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Transcript of Cocaine Answers are from DSM-IV-TR or the Substance Abuse Practice Guideline, AJP Supplement, August...
![Page 1: Cocaine Answers are from DSM-IV-TR or the Substance Abuse Practice Guideline, AJP Supplement, August 2006. As of 9Sep08.](https://reader030.fdocuments.us/reader030/viewer/2022032722/56649f475503460f94c68f02/html5/thumbnails/1.jpg)
Cocaine
Answers are from DSM-IV-TR or the Substance Abuse Practice Guideline, AJP
Supplement, August 2006.As of 9Sep08
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Half-life
Q. Half-life of cocaine?
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Half-life
Ans. 30 – 50 minutes [which helps explain the need for frequent dosing to maintain high].
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Intoxication
Q. DSM-IV list 9 signs of cocaine intoxication. List.
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Intoxication - 1
Ans.1. Tachycardia or bradycardia2. Pupillary dilation3. BP up or down4. Perspiration or chills5. Nausea or vomiting6. Weight loss7. See next slide
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Intoxication - 2
7. Psychomotor agitation or retardation
8. Muscular weakness, R decreased, chest pain, or cardiac arrhythmias
9. Confusion, seizures, dyskinesias, dystonia, or coma.
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With perceptual disturbance
Q. “With perceptual disturbance” is a specifier that is added to the dx of intoxication. What signs might be reported?
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With perceptual disturbance
Ans.
-- paranoid ideation
-- auditory hallucinations
-- tinnitus
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Withdrawal
Q. Signs of withdrawal? DSM list 5.
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Withdrawal
Ans.
1] fatigue
2] vivid, unpleasant dreams
3] insomnia or hypersomnia
4] increased appetite
5] psychomotor retardation or agitation
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Physical exam - snorters
Q. Physical examination of snorters finds?
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Physical exam - sorters
Ans. Nose bleed and, with longer use, perforated nasal septum.
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Babies
Q. Babies of mothers who have used cocaine a lot during pregnancy tend to be?
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Babies
Ans. Low birth weight.
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Prevalence - lifetime
Q. Lifetime prevalence?
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Prevalence - lifetime
Ans. 2% of the US population.
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Prevalence - gender
Q. Which gender predominates?
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Prevalence - gender
Ans. Males
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Urine +
Q. How long is the urine positive after use of cocaine?
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Urine +
Ans.
One dose: 1 – 3 days
Lots of doses: 7 -12 days
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Crack
Q. What is crack and how does it differ from natural cocaine?
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Crack
Ans. Crack is a cocaine alkaloid that differs in that:
-- it is easily vaporized and inhaled which provides an extremely rapid onset.
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Cocaine intoxication management
Q. Management of cocaine intoxication?
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Cocaine intoxicationmanagement
Ans.1. Usually only requires supportive care2. Exceptions include providing the appropriate
med for specific symptoms:-- hypertension-- tachycardia-- seizures-- delusions-- very agitated
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Cocaine withdrawalmanagement
Q. Meds for cocaine withdrawal?
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Cocaine withdrawal
Ans. No meds have been proven to be helpful in controlled studies.
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Psychosocial approaches
Q. Name psychosocial approaches for cocaine dependence.
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Psychosocial approaches
Ans.
1. CBT
2. Behavior therapy
3. 12-step counseling
4. Self-help groups, e.g., Narcotic’s Anonymous
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Meds
Q. If used with psychosocial approaches, what meds “show promise”?
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Meds
Ans.
-- disulfiram
-- modafinil
-- topiramate