Key Concepts in Substance Intoxication
16. Answer B. Acute intoxication is characterized by disinhibition,
emotional lability, inattention, and impulsivity. Withdrawal symptoms
include tremor, anxiety, hyperreflexia, diaphoresis, and autonomic
hyperactivity. Sobriety is the quality of being congruent in mood and
affect with good impulse control, and situationally appropriate responses.
Manic is a state of abnormally elevated arousal, affect, and energy often
with accompanying mood lability.17. Answer D. A lapse is a brief pause in sobriety, which may or may not
lead to relapse. Relapse is a reactivation of the disease or return to a
behavior consistent with substance use disorder after a prolonged period
of sobriety. Withdrawal is a substance-specific cluster of signs and
symptoms that occur when reducing or stopping the consistent use of the
substance. Intoxication is a state of near poisoning, manifesting signs of
inebriation (disinhibition, impaired cognition, delayed neurological
response time).
- Answer A. Alprazolam has an 11-hour half-life; therefore, medications with shorter half-lives are significantly more likely to cause withdrawal symptoms if dependence develops. In contrast, diazepam, clonazepam, and chlordiazepoxide have half-lives exceeding 20 hours. As a result, these longer-acting medications are less likely to trigger withdrawal symptoms, making them a more stable option for patients.
- Answer D. The liver metabolizes chlordiazepoxide through cytochrome P-mediated oxidation. Meanwhile, temazepam, lorazepam, and oxazepam undergo metabolism via conjugation. Thus, these medications depend less on global liver function, making them preferred choices for patients with liver disease and ensuring safer management.
- Answer A. Research shows that citalopram and other SSRIs effectively decrease desirability, liking, and consumption of alcohol in alcohol-dependent drinkers. Given the patient presentation, prescribing an SSRI will help the patient without causing harm. In contrast, disulfiram acts as an aversive agent, creating negative reactions to alcohol. Additionally, buprenorphine reduces cravings and alleviates withdrawal symptoms in patients with opioid dependence. Furthermore, thiamine prevents and mitigates Wernicke–Korsakoff syndrome, which often arises from vitamin B1 deficiency in patients with alcohol dependence.