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Pharmacology- Test 4 > Drugs of Abuse > Flashcards

Drugs of Abuse Flashcards

1
Q

What is Abuse vs. Misuse?

A

Hedonism, social pressure, and vanity vs. Misguided therapeutics

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2
Q

Willful chemical manipulation of mood or behavior circumventing normal behavioral reinforcements is perceived as _____ when there is a cost to the society at large. (abuse, misuse)

A

ABUSE

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3
Q

What are the types of tolerance?

A

(1) Metabolic- nothing in why it is a drug of abuse
(2) Functional- part of the cycle of drug use and dependence (it is initially reinforcing and then you require the drug just to feel normal again)
(3) Behavioral- (psychological) the pattern of life becomes accustomed to the drug; people are impaired but don’t seem intoxicated

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4
Q

T/F Physical dependence arises from a behavioral tolerance.

A

FALSE; functional tolerance

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5
Q

What are the 2 types of dependence?

A

(1) Physical- abstinence syndrome

(2) Psychological- compulsive behavior

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6
Q

Addiction vs. Habit

A

What people are willing to do for addiction as opposed to a habit. (feel free to e-mail me to add more to this flashcard)

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7
Q

T/F Drugs of abuse is a social term, not a scientific one.

A

TRUE

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8
Q

What drugs are not desirable at first? What drugs are desirable from the first time?

A
  • Not desirable: ethanol, heroin

- Desirable: cocaine, amphetamine

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9
Q

T/F There is a specific mechanism of action for drugs of abuse.

A

FALSE; there is no single mechanism of action or neural substrate or brain region involved.

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10
Q

How do many drugs of abuse work?

A

By increases the effects of dopamine in a “reward circuit” involving the midbrain and limbic system.

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11
Q

T/F The more physical dependence, the worse the withdrawal.

A

TRUE

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12
Q

T/F Tolerance is variable among classes, but not among actions for a single class.

A

FALSE, although the first part is true, the tolerance is variable even among actions for a single class (i.e. amphetamines)

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13
Q

<p>

| Genetics vs. Environment in abuse potential</p>

A

<p>
Both have been implicated. Environmental factors are hard to discern from genetics, but animal models suggest genetics links. Also, kids of alcoholics are 4X more likely to become alcoholics (could be genes and modeling behavior).</p>

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14
Q

Drugs of Potential Abuse- Opioids: Mechanism of Action

A

(Heroin, Morphine, Methadone, Codeine)
- increases mu opioite receptors in the brain- endorphin (natural neurochemicals that stimulate these receptors and are part of our endogenous reward system)

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15
Q

Drugs of Potential Abuse- Sympathomimetics: Mechanism of Action

A

(Amphetamine, Methamphetamine, Cocaine)
- increases catecholamine transmission (specifically dopamine and NE for an intrinsic reward mechanism)

(caffeine- espresso)
- decreases adenosine (increases cAMP, increases Ca2+) you get a stimulatory effects

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16
Q

Drugs of Potential Abuse- Depressants: Mechanism of Action

A

(Ethanol, Pentobarbital, Diazepam)

- increases GABA

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17
Q

Drugs of Potential Abuse- Nicotine: Mechanism of Action

A

(Tobacco products)
- Acetylcholine (CNS pre-synaptic )- nicotinic Ach receptors in the CNS like the dopaminergic nerve terminals which increases the dopamine activity in the reward system (very subtle)

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18
Q

Drugs of Potential Abuse- Psychedelics: Mechanism of Action

A

(LSD, Mescaline)- blur the line between your waking brain and sleeping brain
- decrease serotonin transmission

(PCP- phencyclidine; Ketamine)- works with one of the main types of glutamate receptors (will make people have a separation on what is happening to what they think is happening)
- Sigma receptors?/ decrease NMDA

19
Q

Drugs of Potential Abuse- Inhalants: Mechanism of Action

A

(Nitrous oxide, Amyl nitrite, Butyl nitrite)

- likely to work though GABA (really not well known)

20
Q

Drugs of Potential Abuse- Designer drugs: Mechanism of Action

A

(MDMA- ecstasy)

  • alters Serotonin
  • catecholamines (like amphetamines)
21
Q

Drugs of Potential Abuse- Cannabinoids: Mechanism of Action

A

(THC- Marijuana) -cannabinoid ligands

  • high affinity receptor (G-protein coupled)
  • retrograde signal between neurons in the brain
22
Q

What are the multiple simultaneous variables affecting onset and continuation of drug abuse and addiction? (6)

A

(1) Availability
(2) Perceived Risk
(3) Cost
(4) Purity/Potency
(5) Mode of administration (Chewing- absorption via oral mucous membranes, GI, Intranasal, Subcutaneous and intramuscular, IV, Inhalation)
(6) Speed of onset and termination of effects (Pharmacokinetics: combination of agent and host)

23
Q

Host (user): Variables affecting onset and continuation of drug abuse and addiction (4)

A

(1) Heredity (innate tolerance, speed of developing acquired tolerance, likelihood of experiencing intoxication as pleasure)
(2) Psychiatric symptoms
(3) Prior experiences/expectations
(4) Propensity for risk-taking behavior

24
Q

Environment: Variables affecting onset and continuation of drug abuse and addiction (3)

A

(1) Social setting
(2) Community attitudes (peer influence, role models, availability of other reinforcers (sources of pleasure or recreation)
(3) Employment or educational opportunities

25
Q

Pharmacological phenomena: Variables affecting onset and continuation of drug abuse and addiction (2)

A

(1) Tolerance

(2) Variations in metabolism

26
Q

Amphetamine & Cocaine: Similar actions

A

(1) Euphoria
(2) Anorexia
(3) Increased motor activity
(4) Reduced feeling of fatigue

27
Q

T/F Both amphetamine and cocaine interact with the reuptake systems for the monamine DA, NE and 5-HT.

A

TRUE; the reinforcing qualities of these drugs rely most heavily on the DA system, while the NE system may contribute to the euphoric effects

28
Q

Why do amphetamines have additional effects?

A

because it is a substrate for the vesicular transporter, depleting DA from the vesicles and causing non-vesicular release from the cytoplasm into the synapse. This produces a relatively larger increase in extracellular DA and increased motor and psychotic effects. The additional mechanism of amphetamine’s effect also leads to a more sustained duration of effect although binge use still occurs, sometimes over a course of several days.

29
Q

What is the abuse potential for amphetamine and cocaine? Toxicity?

A
  • Very great

- Arrhythmias and convulsions

30
Q

How do you treat acute toxicity of opioids (coma)?

A

(1) Naloxone (antagonist of opioid receptors) long half-life

31
Q

How do you treat acute toxicity of sympathomimetics (sympathetic storm)?

A
  • Amphetamine rarely fatal
    (1) sedate with haloperidol
  • cocaine leads to seizures and stroke:
    (1) propranolol,
    (2) diazepam, or
    (3) calcium channel blockers
32
Q

How do you treat acute toxicity of general depressants (coma, respiratory failure)?

A

(1) mechanical ventilation
(2) positive iontropic drug: dopamine
(3) Hemodialysis or hemoperfusion

33
Q

How do you treat acute toxicity of nicotine, cannabinoids?

A

there are NONE!

34
Q

How do you treat acute toxicity of psychedelics and diliriant hallucinogens?

A

(1) support

(2) Physostigmine may be used after Scopolamine

35
Q

How do you treat acute toxicity for phencyclidine (seizures)? (4)

A

(1) Diazepam for seizures
(2) Antipsychotics contraindicated in acute toxicity
(3) secreted into stomach: suction
(4) acidify urine

36
Q

Why are antipsychotics contraindicated in acute toxicity?

A

They have serious anticholinergic side effects and so does PCP. That possible synergy of side effects is a main reason why most antipsychotics are contraindicated with PCP.

37
Q

How do you treat acute toxicity of inhalants (asphyxiation arrhythmias)?

A

(1) mechanical ventilation

(2) antiarrhythmics

38
Q

What are treatments for withdrawal of opioids?

A

Low levels of long acting drug (i.e. methadone or L-acetyl methadone)

39
Q

What are the treatments for withdrawal of sympathomimetics?

A

Nothing has proven value

40
Q

What are the treatments for withdrawal of general depressants (convulsions, D.T.)?

A

(1) Low levels of a long acting drug (phenobarbital or diazepam)
(2) Propranolol or clonidine (may reduce sympathetic storm)

41
Q

What are the treatments for withdrawal of nicotine?

A

(1) Replacement therapy (nicotine)
(2) Substitution therapy (varenicline)
(3) Bupropion

42
Q

What are the treatments for withdrawal of cannabinoids and psychedelics?

A

None aside from social readjustment

43
Q

What are the treatments for withdrawal of alcohol?

A

(1) Antiabuse

(2) Naltrexone

Pharmacology- Test 4 (11 decks)

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