself-medicate an underlying mental health disorder
adverse effects associated with the acute use of opioids: - CORRECT-
ANSWERS-Itching
-Constipation
-Respiratory depression
-Urinary retention
-Sedation
Ellen is a 35-year-old who has a history of drinking 4-5 alcoholic beverages
per day. She was admitted to the hospital for a respiratory infection and was
treated with benzodiazepines using the CIWA-Ar scale. She has abstained
from alcohol for 8 days and is committed to maintaining abstinence but
would like to take a medication to help her stay away from alcohol. -
CORRECT-ANSWERSdisulfiram
Disulfiram creates unpleasant physical symptoms when taken with alcohol.
This mild negative stimulus can help reinforce the client's abstinence from
drinking alcohol.
Nori is a 24-year-old who has a history of abusing opioid medications and
binge drinking. She is not committed to abstain from using at this time. -
CORRECT-ANSWERSnaloxone
Since Nori is not committed to abstaining at this time, it is important to
provide naloxone along with education to help her remain safe from
overdose.
Juan is a 19-year-old who has a history of using oxycodone that he has taken
from his grandfather and drinking occasional alcohol. He wants to stop using
both substances. - CORRECT-ANSWERSnaltrexone
Naltrexone is a good option for clients who use opioids and alcohol and are
committed to abstinence.
Impulsivity - CORRECT-ANSWERSpredisposition towards rapid, unplanned
reactions to internal or external stimuli, with diminished regard for the
negative consequences of these reactions
-inability to stop initiating actions
-associated with risk seeking
,-action without forethought, lack of reflection on the consequences of one's
behavior
compulsivity - CORRECT-ANSWERSperformance of repetitive and
dysfunctionally impairing behavior that has no adaptive function.
-inability to terminate ongoing actions
-associated with harm avoidance
-action inappropriate to the situation but which nevertheless persists
-characterized by the curious inability to adapt behavior after negative
feedback
-Type of compulsion-habits-responses triggered by environmental stimuli
Impulsivity and compulsivity are thought to be mediated by
neuroanatomically and neurochemically distinct, but in many ways parallel,
components of - CORRECT-ANSWERScortico-subcortical circuitry
-too much "bottom-up" limbic emotional drive or too little "top-down" cortical
inhibition of these drives
Impulsive-compulsive disorder construct - CORRECT-ANSWERS-Impulsivity
can be thought of as the inability to stop the initiation of actions and involves
a brain circuit centered on the ventral striatum and linked to the thalamus,
to the ventromedial prefrontal cortex (VMPFC), and to the anterior cingulate
cortex (ACC).
-Compulsivity can be thought of as the inability to terminate ongoing actions
and hypothetically involves a brain circuit centered on the dorsal striatum
and linked to the thalamus and orbitofrontal cortex (OFC).
Impulsive acts such as drug use, gambling, and over-eating can eventually
become compulsive due to neuroplastic changes that engage the dorsal
habit system and theoretically cause impulses in the ventral loop to migrate
to the dorsal loop.
gambling
natural ways to trigger mesolimbic dopamine neurons to release dopamine
(natural high) - CORRECT-ANSWERSbrains own:
morphine/heroin (endorphins)
marijuana (anandamide)
nicotine (acetylcholine)
cocaine & amphetamine (dopamine itself)
Dopamine theory of addiction - CORRECT-ANSWERSall drugs of abuse have a
final common pathway of causing pleasure by provoking dopamine release in
the mesolimbic pathway
"burn-out" - CORRECT-ANSWERSenduring if not irreversible changes in
dopamine neurons
, -long-lasting depletions of dopamine levels and axonal degeneration
"bath salts" - CORRECT-ANSWERSatypical stimulants
-not for bathing, synthetic stimulants that commonly include the active
ingredient methylenedioxypyrovalerone (MDPV) and may also contain
mephedrone or methylone
-also called "plant food"
-cause agitation, paranoia, hallucinations, suicidality, and chest pain.
other atypical stimulant - CORRECT-ANSWERSinhalants
-direct releasers of dopamine in the nucleus accumbens
-"huffing": toluene found in paint thinner, felt-tip markers, glue, various
aerosol sprays, and even freon found in air conditioners
-cause impaired judgment and possibly hallucinations,
-Short term: sudden death due to cardiac arrest, aspiration, or suffocation,
Freon in particular can cause these effects and can also freeze the lungs,
making it extremely dangerous.
-Long-term can cause depression, weight loss, and brain damage
*Substances that are huffed do not show up on drug tests.
Treatment of Stimulant Addiction - CORRECT-ANSWERSno approved drug
treatments for stimulant addicts
-many dopamine-linked and serotonin-linked therapeutics have failed
nicotine's actions at _________________ directly on dopamine neurons in the
ventral tegmental area (VTA) are those that are theoretically linked to
addiction - CORRECT-ANSWERSα4β2 nicotinic postsynaptic receptors
μ-opioid antagonists - CORRECT-ANSWERSblock the euphoria and "high" of
heavy drinking
-Naltrexone and nalmefene (approved outside the US)
-If you drink when you take an opioid antagonist, the opioids released by
alcohol do not lead to pleasure
Acamprosate - CORRECT-ANSWERSderivative of the amino acid
taurine and interacts with both the glutamate system to inhibit it, and with
the GABA system to enhance it
-"artificial alcohol"
-acamprosate can substitute for alcohol in patients during withdrawal
*mitigate the glutamate hyperactivity and the GABA deficiency
Disulfiram (Antabuse) - CORRECT-ANSWERSclassic drug for treating
alcoholism
-irreversible inhibitor of the liver enzyme aldehyde dehydrogenase that
normally metabolizes alcohol
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