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N216 A/B > [216B] Drug Use and Abuse > Flashcards

[216B] Drug Use and Abuse Flashcards

1
Q

The theory behind addictive personalities is that there is a genetic link to decreased activity in the _________ _____ ____ (part of the brain), resulting in decreased _____ ____.

A

Ventromedial prefrontal cortex.

Impulse control.

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2
Q

T/F: addiction is a disease.

A

True :0

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3
Q

List 3 drug classes considered “downers”.

A
  1. Opioids.
  2. Sedative hypnotics.
  3. Benzodiazepines.
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4
Q

List 3 desired effects of downers abuse.

A
  1. Altered mood.
  2. Relaxation (euphoria).
  3. Uninhibited behaviour.
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5
Q

What are the names of the 3 opioid receptors?

A
  1. Mu.
  2. Kappa.
  3. Delta.
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6
Q

Opioids provide pain relief by inhibiting:

A

Substance P.

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7
Q

Which opioid receptor does morphine bind to?

A

Kappa.

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8
Q

When opioids bind to Kappa receptors, they stimulate ______ release, which is why _____ is a common side effect.

A

Histamine release.

Itching.

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9
Q

List 8 things we should assess for when treating a pt on opioids.

A
  1. Pain relief efficacy.
  2. CNS (altered LOC, dizziness, seizures).
  3. Orthostatic hypoTN (d/t peripheral vasodilation).
  4. Respirations (d/t CNS depression).
  5. Itching (d/t mast cell stimulation/histamine release).
  6. Nausea (d/t decreased peristalsis + substance P binding in chemoreceptor trigger zone).
  7. Constipation (d/t decreased peristalsis).
  8. Urinary retention (d/t mu receptor antagonism).
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10
Q

We should hold opioids if RR is less than

A

12

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11
Q

Opioids are pregnancy category __, which means:

A

D - should not be given to pregnant pts.

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12
Q

Drugs causing ______ [neurotransmitter] release are likely to be addictive because it is responsible for our sense of:

A

Dopamine.

Pleasure/reward pathway.

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13
Q

T/F: usually, ODs are caused by one drug.

A

False D: usually mixes of multiple drugs

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14
Q

Why do we see such a high number of fentanyl ODs?

A

Often laced into other street drugs (cos it’s cheap).

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15
Q

Fentanyl is ___x more potent than morphine.

A

100

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16
Q

Do we use carfentanyl for therapeutic purposes?

A

No D:

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17
Q

What is the tx for opioid OD?

A

Naloxone (Narcan).

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18
Q

T/F: only one dose of naloxone is required to reverse an opioid OD.

A

False :| naloxone’s half-life is shorter than most opioids, so to be safe, we should give repeated doses or start a continuous IV infusion.

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19
Q

What is the therapeutic use for ketamine?

A

Conscious sedation (anesthetic).

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20
Q

List 3 effects of ketamine.

A
  1. Sedation.
  2. Amnesia.
  3. Respiratory depression.
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21
Q

How is ketamine abused?

A

Date rape drug.

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22
Q

PCP (phencyclidine) was originally developed for:

A

anesthesia.

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23
Q

Why is PCP not used in clinical settings?

A

Too lipophilic, potent & addictive.

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24
Q

T/F: PCP can cause an excitation phase and a sedation phase.

A

True: excitation first, then sedation (dose dependent).

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25
Q

What are the 2 active ingredients in mushrooms?

A
  1. Psilocin.

2. Psilocyb.

26
Q

Mushrooms have ________ effects.

A

Hallucinogenic.

27
Q

List 3 categories of substances that would be considered mixed effect.

A
  1. Cannabinoids.
  2. Alcohol (ETOH).
  3. Nicotine.
28
Q

List 3 desired effects of mixed-effect substances.

A
  1. Altered mood.
  2. Relaxation.
  3. Un-inhibition of behaviour.
29
Q

Which mixed effect substance has a 2% risk of psychosis? What is a long-term consequence of this?

A

Cannabinoids: may cause mental illness (ex: schizophrenia).

30
Q

List 2 therapeutic uses for cannabinoids.

A
  1. Nausea.

2. Complex pain.

31
Q

What are 2 notable active ingredients in cannabinoids?

A
  1. THC (tetrahydrocannabinol).

2. CBD (cannabidiol).

32
Q

What receptors do cannabinoids bind to? Where are these found?

A

CB1 & CB2.

CNS & PNS.

33
Q

Which 3 neurotransmitters do cannabinoids increase?

A
  1. Dopamine.
  2. Serotonin.
  3. Anandamide.
34
Q

Where does anandamide act? What can this result in?

A

Amygdala.

Memory loss.

35
Q

CBD ______ the adrenergic NS, resulting in a ______ effect.

A

Antagonizes.

Calming.

36
Q

THC acts on the adrenergic NS to make you feel:

A

Alert, focused, agitated.

37
Q

What happens when you take both CBD & THC?

A

They compete at receptors and balance each other out.

38
Q

What is THC resin? What will it cause (2)?

A

Superconcentrated THC.

Causes voltatile VS changes (BP, HR) & CNS effects (hallucinations/seizures).

39
Q

Which 3 neurotransmitters does alcohol increase?

A
  1. Ach.
  2. Serotonin.
  3. GABA.
40
Q

List 5 ADME characteristics of alcohol.

A
  1. Absorbed via stomach.
  2. Readily crosses BBB.
  3. Uses Vit B during metabolism.
  4. Zero order kinetics.
  5. Liver toxicity/disease: cirrhosis.
41
Q

What do we call alcohol withdrawal syndrome?

A

Delirium tremens.

42
Q

What is the primary tx for an alcohol OD? What is its MoA?

A

Metadoxine: increases metabolism (converts it to use first order kinetics).

43
Q

List 2 adjunct txs for alcohol ODs. Why are they helpful?

A
  1. Anxiolytics (ex: benzos): tx anxiety (ex: restlessness, irritability).
  2. Vitamins (replacement for depletion d/t metabolism).
44
Q

Nicotine is a (2):

A

cholinomimetic & adrenergic.

45
Q

Why is vape juice testing awful?

A

It’s based on ingestion and not inhalation.

46
Q

Nicotine affects adolescent brain development, especially the parts responsible for (3):

A
  1. Intelligence.
  2. Language.
  3. Memory.
47
Q

List 2 ways we can obtain a toxicology sample.

A
  1. Serum (blood draw).

2. Urine.

48
Q

List 2 drugs classes that would be considered “uppers”.

A
  1. CNS stimulants.

2. Psychoactive stimulants (ex: ecstasy).

49
Q

List 3 desired effects of uppers abuse.

A
  1. Altered mood.
  2. Excitation (euphoria).
  3. Uninhibited behaviour.
50
Q

Uppers increase these 3 neurotransmitters:

A
  1. NE.
  2. Serotonin.
  3. Dopamine.
51
Q

Uppers will increase these 4 physiological processes:

A
  1. BP.
  2. HR.
  3. Vasoconstriction.
  4. Metabolic rate.
52
Q

CNS stimulants include these 2 drug classes:

A
  1. Sympathomimetics.

2. Amphetamines.

53
Q

List 1 therapeutic use for stimulants.

A

Tx ADHD (ex: concerta).

54
Q

List 2 stimulant street drugs.

A
  1. Cocaine.

2. Crystal meth.

55
Q

List 2 ways crystal meth differs from concerta (ADHD tx) and is therefore more dangerous.

A
  1. Higher dose.

2. Usually injected (concerta is usually PO) = much higher bioavailability.

56
Q

Cocaine + alcohol is called _____ and has an increased ______ [PK characteristic].

A

“Cocaethylene”.

Increased half-life.

57
Q

List 2 psychoactive stimulant street drugs.

A
  1. LSD (acid).

2. Ecstasy (MDMA).

58
Q

List 4 broad effects of addiction.

A
  1. Impaired CNS synapses.
  2. Malnutrition (electrolyte & vitamin deficiencies).
  3. Infections (d/t needle sharing/contact with body fluids).
  4. Socioeconomic decline.
59
Q

List 8 s&s of impaired CNS synapses.

A
  1. Poor memory & IQ decline with use.
  2. Hallucinations.
  3. Paranoias.
  4. Seizures.
  5. Altered personality.
  6. Impulsive behaviours.
  7. Violence.
  8. Depression.
60
Q

List some adrenergic-like symptoms associated with withdrawals.

A

Anxiety, restlessness, tremors, insomnia.
GI distress (nausea, cramping).
Fever, diaphoresis, tachycardia.
Headaches.

61
Q

List 4 tx for withdrawals.

A
  1. CBT/counselling.
  2. Weaning protocols.
  3. Milder opioids: buprenorphine, suboxone, methodone (satisfies cravings without the “downing” effect).
  4. Adjunct tx: antidepressants, anxiolytics.

N216 A/B (26 decks)

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