43/44: Drugs of Abuse Flashcards Preview

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Flashcards in 43/44: Drugs of Abuse Deck (65):
1

define drug abuse

consumption of drugs without medical approval or supervision to achieve strong feelings of euphoria and reward ; use of a drug in a manner detrimental to the health and well-being of the drug user, other individuals or society as a whole

2

hallmark of drug addiction

compulsive drug use

3

when drug is necessary for normal physiological functioning =

physical dependence

4

pharmacokinetic v. pharmacodynamic tolerance

pharmacokinetic: increased drug metabolism results in decrease in the amount of available drug or duration of drug action at the target site

pharmacodynamic: CNS responds and adapts to presence of drug --> desensitization, down-regulation and/or internalization of receptors

5

compulsive drug use to induce pleasure and/or an escape from reality despite negative consequences

addiction

6

CNS mechanisms of psychological dependence

increased synaptic plasticity and DA release in the mesolimbic reward pathways

7

t or f: all drugs of abuse are addictive

false

8

all addictive drugs activate...

mesolimbic dopamine system --> reward pathway

9

DA neurons from the ventral tegmentum project to...

amygdala
nculeus accumbens
prefrontal cortex
hippocampus

all part of reward pathway

10

RR for CNS depressants and sedative/hypnotics

3

11

ETOH is a depressant --> ________. Why do we use it?

produces sedation and sleep

low doses of ETOH cause suppression of inhibitory systems and mild euphoria, which facilitates social interactions by reducing behavioral inhibitions and self-consciousness

12

basis for breathalyzer test

10% ETOH metabolized in GI tract and excreted through kidney and lungs

13

elimination of ETOH from the blood follows

zero-order kinetics

rate of elimination is independent of time and concentration of ETOH (constant amount eliminated per unit time )

one drink/hr approx

14

converts ETOH into acetaldehyde

alcohol dehyrogenase

part of alcohol metabolism

15

converts acetaldehyde to acetic acid

aldehyde dehydrogenase

16

MOA and use of disulfiram

inhibits ALDH and is used to encourag alcoholic to abstain from ETOH abuse

high acetaldehyde levels cause unpleasant rxns

17

BAC is determined by the __ of ETOH ingestion

rate

0.08 by 2-4 drinks/hr

18

12 oz beer = one drink = ___ liquor = ______ wine

1.5 oz liquor
5 oz wine

19

ETOH MOA

1) potentiates effects of GABA at GABAa receptors (hyperpolarization)
2) inhibits glutamate-activated NMDA receptors --> ETOH related memory loss

20

describe wernicke-korsakoff syndrome

aka wet brain or alcoholic encephalopathy

neurological condition associated with thiamine deficiency B1 in combination with excessive ETOH intake

observe: ocular disturbances, changes in mental state, memory impairment, and movement difficulties

21

describe fetal alcohol syndrome

ETOH is powerful teratogen --> mental retardation, hyperactivity and antisocial behavior

no safe level of alcohol intake for preggers

22

long-term ETOH consumption affect the following organs

-liver cirrhosis
-cardiovascular HTN, arrhythmias, etc
-inhibits ADH in kidney
-gastritis, cancer in GI tract, ulcers

23

most common two-drug combination that results in drug-related death

cocaethylene = cocaine + ETOH

produced in liver --> intensifies cocaine's euphoric effects

24

what should be given to avoid wernicke-kosakoff syndrome

thiamine

25

why give naltrexone for chronic alcoholism?

opioid antagonist that blocks reinforcing properties of ETOH and reduces the rate of relapse

26

flunitrazepam =

date rape drug, benzodiazepine

"roofie"

tastesless when dissolve din a beverage, retrograde amnesia

27

benzodiazepine receptor antagonist useful in treatment of overdose and in reversing the effects of long-acting benzodiazepines used in anesthesia

flumazenil

28

MOA benzodiazepines and barbiturates

positive modulators of GABAa chloride channels ---> increase inhibition

29

how do benzodiazepines and barbiturates work in the reward pathway?

activation of GABAa receptors on interneurons leads to decreased activity and reduced release of GABA --> disinhibiton of VTA DA neurons and activation of mesolimbic reward pathway

30

MOA GHB

disinhibiton of DA neurons in VTA via GABAb receptors

31

GHB causes...

euphoria
enhanced sensory perceptoion
sedation
felling of social closeness
amnesia "date rape drug"

32

RR of addiction for psychostimulants

5

33

"speedballing"

IV heroin and cocaine mixed together

34

reward effects of cocaine

increased DA release in the nucleus accumbers

35

cocaine produces these effects:

intense euphoric effect
increased energy and libido

also linked to cardiovascular toxicity!

36

strongest psychological dependence of any drug

cocaine

37

why might you prefer meth over cocaine?

price
and effects last 6-24 hrs compared to 20-30min with cocaine

38

amphetamines lead to...

euphoria
increased arousal
reduced sleep

39

common name for methylphenidate

ritalin

40

"ecstasy" =

MDMA
evokes feeling of intimacy and empathy

41

MOA MDMA

interferes with 5HT transporters to release 5HT from presynaptic terminals

42

toxicity of MDMA **

hyperthermia and dehydration

43

chronic abuse of psychostimulants can lead to ....

toxic psychosis that is indistinguishable from paranoid schizophrenia

must be treated with antipsychotic agents (haloperidol or chlorpromazine)

44

RR of addiction for psychedelics/hallucinogens

1

45

lysergic acid diethylamide

LSD

46

psilocybin =

magic mushroom

47

ketamine =

special K

48

phencyclidine =

PCP or angel dust

49

MOA for LSD and psilocybin

release glutamate in cortex via thalmic excitation

taget 5HT2a receptors

50

is LSD addictive?

no

does not stimulate mesolimbic doapmine release ---> no dependence or addiction and no withdrawal syndrome

51

what type of anesthetic is ketamine?

dissociative (look awake but the pt doesn't remember anything)

52

MOA ketamine and PCP

block NMDA type glutamate receptors; decrease activity of cortex and limbic system

53

RR of addiction for opioids

4

54

opiates =

morphine
codeine
heroin

55

MOA of opioids

1) inhibition of GABAergic neurons vi aactivation of mu-opiod receptors leads to disinhibition of the VTA DA neurons causing euphoria
2) inhibition of VTA DA neurons via activation of kapp-opioid receptors (inhibitory) causes dysphoria

56

used for emergency overdose of opioids

naloxone

mu opioid receptor competitive antagonist that reverse the effects of morphine or heroin within minutes

57

opioid abstinence syndrome

cessatiion of long-term opiate use leads to withdrawal with dysphoria, nausea and vomiting, lacrimation, flu-like, etc.

subsides within 5 days

58

used to treat opioid withdrawal and opioid addiction

methadone

long-acting opioid agonist that has easier withdrawal symptoms

59

mu opioid receptor antagonist used primarily for maintenance therapy

naltrexone

60

RR of addiction for cannabinoids

2

61

synthetic THC approved for treatment of chronic pain

dronabinol

62

MOA THC

disinhibits DA neurons in the VTA via pre-synaptic cannabinoid receptors --> euphoria, relaxation and sense of well-being

63

MOA nicotine

activation of nicotinic acetylcholine receptors on VTA projection neurons result in DA release in nucleus accumbens and PFC

64

MOA varenicline

high affinity nACHR agonist that competes for binding with nicotine

65

which is more addictive: shcedule I or V?

schedule I